Rectal bleeding can be a concerning symptom that prompts many people to seek medical advice. While it often stems from minor and easily treatable conditions, it always warrants a professional medical evaluation. Self-diagnosing the cause is not advisable; prompt professional guidance is crucial to determine the underlying issue.
Your First Stop for Rectal Bleeding
When experiencing rectal bleeding, your primary care physician (PCP) or general practitioner is typically the initial medical professional to consult. They serve as your first point of contact for a broad range of health concerns. Your PCP will gather a detailed medical history, asking about the nature of the bleeding, its frequency, color, and any associated symptoms like pain or changes in bowel habits.
Your PCP will then perform a physical examination, which usually includes a digital rectal exam to check for abnormalities within the lower rectum and anal canal. Depending on their findings and your symptoms, they might order basic diagnostic tests, such as a stool test for hidden blood or infections, or blood tests to assess for anemia. This initial evaluation helps them determine if a referral to a specialist is necessary.
Specialists for Rectal Bleeding
If your primary care physician determines that your symptoms warrant further investigation, they will likely refer you to a specialist with deeper expertise in digestive health.
Gastroenterologist
A common referral is to a gastroenterologist, a physician specializing in the entire digestive system. This includes the esophagus, stomach, small intestine, large intestine (colon), rectum, and anus. These specialists are adept at diagnosing and treating a wide array of conditions affecting these organs, from inflammatory bowel disease to ulcers and various sources of bleeding.
Gastroenterologists frequently employ endoscopic procedures to visualize the internal structures of the digestive tract. A colonoscopy, for instance, involves inserting a flexible, lighted tube with a camera into the rectum and threading it through the colon to examine its lining for polyps, inflammation, or bleeding sources. Similarly, a sigmoidoscopy offers a focused view of the rectum and lower part of the colon. These procedures allow for direct observation and, if necessary, the collection of tissue samples or the immediate treatment of certain conditions, such as removing polyps or cauterizing small bleeding vessels.
Proctologist (Colorectal Surgeon)
Another specialist your PCP might recommend is a proctologist, also known as a colorectal surgeon. These physicians have a highly specialized focus on diseases specifically affecting the anus, rectum, and colon. Their expertise encompasses both medical and surgical management of conditions in this particular area. While gastroenterologists manage the broader digestive system, proctologists possess a more concentrated understanding of the intricate anatomy and specific disorders of the colorectum.
Colorectal surgeons are skilled in advanced diagnostic techniques and surgical interventions for conditions like hemorrhoids, anal fissures, fistulas, diverticular disease, and various colorectal cancers. They are particularly adept at performing procedures that might involve the physical removal of abnormal tissues or the repair of structural issues within the lower gastrointestinal tract, often providing lasting relief through surgical solutions for complex cases.
When to Seek Emergency Care
Rectal bleeding can sometimes indicate a severe condition requiring immediate medical attention. Seek emergency care if you experience:
A large amount of bleeding, such as blood soaking through clothing or filling the toilet bowl.
Continuous bleeding that does not stop.
Accompanying symptoms like severe abdominal pain, dizziness, lightheadedness, or fainting.
Signs of shock, including a rapid pulse, shallow breathing, confusion, or cold, clammy skin.
Passage of black, tarry stools (melena), which signals bleeding higher in the digestive tract.
In these situations, an emergency room physician can quickly stabilize your condition and initiate necessary treatment.