Per Rectal Bleeding (Blood in Stool)

Per rectal bleeding, also known as hematochezia, refers to the presence of bright red blood in the stool. It can be alarming and may indicate underlying health issues. Let's explore the causes, potential concerns, recommended investigations, and risks associated with untreated per rectal bleeding.

Per Rectal Bleeding Colonoscopy Sydney Surgeon

Causes of Per Rectal Bleeding?

  1. Haemorrhoids: Swollen blood vessels in the rectum or anus are a common cause of rectal bleeding. These are often benign but can be uncomfortable.
  2. Anal Fissures: Small tears in the lining of the anus can lead to bleeding during bowel movements.
  3. Diverticulosis: Small pouches (diverticula) in the colon can bleed if inflamed or irritated.
  4. Inflammatory Bowel Disease (IBD): While relatively uncommon as a cause of rectal bleeding, conditions such as ulcerative colitis and Crohn's disease can lead to chronic inflammation in the digestive tract, resulting in bleeding.
  5. Colorectal Polyps: These growths in the colon or rectum can bleed and may be precursors to cancer.
  6. Colorectal Cancer: A more serious cause, especially in older individuals.
  7. Anal Cancer: Again, this can be the more serious cause for the bleeding.


It is important that you speak to your GP about your concerns about the bleeding in your stool.

  • Severity: The amount of blood and the frequency of bleeding matter. Severe or recurrent bleeding requires prompt evaluation.
  • Age: Older individuals are at higher risk of serious conditions like colorectal cancer. However recent Australian data has seen an increase in the 25-44 age group, (Source: Australian Institute of Health and Welfare).
  • Associated Symptoms: Fever, weakness, vomiting, or large amounts of blood in the stool are concerning signs.
  • Family members with colorectal conditions: A family history of colorectal cancer or polyps may increase your risk. Approximately 30% of colorectal cancer cases result from hereditary factors or a family history (Source: Australian Institute of Health and Welfare).


Your GP can help guide you through the best investigations for your symptoms.

  1. Colonoscopy: A direct examination of the colon and rectum to identify the source of bleeding. Read more about colonoscopy here.
  2. Flexible Sigmoidoscopy: Similar to a colonoscopy but focuses on the lower part of the colon.
  3. Blood Tests: To check for anaemia or other abnormalities.
  4. Imaging: CT scans or MRIs may reveal structural issues.

Risks of Untreated Per Rectal Bleeding

  1. Anaemia: Chronic bleeding can lead to low red blood cell count.
  2. Delay in Diagnosis: Serious conditions like colorectal cancer may go undetected. Colorectal cancer is the second most common non-cutaneous malignancy in Australia, 15, 367 cases in 2023 (8133 men and 7234 women) and second only to lung cancer in terms of cancer mortality. In 2021 there were 5,350 deaths attributed to colorectal cancer (Source: Australian Institute of Health and Welfare). Early detection is crucial, with 90% of cases successfully treatable.
  3. Complications: If the underlying cause worsens, complications can arise.

Remember that early evaluation and appropriate management are crucial for better outcomes.

For further information or to discuss treatment options, please contact our team for a consultation with Dr Golani. You will require a referral from your GP for this consultation.

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What do I bring to my appointment?

  • Referral letter
  • X-Rays/Scans
  • Test results relating to referral
  • Health fund card
  • Medicare card

Royal College of Surgeons     Colorectal Surgical Society of Australia and New Zealand     Royal College of Edinbirgh     Gastroenterological Society of Australia     Sydney Adventist Hospital (SAN)     The Mater Hospital     Norwest Private Hospital