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RECTAL BLEEDING

(CROHN'S REGIONAL ENTERITIS)
Rectal Bleeding

WHAT YOU NEED TO KNOW:

What can cause rectal bleeding?

  • Constipation

  • Hemorrhoids (swollen blood vessels in your rectum)

  • Anal fissures (tears in the tissue inside your anus)

  • Medical conditions, such as cancer, colitis, or diverticulitis

  • Growths, such as tumors or polyps

  • Medical treatments, such as radiation or rectal surgery

What increases my risk for rectal bleeding?

  • Older age

  • Certain medicines, such as blood thinners and NSAIDs

  • Medical conditions, such as inflammatory bowel disease, liver disease, or HIV

What other signs and symptoms may happen with rectal bleeding? You may have pain in your rectum or anus. You may also have abdominal pain or cramping.

How is the cause of rectal bleeding diagnosed?

  • Rectal exam: Your healthcare provider may gently insert a gloved finger into your anus. He will collect a bowel movement sample and send it to a lab for tests.

  • Blood tests: You may need blood taken to check for anemia (low amount of red blood cells).

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of the organs and blood vessels in your abdomen. The pictures may show problems that could cause bleeding. You may be given a dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

  • Colonoscopy: This is a procedure to look inside your lower bowel. It may show where the bleeding is coming from and what is causing it. A tube with a light on the end will be put into your anus and then moved into your colon. If your healthcare provider finds a growth, he may remove it.

  • Endoscopy: This is a procedure to look inside your upper bowel. It may show where the bleeding is coming from and what is causing it. A tube with a light on the end is inserted into your throat and moved down into your stomach and upper bowel. If your healthcare provider finds a growth, he may remove it. He may put a shot of medicine in bleeding areas to narrow the blood vessels and stop the bleeding. Heat, laser, or electric currents may also be used to make the blood clot.

How is rectal bleeding treated?

  • Medicine:
    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Vasoconstrictors: This medicine decreases the size of your blood vessels and may help stop the bleeding.

    • Iron supplement: Iron helps your body make more red blood cells.

    • Steroids: This medicine decreases inflammation in your rectum. It may be applied as a cream, ointment, or lotion.

  • IV: You may need an IV if you are dehydrated and need extra liquids.

  • 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.

  • Surgery: You may need surgery to remove hemorrhoids, tumors, or polyps.

What are the risks of rectal bleeding?

  • You may have abdominal pain or damage to nearby organs and blood vessels with surgery. Even with treatment, rectal bleeding may continue. Or, it may go away for a time and start again.

  • Without treatment, you may continue to have pain and cramping. You may develop anemia. You may need a blood transfusion. You may lose a large amount of blood. This can be life-threatening.

How can I manage my symptoms? Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. This will help prevent dehydration and constipation.

When should I contact my healthcare provider?

  • You have a fever.

  • Your rectal bleeding stopped for a time, but has started again.

  • You have nausea.

  • You have cold, sweaty, pale skin.

  • You have changes in your bowel movements, such as diarrhea.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You are breathing faster than usual.

  • You are dizzy, lightheaded, or feel faint.

  • You are confused or cannot think clearly.

  • You urinate less than usual or not at all.

  • Your rectal bleeding is constant or heavy.

  • You have severe abdominal pain or cramping.

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.