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Rectal Bleeding

You are having both pain and bleeding with your bowel movements. An inspection of your anus and rectum in an office visit with your doctor will be necessary to identify your diagnosis. A lubricated hollow cylinder called an "anoscope" may be used by your doctor during your examination. This hollow tube is approximately the diameter of a normal bowel movement. It can be pushed gently against your anus and inserted four or five inches into your rectum so that your doctor can view your rectum. The most common causes of bleeding with pain in the rectum or anus area include:

Anal fissure

An anal fissure, a cut or tear at the anal opening can occur if the anus is overstretched by trauma or by very hard stools, or it can occur if there is an infection within the rectum.

Hemorrhoids

Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some do cause pain, particularly if a blood clot forms, creating a "thrombosed" hemorrhoid.

Proctitis

Inflammation inside the rectum is known as "proctitis." Proctitis can be caused by inflammatory bowel disease (ulcerative colitis or Crohn's disease), by contamination of the rectum with bacteria that is passed through sex (gonorrhea or a Chlamydia infection), or by recent or previous radiation treatments.

Rectal ulcer

An open sore in the lining of the rectum is called a rectal ulcer. The most common cause of a rectal ulcer is a herpes infection. Swelling around a rectal ulcer can cause a sensation that your rectum will not completely empty. Rectal ulcers can also cause you to pass mucus with or between your bowel movements.

Rectal cancer

Rectal cancer (colorectal cancer in the rectum) is a concern, especially if you are older than 50. Colorectal cancer is the second most common cause of death from cancer in the United States. It is preventable, if colon polyps are identified and removed promptly. Colorectal cancer can be cured by surgery if it is identified at an early stage.


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