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Rectal Bleeding


As the name suggests, rectal bleeding is the passage of blood out of the rectum. It usually appears during defaecation and can be separate or mixed in with the stool.


  • Rectal bleeding can manifest in various ways and can be mild to severe.R
  • ectal bleeding can be bright red. This is usually the case if bleeding is from the anus or the rectum.
  • Rectal bleeding can be darker red if the bleeding is coming from further up the colon especially from the right colon or even small intestine.
  • Rectal bleeding may be black in colour and tarry in appearance. This is from bleeding from the stomach or duodenum.

Occult Rectal Bleeding

This is bleeding that occurs without a person being aware. It usually means a very slow rate of bleeding or from a source in the upper gastrointestinal tract. It is diagnosed by a Faecal Occult Blood Test (FOBT) or may manifest as iron deficiency anaemia on blood tests. It warrants further investigation to exclude serious causes.


There are many causes of rectal bleeding. Fortunately, the majority is not cancer and is not serious.

Very common causes

  • haemorrhoids (piles)
  • anal fissure
  • minor trauma

Other causes

  • IBD – Crohn’s disease, ulcerative colitis
  • Diverticular Disease
  • Colorectal Cancer
  • Colonic Polyps
  • Peptic ulcers
  • Angiodysplasia (abnormal blood vessels in bowel)


Whilst most rectal bleeding is not serious, all cases should be investigated and NOT ignored.

In people under 40, a rectal examination and proctoscopy can be done in the rooms. If a cause is found, this can be treated often on the spot.

In people over 40 with new onset rectal bleeding, investigation should include a colonoscopy to visualise the entire colon and rectum to exclude significant causes. A gastroscopy visualising the oesophagus, stomach and duodenum may also be needed.If these tests are normal, then a PILCAM may be indicated to visualise the small intestine.

  • Prince of Wales Private Hospital
  • The Royal Hospital For Women Foundation
  • Colorectal Surgical Society of Australia and New Zealand
Randwick Rooms

Prince of Wales Private
Suite 17, Level 7
Barker Street
Randwick NSW 2031

Phone: (02) 9099 4400
Fax: (02) 9650 4924

Double Bay

Level 1
451 New South Head Rd
Double Bay NSW 2028
(Opposite Woollahra Library Double Bay)

Phone: (02) 9096 3133
Fax: (02) 9096 3199

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