Intestinal bleeding can be a symptom that can occur in many different diseases. These can range from very mild and harmless to serious diseases. The most common cause of intestinal bleeding is haemorrhoidal disease.
These are dilated vascular cushions of the rectum that can bleed over time, especially after bowel movements. Intestinal bleeding can manifest itself in a variety of ways. It can manifest itself with slight traces of blood on the toilet paper up to large amounts of blood in the bowel movement.
The place of origin of an intestinal bleeding can also be very different. The bleeding can occur directly at the intestinal outlet, i.e. at the anus, or in the course of the entire intestinal tract. Bleeding can therefore theoretically originate at any point in the small intestine or the large intestine.
Any kind of bleeding in this area is then called intestinal bleeding. Even if a harmless cause such as a haemorrhoidal disease is most likely to be assumed, a possible cancer can always be behind it. It is therefore very important to consult a doctor as soon as blood is found in the stool or on toilet paper.
Symptoms
Intestinal bleeding can have many different causes. Depending on the type of disease, a distinction can be made between light red bleeding, or blood deposits on the bowel movements, and dark red blood deposits on the bowel movements. Depending on the disease, there are other symptoms in addition to intestinal bleeding, such as abdominal pain or pain and itching in the anus region.
Other additional symptoms can also be creeping tiredness and listlessness. Intestinal bleeding can also occur in connection with changes in bowel movements and may be accompanied by diarrhoea, for example. If intestinal bleeding occurs due to a serious cancer such as a colon carcinoma, i.e. a tumour in the area of the large intestine, further symptoms may occur.
Typical tumour symptoms can present themselves as night sweats, unintentional weight loss, limpness or even fever. The tumour can also cause chronic constipation and laxative problems. If chronic inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, are the cause of intestinal bleeding, an increased incidence of diarrhoea can often be observed. These diarrhoea can alternate with constipation problems.
Diagnostics
When intestinal bleeding occurs, as with any other disease, there are a number of diagnostic possibilities. As always, the first step is to ask the patient about his or her main symptoms, the course of the disease over time, possible additional symptoms and changes in stool and eating habits. The next step is a physical examination with special attention to the abdomen.
In the case of intestinal bleeding, an additional examination includes palpation of the rectum with the finger to check for bleeding, changes in the mucous membrane or tears in the sphincter muscle. Even though this examination is often very unpleasant and full of shame, it is still necessary in case of intestinal bleeding. The physical examination is followed by the use of technical equipment such as ultrasound.
Here, for example, one can look for free fluid in the abdominal cavity or for tumours. The next step in diagnostics is the possibility of using computer tomography or magnetic resonance imaging to look at the structures in the abdominal area and search for the cause of the intestinal bleeding. To search for sources of bleeding, a so-called colonoscopy can also be used.
This is a colonoscopy in which a camera is inserted through the anus and advanced along the colon. The camera can be used to look for possible changes in the mucous membrane and sources of bleeding. The causes of intestinal bleeding can range from harmless diseases to serious cancer.
The rather simple, harmless diseases that can cause intestinal bleeding include Haemorrhoids occur mainly in patients with sedentary jobs or chronic constipation. This leads to an expansion of the vascular cushion at the end of the rectum, which can lead to bleeding in the context of chronic constipation and constant pressing during bowel movements. At the same time, pain and itching frequently occur in this area.
An anal fissure can also lead to intestinal bleeding. An anal fissure is a tear in the area of the anus. It is often caused by chronic constipation or very hard bowel movements.
Constipation or very hard bowel movements then lead to a tear in the mucosa at the exit of the anus. The anal fissure is mainly noticeable by strong pain during bowel movement, but also by intestinal bleeding. The cause of intestinal bleeding can also be a so-called proctitis.
This is an inflammation in the anal region, which in most cases is accompanied by pain in the anal region. It is often caused by the transmission of venereal diseases such as gonorrhea or syphilis. However, chronic inflammatory bowel diseases can also cause proctitis.
In addition to intestinal bleeding or bloody secretion from the anus, proctitis, like haemorrhoids, is accompanied by itching. Another disease that can lead to intestinal bleeding is the so-called diverticulitis. Mostly older people are affected.
These are bulges of the intestinal mucosa through the muscle layer of the intestinal wall. These bulges can lead to an accumulation of bowel movement. These accumulations can become infected, inflamed and then lead to pain and intestinal bleeding.
