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Rectal bleeding refers to bleeding in the rectum, thus a form of lower gastrointestinal bleeding. There are many causes of rectal hemorrhage, including inflamed hemorrhoids (which are dilated vessels in the perianal fat pads), rectal varices , proctitis (of various causes), stercoral ulcers , and infections .
Unlike esophageal varices, rectal varices are less prone to bleeding, are less serious when a bleed does occur, and are easier to treat because of the more accessible location. [9] However, in some cases, rectal varices can result in severe bleeding. [10] Typically, treatment consists of addressing the underlying portal hypertension.
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Hematochezia is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper gastrointestinal bleed. The difference between hematochezia and rectorrhagia is that rectal bleeding is not associated with defecation; instead, it is associated with expulsion of fresh bright red blood without stools. [2]
Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. [6]
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
Hemosuccus pancreaticus is a rare cause of hemorrhage in the gastrointestinal tract.It is caused by a bleeding source in the pancreas, pancreatic duct, or structures adjacent to the pancreas, such as the splenic artery, that bleed into the pancreatic duct, which is connected with the bowel at the duodenum, the first part of the small intestine.
These patients may even have blood on their rectal exam, due to passing small amounts of stool around the ulcer and adjacent fecaloma. [2] Patients may have unstable vital signs if they have been having rectal bleeding, have developed stercoral colitis, and/or have had a perforation of the ulcer.