Hematochezia: IR method to heal the massive bleeding

Well, it can be a scary condition to live with, especially if you don’t know what the cause of your bloody stool is. Anytime we lose blood, it is a cause for concern, especially if it is from your rectum.

Rectal bleeding, or hematochezia definition, refers to the passage of blood through the anus which is mixed with stool or other blood clots. Although blood is being passed through the anus, the source of the blood can vary from the gastrointestinal tract to the anus lining itself. Where the bleeding is coming from determines the severity of the condition along with the treatment for it.

For some, rectal bleeding may be temporary and stop on its own. Some patients may only notice a few drops of blood on the paper when wiping while others may notice blood in the toilet bowl itself.

Rectal bleeding can vary in severity to a few drops to more severe bleeding, which is brighter and more noticeable. Rectal bleeding may appear a bright red or a maroon or black stool. For some, blood in stool isn’t visible by the human eye.

What are the causes of hematochezia?

There are several different causes of hematochezia, which range in severity. Blood in the stool can derive from different areas within the digestive system, some more serious than others. It’s important that you are examined thoroughly, and the exact hematochezia cause is uncovered so that treatment can be prescribed and the risk of complications is greatly reduced.

Here are possible hematochezia causes to be mindful of:

Diverticulitis

Diverticulitis is a condition that results from the inflammation of diverticula—pouch-like like bulges that are found in the lower part of the large intestine. Diverticula in themselves are not harmful and are actually commonly found in adults over the age of 40, but when these pouches become infected, it can lead to the diagnosis of diverticulitis.

Diverticula are thought to occur due to a combination of increased intestinal pressure and weak spots of the intestinal mucosa leading to the formation of small bulges. They don’t usually present with symptoms and are typically found during a routine colonoscopy. In situations in which diverticula become infected, they have the potential for bursting, releasing their contents outside of the large intestine. This can lead to a bunch of new, more serious complications.

Hemorrhoids

Hemorrhoids can be caused by many reasons, including straining to release a bowel movement, constipation, pregnancy, aging, chronic diarrhea, sitting for long periods of time – especially on the toilet, anal intercourse, obesity, and genetics.

Hemorrhoids can occur within the anus or above, but they can also be external and under the skin of the anus.

Symptoms of hemorrhoids include painless bleeding during a bowel movement, itching and irritation in the anal region, pain and discomfort, swelling of the anus, a lump near the anus, and leakage of feces.

Colonic ischemia

Colonic ischemia is when tissue damage occurs as a result of reduced blood flow and is associated with lack of oxygen. This is often a temporary condition and affects the colon lining.

Colonic angiodysplasia

This condition refers to a blood vessel abnormality which occurs in the colon. This is a degenerative process of the blood vessel that causes them to weaken over time. Weak blood vessels mean the appearance of blood in the stool.

Inflammatory bowel disease

Inflammatory bowel disease (IBD), as its name suggests, is a chronic inflammation of the intestines. Being inflammatory in nature, IBD can present itself in many avatars – Crohn’s disease, ulcerative colitis, indeterminate colitis and other inflammations. IBD produces destructive inflammation that is absent in IBS, so in many respects, it is a more serious condition. It could result in intestinal bleeding, permanent harm to the intestines, or other harmful complications like colon cancer, and other gastrointestinal diseases. IBD often requires hospitalization, and treatment usually involves surgery or powerful medications like immunosuppressives and or steroids.

Colorectal polyps and cancer

Colon polyps are small clumps of cells that form in the lining of the colon. Usually, colon polyps are harmless, but sometimes they can be indicative of a more serious condition such as colon cancer.

Colon polyps can develop at any age, but are most commonly found in those over 50. Even if colon polyps do not cause any symptoms, monitoring is still important because they can be safely removed during their early stage.

The problem with abnormal growths (polyps) in the colon or rectum is their potential for spreading to other parts of the body. While there are many different forms of colorectal cancer, they typically are due to old age and lifestyle, with a small number cases being due to genetic predisposition.

As of 2010, colorectal cancer affects nearly one million people and accounts for about 715,000 deaths worldwide—up from the reported 490,000 in 1990.

Other causes:

Other causes of rectal bleeding include anal fissures, infectious proctitis, infectious colitis, Meckel diverticulum, rectal varices, and heavy bleeding originating from the upper digestive tract such as the stomach, esophagus, and small intestine.

Treatment

Embolization:

This is the most common vascular emergency treated by IR.  Hemorrhage can come from almost anywhere e.g. from the gut, secondary to major injury or following birth.  Bleeding can often permanently be stopped by blocking the vessel (embolization), relining the vessel with a stent graft or by blowing up a balloon in the vessel to stop the bleeding until emergency surgery can be performed.  Interventional radiology is also used to prevent bleeding during some sorts of surgery e.g. during cesarean section in patients with a high risk of bleeding from an abnormal placenta (postpartum hemorrhage).