Rectal bleeding

Origins and Causes This mostly comes from veins just inside the back passage or the anal canal and anus. The veins are normal structures and bleeding can be caused by straining or from small abrasions to the skin caused by hard stools. It is often stops without any treatment – it is self-limiting. It may be associated with other anal symptoms, which also require attention – see treatment of pile and perianal symptoms in this section.

Treatment First try eating more roughage or fibre to make the stools softer and easier to pass – more fruit and vegetables, wholemeal bread and cereals containing wheat fibre such as wheatabix and bran flakes. This softens the stools to make them easier to pass. It is normal to strain a little when going to the toilet but too much makes the veins in the anal canal and around the anus swell and they become more likely to bleed. If the bleeding continues it is important to make sure it isn’t from something else, the risk of this becomes more significant in people over 55 years of age.

Occasionally it requires simple treatments in hospital outpatients such as injections and bandings of the anal cushions or ‘piles’. Very rarely it may require surgery.