As frightening as it can be, seeing blood when wiping is not always a sign of anything serious. It can often be a symptom or side effect of a relatively minor problem. However, because of the possibility of something more serious, rectal bleeding should never be taken lightly. Rectal bleeding should be monitored and any issues of immediate concern should be promptly reported to the family physician.
Rectal bleeding, also called hematochezia, can cause a little excitement over practically nothing or it can be the first sign of some more serious problem. In most cases the blood will be from a fissure, which was caused by straining to pass a bowel movement. In other cases, however, the visible blood can be coming from hemorrhoids, diverticulitis or colitis, among other things. The worst case scenario would be cancer.
A physician will generally begin gathering evidence to make a diagnosis by determining the amount of blood loss. The blood loss can be categorized as mild, moderate or severe. Mild blood loss would be considered something that could only be seen on the tissue when wiping or just tinting the toilet water with a few drops of blood. People who suffer from moderate blood loss will discover a larger amount of blood in stool and this may or may not consist of clotting as well. This blood will either be bright or dark red. In the worst cases where there is severe blood loss a large amount of blood will be expelled with the stool, and this may produce other symptoms, such as low blood pressure and dizziness.
The extent of the rectal bleeding will usually dictate the procedure used to diagnose the problem. In most all cases the physician will begin with a history and physical. There are a variety of tests that may be pursued to determine the origin of the blood. The most invasive of these, a colonoscopy, can get a good picture of any problems going on inside of the colon. A physician will use the patient's age and other factors, such as family history, to determine the extent of testing.
The treatment plan for rectal bleeding can be as simple as prescribing a stool softener to aid in healing a fissure. It can also be as complex as hospitalization to give intravenous fluids and blood transfusions to a patient who is severely anemic from blood loss. Most cases don't require anything this extreme. Some problems can be corrected with a change in diet and the addition of fiber supplements. Other cases, such as severe diverticulitis or cancer, may require surgery to remove the part of the bowel that is affected.
Any problem with rectal bleeding, no matter how slight, should be monitored. Even if it is a small amount and it continues for several days or stops and starts again this should be reported to the patient's physician. Any episode of moderate to severe blood loss should be reported promptly so that the patient can be seen and diagnosed without delay. If a severe blood loss occurs after office hours the patient should report to the local emergency room or call 911 for help.