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Medical Author:

Dedra R Tolson, MD

Medical Editor:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Tumors and polyps

Polyps: Lumps of tissue or polyps bulge out from the lining of the colon. Bleeding occurs when large polyps develop, which can be hereditary. Usually harmless, some types can be precancerous.

Tumors: Both benign and malignant forms are frequently found in the colon and rectum. People older than 50 years of age are most affected. However, tumors can be found in younger people.

• Less than 20% of people with tumor or polyps will have rectal bleeding. When bleeding does occur, it is usually slow, chronic, and minimal.
• If cancerous lesions are advanced, additional symptoms such as weight loss, a change in the caliber of stools, a sense of rectal fullness, or constipation may be experienced.
• Diagnosis requires evaluation with colonoscopy.

Trauma: Rectal bleeding from a traumatic cause is always a critical concern. Rectal damage from a gunshot wound or foreign body insertion can result in extensive infection or rapid and fatal blood loss. Prompt emergent evaluation is necessary.

Upper gastrointestinal source: A common source of rectal bleeding is bleeding from the upper gut, usually the stomach or duodenum. This can occur after someone has swallowed a foreign object that causes injury to the stomach lining, bleeding stomach ulcers, or Mallory-Weiss tears. (Mallory-Weiss tears are cuts or ruptures of vessels in the lining of the esophagus or stomach. They are usually due to continuing or forceful vomiting.)

• Alcohol consumption can also cause ulcers and gastritis.

Meckel diverticulum: A rare condition, this occurs in less than 2% of the population. In this condition, gastric lining is found in an inappropriate location of the gastrointestinal tract. As a result, the gastric acid secreted from this lining erodes tissue and ultimately causing hemorrhage.

• Rectal bleeding in a Meckel diverticulum is painless and appears bright red. Admission to the hospital is essential because surgery is often definitive treatment.

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