Hematochezia is a medical term used to describe the passage
of fresh blood through the anus, usually in or with stools. Sometimes it is accompanied by clotting.
It is a condition commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper GI bleed.
The difference between this condition and rectorrhagia is that the latter rectal bleeding is not associated with defecation, Instead, it is associated with expulsion of fresh bright red blood without stools.
There is a wide variation in the amount of blood that is passed depending on what the source of the bleeding is.
Often times the amount will only be a few drops that are present on the wipe or enough to turn the water in the toilet bowl a pinkish color.
Other times there may be a couple of teaspoons of blood.
These amounts are considered relatively mild and will often stop on their own or may be treated without hospitalization or urgent diagnosis and care.
Moderate to severe bleeding includes repeatedly passing bright red or maroon colored blood which may be mixed with stool or in clotted clumps.
These instances of bleeding may happen in a single bowel movement or may be recurring over several movements but will always be associated with larger amounts of blood.
This can cause a rapid decline in the body's supply of blood occasionally resulting in dizziness, fainting or signs of low blood pressure especially when standing up suddenly.
In rare cases the bleeding might be so severe as to cause shock.
The more voluminous amounts of blood due to moderate and severe bleeding should be evaluated and treated in a hospital. Emergency care and possibly even a blood transfusion could be required if large quantities of blood are lost over a short period of time.
In a word, yes hematochezia can be very serious.
Anyone who has experienced what it is like to be bleeding from the rectum knows that it can be some worrisome and scary stuff.
The thing to understand about hematochezia or bleeding from the rectum is that it may not mean for sure there is a life threatening condition going on, but it certainly is cause for one to investigate further.
A quick clue as to the origin of the blood can be had by examining the color of the blood passed. The blood's color will vary depending on where it came from and how long it has been in the GI tract.
Generally speaking, the closer the source of bleeding is to the bottom of the GI tract, the brighter red the blood will be.
Blood coming from further up in the tract including the transverse and descending colon will tend to be darker in color even a maroon shade.
A bleed from the stomach or duodenum will manifest in a black, tarry, foul smelling substance due to the action of acid and enzymes upon the blood. This type of stool is referred to as melena.
In the lower GI tract which, which includes the last part of the colon (commonly called the sigmoid colon) the rectum and the anus, the blood might be coming from internal hemorrhoids and associated with the bleeding often experienced as this condition worsens.
The good news here is that hemorrhoids are relatively easy to overcome and can be treated with simple changes to the lifestyle and diet.
Another place that the blood might be coming from is a condition known as diverticulosis which involves the formation of little pouches on the outside of the colon.
These pouches (called diverticula) occasionally rupture and become infected causing a more severe condition known as diverticulitis that can be painful and result in some bleeding.
This blood loss is generally more brisk and severe than that which comes from hemorrhoids or anal fissures.
Bleeding from colon polyps and cancers tends to be mild (the amount of blood loss is small), intermittent, and usually does not cause low blood pressure or shock.
The colon cancers and polyps located near the rectum and the sigmoid colon are more likely to cause mild intermittent bright red rectal bleeding; while colon cancers located in the right colon are more likely to cause occult bleeding that over time can lead to moderate or severe iron deficiency anemia.
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