How is rectal bleeding diagnosed?
The physician will inspect the anal area looking for tears and hemorrhoids. The focus is on finding the source and extent of bleeding. Priority is to identify significant low blood volume and begin appropriate treatment. This is the most life-threatening situation. Low blood pressure and elevated heart rate will indicate significant loss of blood. High temperature will suggest
an infectious source. The physician will search for abdominal distension, discomfort, or tenderness that may suggest a possible bleeding ulcer. A mass the doctor can feel is cause for concern about cancer. he anus will be inspected for possible external sources of bleeding such as trauma, foreign body, or hemorrhoids. A finger examination is performed to assess tenderness, character of stool, and the presence of masses.
Flexible sigmoidoscopy will be used for the examination of the rectum and sigmoid colon which is the last 1 to 2 feet of the colon, just above the rectum. Patients are usually unsedated. There are several types of endoscopes used to view the colon. In the office, the physician may use a rigid or, more commonly, a flexible viewing sigmoidoscope. This exam is called flexible sigmoidoscopy and is performed in 5 to 10 minutes. A more thorough exam is accomplished with a colonoscope, allowing the physician to view the entire 5- to 6-foot long colon. Sedation is usually given for this exam. Frequently a bleeding lesion will be present beyond the reach of the sigmoidoscope. So colonoscopy may be the best initial exam. Both exams are usually done on an outpatient basis.
Barium Enema X-ray is a complementary exam that uses liquid barium inserted by enema into the rectum. X-rays highlight abnormal shadows, such as tumors, diverticuli and colitis. By itself, however, it does not identify an actual bleeding point. |
