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Mr Peter Goodfellow, Consultant General & Colorectal Surgeon
Claremont Clinics: Monday, Tuesday, Thursday, Friday
“I’ve seen some blood!” is a common presentation when people have noticed blood on the toilet paper or with their motion after opening their bowels. Many patients are anxious there may be a serious underlying cause, but although these do need ruling out, most causes are not sinister and are easily treated.
These are common problems. Around 1 in 10 adults experience rectal bleeding every year in the UK and the NHS advises you should always get rectal bleeding checked to rule out more serious causes. Most bleeding is bright and usually from low in the gut, but if the blood is darker in colour, the bleeding may have occurred higher up your digestive system.
GP’s will usually advise if there is an obvious cause, but if there is ongoing bleeds, or any other symptoms then referral for investigation is usually needed.
Common causes are:
Haemorrhoids (Piles) – By far the commonest cause, swollen tissue in the rectum which often causes bleeds and can also cause itching, slime discharge and pain. These can sometimes come down to the outside too.
Anal Fissure – A small tear or split that is usually painful with stool passing and causes bleeding too.
Anal Infections – Glands which get infected and discharge pus, these can leave a track behind which can bleed and persist (sinus or fistula).
Inflammation in the Bowel – Which can be an infection or an inflammatory bowel disease, often associated with diarrhoea (Colitis or Crohn’s disease).
Diverticular Disease – Pockets on the side of the bowel. These are very common and can sometimes cause significant lower gut bleeds.
Polyps – Small grape like growths on the bowel wall, usually removed with Endoscopy.
Bowel Cancers – Bleeding and may be associated with a change in bowel habit, discharge, anaemia or abdominal pain. Investigated by Endoscopy to exclude as a cause for symptoms.
The investigations performed at hospital for bleeding or other lower bowel symptoms are Flexible Sigmoidoscopy and Colonoscopy.
Flexible Sigmoidoscopy and Colonoscopy are procedures where the rectum and the lower (sigmoid) colon (sigmoidoscopy) or whole colon (colonoscopy) are examined. The endoscope is a long flexible camera about the thickness of your little finger. It is inserted gently into the anus and advanced slowly into the rectum and the colon. The procedures usually last 5 minutes (sigmoidoscopy) or 20 minutes (colonoscopy).
If you’re worried, Mr Goodfellow will be happy to see you at Claremont.