The rectum is the last portion of the large bowel before the anus. Bleeding from this area can be mild, serious, or even life-threatening. It is very common once in a while in babies and adults. The reason for rectal bleeding can be very mild like a skin aberration in the rectum or serious like carcinoma. It can be fresh blood known as splash in the toilet or blood mixed with faeces.
In any situation, bleeding per rectum is a medical emergency. You need to get immediate medical care in that condition. Proper diagnosis and treatment are very much essential.
SIGNS AND SYMPTOMS of Rectal Bleeding
- maroon-coloured stools,
- bright red blood on or in the stool,
- blood on the toilet paper, or
- blood staining the toilet bowl water red.
- abdominal and /or rectal pain,
- low blood pressure,
- rapid heartbeat, and
CAUSES of Rectal Bleeding
- anal fissures
- diverticula (diverticulitis)
- infections (bacterial and other pathogens)
- inflammatory bowel diseases
- bowel trauma.
- Upper GI tract problems like ulcers and Mallory-Weiss tears in the oesophagus
- a dilated vein or varix.
PATHOPHYSIOLOGY of Rectal Bleeding
Pathophysiology of rectal bleeding varies according to the cause. Blood never gets mixed with food or stool anywhere in any normal pathway of digestion. Bleeding per rectum means somewhere the capillaries are broken and bleeding happened. Any pathology in the GI Tract leading to bleeding produces rectal bleeding. Bright red blood usually means bleeding that’s low in the colon or rectum. Dark red or maroon blood can mean bleeding higher in the colon or the small bowel. Melena or dark stools is a sign of bleeding in the stomach, which may be from ulcers.
DIAGNOSIS of Rectal Bleeding
nuclear medicine studies.
TREATMENTS of Rectal Bleeding
It depends upon the cause.
Stabilizing the patient by blood replenishment and fluid maintenance.
PROGNOSIS of Rectal Bleeding
The prognosis of rectal bleeding depends on the cause. It is different according to the person’s response to treatment. Prognosis is better when the condition is not associated with severe diseases.
COMPLICATIONS of Rectal Bleeding
The majority of complications like weakness, dizziness, or fainting occur from rectal bleeding when large amounts of blood have been lost.
Ayurvedic Concept of Rectal Bleeding
Ayurvedic NIDANA of Rectal Bleeding
Causative factors for the vitiation of PITT-rakta, especially
Kshata in koshtha or gudavali
Food that is not habitual or suitable to the body
Faulty routine during ghee intake (as a treatment)
Suppression of natural urges
Ayurvedic PURVARUPA of Rectal Bleeding
Ayurvedic SAMPRAPTI of Rectal Bleeding
Due to the causative factors, Pitta dosha vitiates along with rasa-raktadhatus. When these dosha-dooshyas get lodged inside koshtha & guda, raktavahini siras & dhamanis are broken and bleeding happens. It is then expelled through anus.
Ayurvedic LAKSHANA of Rectal Bleeding
Passing of stools with blood
Pain & burning sensation of rectum & anus
Ayurvedic Divisions of Rectal Bleeding
Ayurvedic Prognosis of Rectal Bleeding
Kricchrasadhya in healthy individuals without any complications & dhatudushti.
Asaadhya in children, old persons and with complications.
Ayurvedic Chikithsa of Rectal Bleeding
Ayurveda treatment for gudaja raktasrava includes avoiding the causative factors. Treatment depends upon the disease or condition that is causing the disease. For example, if arsas is causing gudaja raktasrava, treatment for arsas should be done and the bleeding will reduce. Mild fasting is advised if indigestion is present in adults. It cannot be done in small babies & weak people. Management of aggravated Pitta and bringing back the normalcy of Rasa-raktadhatus are the treatment methods.
Internal medicines with tiktarasa and rookshaguna
Stambhana if the bleeding is heavy
Seethaguna externally and internally
No sodhana is done in children unless fatal & emergency condition.
Therapies done in adults for sodhana include:
Commonly used Ayurvedic medicines for Rectal Bleeding
Home remedies for Rectal Bleeding
Rectal bleeding is a medical emergency. Better to seek medical help than relying on home remedies.
Diet for Rectal Bleeding
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
carbonated drinks – makes the stomach more acidic and disturbed digestion
refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)
curd – causes vidaaha and thereby many other diseases
- To be added
Drink only boiled water
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Better to avoid extreme hot climate
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Avoid sitting continuously for a long time and avoid squatting.
Avoid holding or forcing natural urges like cough, sneezing, urine, faeces etc.
Yoga for Rectal Bleeding
Yoga is not advised in people with severe rectal bleeding. Complete bedrest is advised for even an adult patient with loose stools. After regaining normal health, following a daily exercise routine will help the person to improve digestion & health.
Stretching exercises and specific yoga asanas like pavanamuktasana, vajrasana, bhujangasana etc are recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within and with surroundings.
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
RESEARCH ARTICLES of Rectal Bleeding
In patients with moderately to severely active ulcerative colitis, etrasimod 2 mg was more effective than placebo in producing clinical and endoscopic improvements.
In patients with advanced cirrhosis with coagulopathy and nonvariceal upper GI bleeding, TEG-guided transfusion strategy leads to a significantly lower use of blood components, without an increase in failure to control bleed, failure to prevent rebleed, and mortality in a randomized controlled trial.