Anal bleeding

Bleeding from the back passage is something that you should always see your doctor about, even if you are convinced it is piles or an anal fissure. The reason you need to be checked is that bleeding from the back passage can be a symptom of bowel (colon or rectum) cancer. If you are worried about being examined in that area, look at the section on seeing your doctor about an anal problem.

In general, if the bleeding is bright red and you have anal pain, especially when you pass a stool, it is probably a non-serious condition such as anal fissure or piles – but your doctor needs to make sure.

What do you know about bowel cancer? A survey by BUPA, a private healthcare organization in the UK, showed that people do not know much about bowel cancer. When prompted with a list of eight possible symptoms, only 57% of men and 70% of women in the UK named rectal bleeding as one of the main symptoms of bowel cancer. In 2006–2007, the UK Government is spending £37 million sending home-testing kits for blood in the faeces to people aged 60–69 years. The aim is to detect bowel cancer early. So if you receive a kit, use it and return according to the instructions.

If the bleeding is dark red, or in clots, or mixed with a lot of slime, or mixed in with the faeces, it could be a more serious condition (such as colitis, diverticular disease or cancer of the rectum or colon) that needs prompt treatment. Other symptoms that might be serious are a decreased frequency and/or hardness of the faeces, or an increased frequency and/or looseness of faeces.

Useful contacts
American Academy of Family Physicians have two detailed articles on ‘Common Anorectal Conditions’ on their website. The articles are intended for doctors. They explain how doctors examine the anus. They discuss itching, pain, bleeding, lumps, constipation and incontinence of faeces.
www.aafp.org/afp/20010615/2391.html
www.aafp.org/afp/20010701/77.html

Core – the digestive disorders foundation is a UK not-for-profit organization that provides reliable information about all gut problems. They supply a range of leaflets, which are available on the ‘Information’ page of their website (www.corecharity.org.uk) or by post (send a large sae). Write to: Core, Freepost, LON4268, London, NW1 0YT indicating which specific leaflet or factsheet is required. Tel: 0207 486 0341 (this not a helpline).

National Digestive Diseases Information Clearinghouse is a US government organization. Its website has pages on piles (haemorrhoids/hemorrhoids), constipation and other gut problems. Write to: 2 Information Way, Bethseda, MD 20892-3570, USA.
www.digestive.niddk.nih.gov/ddiseases/a-z.asp

The American Gastroenterological Association is an organization for doctors who specialize in the gut. Look in the Patient Center of the website for excellent information about various gut problems including piles (hemorrhoids) and constipation.
www.gastro.org/clinicalRes/brochures/hemorrhoids.html

The Imperial Cancer Research Fund, a UK organization, has a bowel cancer section on its website.
www.cancerhelp.org.uk/help/menuforthistopic.asp?page=2786

Beating Bowel Cancer is a UK not-for-profit organization that provides information about all aspects of bowel cancer, Its lively website is worth a look.
www.beatingbowelcancer.org

Colon Cancer Prevention is a US not-for-profit organization that provides information about screening and prevention. Not all the information applies to all countries.
www.coloncancerprevention.org

Other useful sections

• How the anus works
• Anal itching
• Anal pain
• Faecal incontinence
• Piles
• Seeing your doctor about an anal problem
• Useful contacts