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July Edition - Rectal Bleeding

One of the most common symptoms of colorectal disease is rectal bleeding. This is when blood can appear in the stool itself, upon wiping or even dripping into the toilet following defecation. Clearly, this can be quite disturbing when first noticed and there is the worry that it can represent a serious underlying problem.


There are specific features of the bleeding that are important in determining what the underlying cause may be and these include the colour of the blood (fresh bright red bleeding versus darker clot-like bleeding), whether or not there is anal pain associated with the bleeding and whether the blood is mixed within the stool rather than separate from it.


The most common cause of rectal bleeding is haemorrhoids but it can signify something more serious. The gold standard investigation is to undergo a colonoscopy but there are alternative examinations which are less invasive such as a CT colonoscopy.


More recently we have been able to use stool  sample tests such as faecal occult blood testing  (FOBT) and faecal immunochemical testing to more accurately risk stratify for serious underlining conditions such as colorectal cancer. We offer these tests as part of the practice as well as a detailed assessment of symptoms and examination of the back passage.


Whilst we understand the distressing nature of noticing rectal bleeding it is important to say that the most common causes are benign and that the advent of new store sample tests such as the faecal immunochemical test offer considerable reassurance in a timely manner.


There have been encouraging results from the initial studies of the faecal immunochemical testing system and we will see this rolled out in greater numbers across the NHS and private sector in coming months.


If you have any concerns with such symptoms then please do get in touch. 

Take care,

Manish Chand

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