Rectal Bleeding

WHAT YOU SHOULD KNOW:

• The large intestine, also called the bowel or colon, ends in a section called the rectum. At the end of the rectum is the anus. The anus is the opening where stool, or bowel movements, leave your body. With rectal bleeding, there may be blood found in your rectum, or you may be bleeding out of your anus.
  
  
• Rectal bleeding may be acute (short-term) or chronic (long-term). With rectal bleeding, you may lose a small or large amount of blood, and the bleeding may be slow or fast. Caregivers may collect blood and stool samples, and do a rectal exam and colonoscopy to find the cause of your bleeding. Your treatment depends on the cause of your bleeding, and can include medicines or surgery. Once caregivers learn what is causing your rectal bleeding, treatments or procedures may be done to make it stop. Signs and symptoms caused by rectal bleeding, such as pain or dizziness, may decrease or go away once the bleeding stops. Treatment can also help prevent anemia and other medical problems.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• You may be allergic to the dye used in tests and have trouble breathing. Medicine that may be used during an endoscopy can harm your kidneys. You may get a fever, abdomen pain, or damaged blood vessels after embolization. After surgery to fix an anal fissure, you may have trouble having bowel movements. Even with treatment, rectal bleeding may continue, or it may go away for a time and then begin again.
  
  
• Without treatment, you may continue having pain and other symptoms. You may be confused or faint when you lose too much blood. You may get anemia. This is a problem that happens if you do not have enough blood cells to carry oxygen inside your body. If you lose too much blood, you may need a blood transfusion. These problems can be life-threatening. Call your caregiver if you have questions about rectal bleeding, or your medicine or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

• Iron: If you lose too much blood, you may need to take iron. Iron helps your body make more red blood cells.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Steroids: Steroid medicine may help decrease pain and swelling in your rectum. This medicine may be put in your rectum as a cream, ointment, or lotion.
  
  
• Vasoconstrictors: Your caregiver may put vasoconstrictor medicine on the blood vessels in your rectum. Vasoconstrictor medicine decreases the size of your blood vessels, and may stop them from bleeding.

Tests:

Your caregiver may check your rectum by gently inserting his gloved finger into your anus. He may take a stool sample to test your stool for blood. You may need one or more of the following tests:

• Blood tests: Your caregiver may collect a sample of blood, and count your blood cells. The blood is taken from a blood vessel in your hand, arm, or the bend in your elbow. Your caregiver also may check your blood type.
  
  
• Angiography: Your caregiver may use angiography to see blood vessels in your body. This test may show growths, tissue damage, or problems with blood flow.
  
  
• Colonoscopy: To do a colonoscopy, caregivers may use a scope (a long tube with a light on one end) to see inside your colon. A colonoscopy may show the location where the bleeding is coming from, and what is causing it.
  
  
• Computed tomography scan: This test is also called a CT scan. An x-ray machine uses a computer to take pictures of the organs and blood vessels in your abdomen. Your caregiver may use a CT scan to check for problems that could cause bleeding. You may be given dye before the pictures are taken. The dye may be given through an intravenous (IV) line, which is a tube placed in your vein. The dye may help your caregivers see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to this dye. Tell caregivers if you are allergic to shellfish or dyes.
  
  
• Radionuclide scintigraphy: Radionuclide scintigraphy may be used to look for bleeding in your intestines. Before taking the pictures, tracer chemicals are put in your IV to show areas where there is bleeding.

Treatment:

You may need to have an IV placed to give you liquids. The amount of oxygen in your blood may be checked with a pulse oximeter. This is a small device that sticks or clips to your finger, ear, or toe. Depending on the cause of your rectal bleeding, you may need any of the following treatments:

• Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
  
  
• Endoscopy: To do an endoscopy, caregivers use a scope to see the inside of your digestive tract. During the endoscopy, small tumors may be removed. Caregivers may put a shot of medicine in bleeding areas to narrow the blood vessels and stop the bleeding. Heat, laser, or electric currents may be used to fix tissues and make the blood clot. Clamps or clips may also be used to stop the bleeding.
  
  
• Embolization: If you have an angiography, you may also need embolization. With this treatment, plugs are used to stop blood vessels from bleeding.
  
  
• Medicine:
  
  
  • Vasoconstrictor medicine: This medicine decreases the size of your blood vessels, and may help stop them from bleeding.
    
    
  • Iron: You may need to take iron if you lose a lot of blood. Iron helps your body make more red blood cells.
  
  
• Surgery: If you need surgery, the type of surgery that you need depends on what is causing your rectal bleeding. You may need surgery to remove hemorrhoids. If you have a tumor, polyp, or growth in your colon or rectum, you may need surgery to remove it. Ask your caregiver for more information if you need to have surgery.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Rectal Bleeding (Inpatient Care)