Rectal bleeding is a common yet alarming symptom. The evaluation and treatment of rectal bleeding is often managed by primary care doctors, gastroenterologists, and proctologists. The symptom is often related to benign sources such as internal hemorrhoids and anal fissures. Sometimes, it is caused by more worrisome causes such as ulcers, cancers, and inflammatory or infectious disorders.
Most doctors use a focused history to help guide the workup and care. The aggressiveness of the workup and treatment depends on the patient’s age, duration, and quality of symptoms. Primary care doctors are able to use their knowledge and experience to treat an expected benign source of rectal bleeding. They refer the patient to a specialist when symptoms are more worrisome or fail to improve with conservative management. Gastroenterologists will often perform a colonoscopy to evaluate the inner lining of the GI tract to get a more concrete diagnosis which they can treat with more aggressive medical management.
Our experiences doctors accomplish all of these tasks during an evaluation in the comfort of our office. We are able to evaluate the GI tract with anoscopy or video flexible endoscopy as indicated. Along with optimized medical management, we offer significantly more options for treatment of rectal bleeding. These are painless procedures that allow our patients to forgo the need for a complete colon cleanse and the inconvenience of needing to take time off from work for recovery. Also, it saves them the cost of anesthesia, anesthesiologist, and the facility charge from a surgery center or hospital.
After verifying the cause of the bleeding, we spend time to educate about the underlying source of the rectal bleeding and the potential behavioral and dietary causes for the symptoms. We then discuss in detail the many medical and surgical management options available for treatment of rectal bleeding so our patients can make an informed decision.
A common scenario we see is that of bright red bleeding with bowel movement resulting from internal hemorrhoids. When these fail to respond to dietary and behavioral changes, we offer rubber band ligation as well as infrared light “LASER” coagulation as office-based outpatient procedures associated with minimal discomfort and a quick recovery. Worrisome lesions found during the evaluation are biopsied for confirmation. Inflammatory or infectious processes are treated with specialized and specific medical management as appropriate.