Bloody (not the expletive) pertinently depicts bowel movement bleeding. Down the legs and into the toilet bowl, bright red drops of blood drip. Red blood oozes from the surface of stools. Toilet tissue may be stained by scarlet red blood. Our hearts may skip a beat in alarm. What is going on?

There is no need to be unduly alarmed yet as the hemorrhaging (technical jargon for bleeding) may be the result of any one of 6 likely reasons. As annoying as they are to our daily lives, most of the 6 causes are not severe and treatable if approached correctly. Nevertheless, complacency is not wise. Monitor closely. If bleeding persists more than a week, accompanied by pain, visit a medical doctor right away.

A proper diagnosis will identify the exact cause so that correct treatment can be administered to solve the problem. More alarmingly, bowel movement bleeding may be the consequence of some form of cancer.

Melena or Hematochezia

Rectal bleeding is referred to medically as melena (tarry or sticky black colored stools) or hematochezia (maroon colored or bright red blood). Termed as rectal because the bleeding exits the body via the rectum, the 6 causes are proctitis, anorectal fistulae, anal fissures, rectal prolapse, internal hemorrhoids and external hemorrhoids.

Proctitis

Proctitis is medically listed in the IBD (inflammatory bowel disease) group which includes the small intestine and the colon or large intestine. Inflammation by itself is a positive bodily reaction to heal wounded tissue. Inflammation is a double-edged sword, triggering off healing of wounded tissue but causing tissue weakening if left unfettered. Ulcers cause proctitis in the rectum by eroding the mucous membrane lining.

Among other symptoms, bowel movement bleeding is a common encounter. The elimination of proctitis as the cause of rectal bleeding is critical as at an advanced stage, the rectum can become perforated.

Anorectal Fistulae

Between two or more unconnected internal organs, an anorectal fistula is a passageway that cuts right through. It can continue all the way until it reaches the surface of nearby skin. An anorectal fissure has its opening at the anal surface. The discharge of urine and stools via this fistula is not unheard of.

The leading causes of anorectal fistulae are inflammatory bowel diseases, chiefly Crohn's disease, ulcerative colitis and ulcerative proctitis. Apart from infection pus, bowel movement bleeding is also one of the symptoms.

Fistulae must be accurately diagnosed as it can be due to peritonitis (abdominal lining inflammation) which can be life-threatening. Surgery and antibiotic therapy are usual treatment methods following tracing of the fistula's complete path.

Anal Fissures

Fissure or tear, they mean the same thing. Undue physical strain during constipation usually result in an anal fissure, a tear around the opening of the anus. Hassle-free bowel motion is contingent upon the external and internal anal sphincter muscles being in a relaxed state. Fissures may worsen as they cause the internal sphincter muscle to break into bouts of spasms. A dangerous cycle develops resulting in added pain and bowel movement bleeding.

A change in diet to reduce constipation coupled with medication (lidocaine or hydrocortisone) may relieve the pain, inflammation and the harmful spasms.

Rectal Prolapse

An ancient sickness, the earliest recorded rectal prolapse was in 1500 B.C.! Afflicting largely aged women, this condition is characterised by the rectum hanging visibly out of the anus. Weakened muscles, including external and internal sphincter muscles, and ligaments fail to hold the rectum in its place.

Constant constipation, persistent diarrhea, severe pelvic floor descent and strenuous bowel movements are common attendant symptoms. Frequently, the only solution is surgery.

Internal & External Hemorrhoids

Notwithstanding the above weighty narration, it may be ironic relief that the most frequent reason for bowel movement bleeding is hemorrhoids, both internal and external.

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