A pure protrusion of the mucous membrane is called diverticulosis and usually does not lead to intestinal bleeding or pain. Only an inflammation, which then turns into the above-mentioned diverticulitis, can cause lower abdominal pain in addition to bleeding. A duodenal ulcer can also cause intestinal bleeding.
The duodenum is the part of the small intestine that is directly connected to the stomach. Just as in the stomach, ulcers can also develop in the area of the duodenum, medically called duodenum. At first, these usually cause only pain, which manifests itself mainly as sobriety pain.
If the small intestinal ulcer is not treated, it can “eat” its way into the depths and possibly meet a blood vessel there. This can then lead to intestinal bleeding. Another cause of intestinal bleeding is the occurrence of a chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease.
Ulcerative colitis is a chronic inflammation that mainly affects the bowel. Ulcerative colitis starts in the rectum and then progresses continuously towards the mouth. In contrast, Crohn’s disease affects various sections of the intestine with healthy parts of the bowel in between.
Cancer in the area of the intestine can also lead to intestinal bleeding. The most common form of cancer of the bowel is the so-called colon carcinoma, also known as colon cancer. – Haemorrhoids,
- An anal fissure
- Or vascular malformations.
Bright red blood on the toilet paper or as a deposit on the bowel movement can be a sign of existing haemorrhoids. They are enlargements of the so-called arterio-venous vascular cushion in the area of the anus. They can be caused or worsened by weak connective tissue, chronic constipation or sedentary activities.
Depending on the symptoms, haemorrhoids can be divided into different stages. The early stages in particular are often accompanied by intestinal bleeding. Here the patient usually first notices light red blood, which is visible on toilet paper after bowel movement.
In the subsequent stages, there is also pain, burning and itching. In adulthood more than half of all people have hemorrhoids. (Diclofenac belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs).
It is used to treat pain and inflammation. One disadvantage of this group of drugs is that although it is used to treat pain and inflammation, it also attacks the mucous membrane of the stomach and intestines and can lead to ulcers in this area. So these side effects when taking Diclofenac (and most other non-steroidal anti-inflammatory drugs) can therefore lead to intestinal bleeding.
This bleeding may be lighter or heavier and may be noticed by the patient during bowel movements. If intestinal bleeding occurs after the bowel movement, this can have several causes. In most cases, harmless diseases are more likely to be the cause.
Many patients suffer from chronic constipation because they have a low fibre diet and often drink too little throughout the day. As a result, they often have irregular and often hard bowel movements. Among other things, this circumstance leads to intestinal bleeding in the context of a haemorrhoidal disease and anal fissure.
If, in the course of time, the vascular cushions in the area of the rectum dilate, they can of course burst during hard bowel movements and the associated increased pressing and lead to noticeable intestinal bleeding after the bowel movement. Another cause of bleeding after defecation is anal fissure. It is also often caused by chronic constipation and hard stools.
In this case the mucous membrane in the area of the external sphincter muscle tears. If this does not heal in the acute stage, over time it can turn into a chronic anal fissure, which may require surgical treatment. Children can also suffer from intestinal bleeding.
Even in children this is usually harmless. Children, like many older adults, often have a tendency to chronic constipation (Another cause can be chronic inflammatory bowel disease. Children can also develop ulcerative colitis and Crohn’s disease.
In the context of these diseases, children can suffer from intestinal bleeding. However, this usually occurs more in the form of bloody-smeary diarrhoea. If blood appears in the stool of a child who also complains of severe abdominal pain and vomiting, the cause may be an intussusception of the child’s intestine.
An intussusception is an invagination of parts of the intestine. In most cases, part of the small intestine is invaginated into the large intestine, which causes the corresponding symptoms. Endometriosis is a disease in which there is a metastasis and scattering of mucous membrane cells from the uterus.
These can settle on the surrounding tissues such as the ovaries, fallopian tubes, bladder or even the intestines. Similar to the normal lining of the uterus, they are subject to oestrogen levels. From this it can be concluded that these cells also build up according to the female cycle and break down again by menstruation.
In so-called intestinal endometriosis, the cells of the uterine mucosa migrate into the intestinal wall. In addition to cyclical pain in the lower abdomen, pain can also regularly occur during bowel movements. At the same time, endometriosis can lead to cyclical intestinal bleeding, i.e. bleeding that occurs regularly and parallel to the period. Endometriosis can also lead to adhesions in the abdomen. This can also cause abdominal pain.
