Summary about Disease
Hematochezia refers to the passage of fresh, bright red blood from the anus, usually with or in stool. It indicates bleeding in the lower gastrointestinal (GI) tract, which includes the colon, rectum, and anus. While the color of the blood can sometimes offer clues about the bleeding location, upper GI bleeding can sometimes appear as hematochezia if transit time is rapid.
Symptoms
Bright red blood in stool
Blood clots in stool
Rectal bleeding
Change in bowel habits (diarrhea or constipation)
Abdominal pain or cramping (depending on the cause)
Feeling of incomplete bowel movement
Lightheadedness or dizziness (if significant blood loss)
Fatigue or weakness (if chronic blood loss)
Causes
Hemorrhoids: Swollen veins in the anus and rectum.
Anal fissures: Small tears in the lining of the anus.
Diverticulosis/Diverticulitis: Small pouches in the colon that can bleed or become inflamed.
Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis cause inflammation and ulcers in the GI tract.
Colorectal polyps: Growths in the colon or rectum that can bleed.
Colorectal cancer: Cancerous tumors in the colon or rectum.
Infections: Certain infections can cause inflammation and bleeding in the lower GI tract.
Angiodysplasia: Abnormal blood vessels in the GI tract that can bleed.
Ischemic colitis: Reduced blood flow to the colon.
Medicine Used
The medications used depend entirely on the underlying cause of the hematochezia. Some examples include:
Hemorrhoids/Anal Fissures: Topical creams (hydrocortisone, lidocaine), stool softeners, fiber supplements.
IBD: Anti-inflammatory drugs (corticosteroids, aminosalicylates), immunomodulators, biologics.
Infections: Antibiotics or antiparasitics.
Iron supplements: To treat anemia resulting from blood loss.
Vasopressors: Used in cases of severe bleeding to control blood pressure.
Proton pump inhibitors (PPIs): Sometimes used to prevent further irritation in the GI tract. It's CRUCIAL to remember that these are examples. A doctor must diagnose the cause of the bleeding before any medication is prescribed.
Is Communicable
Hematochezia itself is NOT communicable. However, if the hematochezia is caused by an infectious agent, then the underlying infection could be communicable. Examples include certain bacterial or parasitic infections of the GI tract.
Precautions
Seek medical attention: It's crucial to see a doctor to determine the cause of the bleeding.
Follow doctor's recommendations: Adhere to the prescribed treatment plan, including medications and lifestyle changes.
Maintain good hygiene: Wash hands thoroughly to prevent the spread of any potential underlying infections.
Avoid straining during bowel movements: This can worsen hemorrhoids and anal fissures.
Eat a high-fiber diet: This can help prevent constipation and promote regular bowel movements.
Stay hydrated: Drink plenty of fluids to prevent constipation.
Avoid irritants: Limit consumption of alcohol, caffeine, and spicy foods, as they can irritate the GI tract.
How long does an outbreak last?
The duration of hematochezia depends entirely on the underlying cause and its treatment.
Hemorrhoids/Anal fissures: May resolve within a few days to weeks with appropriate treatment.
Infections: Duration depends on the type of infection and response to treatment (days to weeks).
IBD: Can be a chronic condition with flare-ups and remissions lasting for varying periods.
Diverticulitis: Can last for a few weeks with treatment.
Colorectal cancer: Will persist until treated (surgery, chemotherapy, radiation). In some cases, the bleeding may stop on its own, but it is still imperative to seek medical attention.
How is it diagnosed?
Physical exam: Including a rectal exam.
Medical history: Reviewing the patient's symptoms, past illnesses, and medications.
Blood tests: To check for anemia, infection, and other abnormalities.
Stool tests: To check for blood, infection, or parasites.
Colonoscopy: A procedure in which a flexible tube with a camera is inserted into the colon to visualize the lining.
Sigmoidoscopy: Similar to colonoscopy, but only examines the lower portion of the colon.
Anoscopy/Proctoscopy: Visual examination of the anus and rectum.
Angiography: An X-ray of blood vessels to identify the source of bleeding.
Capsule endoscopy: A small wireless camera is swallowed to take pictures of the small intestine.
Barium enema: An X-ray of the colon after it has been filled with barium.
Timeline of Symptoms
The timeline is highly variable.
Sudden onset: Can occur with hemorrhoids, anal fissures, diverticular bleeding, or infections.
Gradual onset: May be seen with IBD, colorectal polyps, or colorectal cancer.
Intermittent: Bleeding may come and go, especially with hemorrhoids, anal fissures, or IBD.
Chronic: Persistent bleeding over time may be seen with colorectal cancer or IBD. The timing, frequency, and severity of symptoms should always be discussed with a doctor.
Important Considerations
Never ignore rectal bleeding: It is always essential to determine the underlying cause.
Hematochezia can be a sign of serious conditions, including colorectal cancer.
Early diagnosis and treatment are crucial for better outcomes.
Do not self-diagnose or self-treat.
Certain medications (e.g., blood thinners) can increase the risk of bleeding. Inform your doctor about all medications you are taking.
If you experience significant blood loss, seek immediate medical attention.