Rectal Bleeding Content

Rectal bleeding refers to blood that passes from the rectum or anus and is indicative of various medical conditions. You may notice blood in your toilet bowl, on the toilet paper as you wipe, or in the stool. The color of the stool is also an indication of rectal bleeding and can range from bright red to maroon and black.

Causes of Rectal Bleeding


Haemorrhoids (also known as piles) are one of the most common causes of rectal bleeding. They are inflamed and swollen veins around the lower rectum area that occur internally or externally. Strain from bowel movements, diarrhoea, and chronic constipation are all causes of haemorrhoids.

Anal Fissure:

This condition happens when you are constipated or struggle to pass a hard stool. The pressure from pushing exerted on the area surrounding the anus results in a tear or split in the skin.

Anal abscess or fistula: 

Small glands inside your anus are meant to help you pass stool. Should these glands become infected, they can cause fistulas or abscesses.

Inflammatory bowel disease (IBD): 

Inflammatory bowel disease is a term which describes pain and swelling of the digestive tract. Symptoms include bleeding during bowel movements, pain, weight loss, and diarrhoea, 



Diverticulosis refers to the formation of small pockets in weakened sections of your intestine. Diverticulitis occurs when these pockets become painful or swollen and lead to rectal bleeding, amongst other symptoms such as nausea or fever. 



Ulcers are sores that form along the inside of your stomach lining and intestines. If they become infected, they can bleed, causing a dark stool. Indications that you may have an ulcer include rectal bleeding, blood in your stool, and painful bowel movements.



A polyp is a growth that forms out of the side of the bowel. Polyps are usually benign, but some polyps may turn cancerous if not removed. Changes in the color of your stool and changes in bowel movement habits are common indicators of polyps.

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When should you book an appointment with us?

Should you be experiencing one or more of the following symptoms, please do not hesitate to schedule an appointment with us:

  • A change in your bowel habits
  • Stomach pain or inflammation
  • Recent Weight Loss
  • Persistent bleeding
  • Diarrhoea of a severe or prolonged nature
  • Involuntary leakage of stools
  • Inability to have a bowel movement

What to expect at your first consultation:

Dr Du Plessis will first record your medical history and perform a physical examination.


You may be asked the following questions:

  • Have you experienced any trauma to the rectum or abdomen?
  • Have you experienced blood in your stool on more than one occasion?
  • Do you experience blood in every stool?
  • Have you recently lost weight?
  • Is the blood only on the toilet paper?
  • Please describe the colour of your stool
  • Do you remember when this first occurred?
  • Are you experiencing any other symptoms such as vomiting, diarrhoea, abdominal pain, bloating, fever or excessive gas?

The physical examination may include one or more of the following:

  • A physical examination of the rectum and anus.
  • Colonoscopy: Done by inserting a thin tube with a camera at the end into the anus in order to find or treat the source of bleeding. 
  • Sigmoidoscopy: involves a thin, lubricated sigmoidoscope that is passed through the rectum into the lower intestine.

Dr Du Plessis may also perform additional testing, such as:

  • Angiography: This test uses X-rays to view blood vessels
  • Faecal occult blood test: A lab test used to detect blood that’s hidden in the stool
  • Complete blood count (CBC)
  • Serum chemistries
  • Clotting studies
  • Stool culture

Treating Rectal Bleeding:

Our approach to treating rectal bleeding focuses on its underlying causes, as it usually forms part of a more significant issue. The bleeding ceases once the condition has been treated. These conditions vary in nature, from mild to chronic. Anal fissures are an example of a mild condition that goes away over time or can be treated with ointments. Haemorrhoids in a mild case can be treated by relief from constipation problems, changes in your diet and increasing your water consumption. More severe cases of this condition may warrant surgery. When the cause of bleeding is cancer-related, a treatment plan is developed and set in place to manage cancer, with tumours being removed.

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“My 18-year old daughter, Shanice had an op with Dr. Du Plessis to remove a fibroadenoma in her breast. He handled Shanice with so much care and made her feel very comfortable … I would recommend Dr. Du Plessis as a surgeon to any patient.  His advice and his medical knowledge is the best.”

- Rene Cole


“I would like to thank you and your team for all the amazing service I received during my stay at Melomed Tokia for surgery for a bilateral inguinal hernia. From the moment I met you my mind was set at ease. The professional yet friendly way things were explained to me was refreshing.”

- Tristan Lee


The very thought of hospitalisation is scary and traumatising, but caring doctors like you make it friendly and pleasing.

Your team took care of me as i was the most important person on earth 🙂 Nicole Andrews

- Nicole Andrews

Specialist Surgeon
Dr. Maré Du Plessis, MBCHB (UP) MMED Surg (US) FCS (SA)

Mediclinic Milnerton
Suite 169, 1st Floor, Mediclinic Milnerton, Racecourse Road, Milnerton, 7441
P.O Box 61, Plumstead, 7801
Tel: 021 555 1877
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