Evaluating and Treating Rectal Bleeding

To find the site and cause of your bleeding, you'll have a physical exam. You'll be asked about your health history. Tests may be done to help confirm the diagnosis and plan your treatment.

Tests you may have

As part of your evaluation, a flexible sigmoidoscopy or colonoscopy may be done.

You will have blood work done. You may also have these tests:

• Stool sample. A small amount of your stool will be checked for blood.

• Anoscopy. This test uses a small tube (anoscope) to examine the anus. It checks for problems, such as hemorrhoids.

• Sigmoidoscopy. This test uses a lighted tube to check your rectum and the part of the large intestine that's closest to the rectum (the sigmoid colon).

• Colonoscopy. This test looks at your rectum and entire colon. You will be given medicine through an IV (intravenous) line to help you relax.

• Lower GI (gastrointestinal) series, orbarium enema. This is an X-ray test to view your colon. A milky liquid containing barium is passed through your rectum and into the colon. This liquid makes it easy to see your colon on the X-ray. This test is not done that often anymore.

• Upper endoscopy. This test checks your esophagus, stomach, and upper small intestine. It's done in cases of rectal bleeding along with other symptoms like low blood pressure and rapid heartbeat. This test may also be done if your stools are dark black and tarry.

• Capsule endoscopy. For this test, you swallow a pill that has a tiny camera inside. The camera takes pictures of your small intestine. It can get to areas that are hard to reach with colonoscopy and upper endoscopy.

• Balloon or spiral enteroscopy. These tests use a special tube (scope) to get deep into the small intestine.

• Tagged red blood cell scan. This test marks (tags) red blood cells with very small amounts of radioactive material. The cells can then be seen and tracked on a scan.

• Angiography. This test threads a tube (catheter) through a vein, often in the leg. Dye is injected through the tube into your blood vessels to see where the bleeding is taking place.

Your treatment plan

Your treatment will depend on the cause of your rectal bleeding, as well as the severity of the bleeding. Your healthcare provider will create a treatment plan that’s right for you. Sometimes rectal bleeding stops on its own. Either way, be sure to see your provider to find the cause of the problem.

What you can do

Follow all your healthcare provider’s instructions. Keep working with your provider after your treatment. Make and keep your follow-up visits. If you have more rectal bleeding, call your provider. It may be a sign of the same or another health problem.