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The colon and rectum are part of your lower gastrointestinal tract. Bleeding in the colon or rectum is often a symptom that there are underlying conditions or diseases in your gastrointestinal tract rather than a condition or disease on its own. You may experience anywhere from a slight amount of bleeding which only shows up when examined microscopically to a large, life-threatening haemorrhage (loss of blood), which is considered a medical emergency.
Haemorrhoids are a common cause of bleeding in the lower gastrointestinal tract. Haemorrhoids are enlarged veins in your anal area that can rupture and result in bleeding.
Colitis is a common cause of bleeding in many cases. Colitis occurs due to inflammation or ulceration of the lining of your colon. Colitis may be caused by ulcerative colitis, Crohn’s disease, an infection, food poisoning, parasites, radiation treatment and poor blood circulation in your colon.
Anal fissure which is a tear(s) in the lining of your anus may cause bleeding of the colon and rectum as well. It is a painful condition usually caused by constipation or passing hard stools
Colon polyps are masses that grow in your colon. It may cause bleeding or develop into colorectal cancer which causes bleeding as well.
Diverticular disease can lead to bleeding in your lower gastrointestinal tract. This happens when small sacs form and push outward through the weak parts of your colon wall.
Angiodysplasia is a condition where you have abnormal or swollen blood vessels in your gastrointestinal tract. These blood vessels may become fragile and bleed quickly.
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Bright red blood in your stools is usually an indicator of bleeding in your lower gastrointestinal tract which is your colon and rectum. However, bleeding from your colon and rectum may not always be visible. Sometimes, you may need a stool test for occult blood loss. If the results are positive, it means blood is present in your stools. You may also experience other symptoms such as:
Your doctor may carry out a colonoscopy to diagnose and determine the cause of bleeding of the colon and rectum. During colonoscopy, a small, flexible tube with a camera attached at one end will be inserted into your rectum. This enables your doctor to view your entire colon. A tissue sample of your colon, also known as biopsy, might be taken for further testing.
There are several methods of colorectal cancer screening, and each has its pros and cons.
In Singapore, there are a total of 4 methods for screening:
The Faecal Occult Blood Test (FOBT) is a stool test used to detect hidden (occult) blood in the digestive system. Through the test, blood in the stools can help doctors assess if these indications are signs of colorectal cancer or polyps of the colon or rectum.
However, this test is not conclusive as not all forms of cancers or polyps can lead to bleeding, which affects the accuracy of the test. In addition, other conditions such as haemorrhoids and food intolerances can also cause bleeding, which can give false-positive results. Despite its limitations, the FOBT is still a valuable screening tool that can help to detect colorectal cancer at an early stage.
The Faecal Immunochemical test, or FIT, is a quick and easy way to test for tiny traces of blood in your stools. This method is similar to the FOBT in that it is a simple and non-invasive way to screen for colon cancer.
However, there are some drawbacks to this method of testing. First, other medical conditions such as inflammatory bowel diseases can produce similar symptoms. Second, the FIT may not be able to detect minimal amounts of blood in the stool. Finally, this method of testing may produce false-positive results, leading to unnecessary anxiety and follow-up tests.
Despite these limitations, the FIT remains a popular option for testing for blood in the colon or rectum.
Faecal Occult Blood Test/Faecal Immunochemical Test Cost: $3-$40
Faecal DNA testing is a non-invasive method used to screen for various gastrointestinal conditions, including the presence of blood in stool. This test analyses stool samples for DNA markers associated with colorectal cancer and other digestive disorders. By detecting specific genetic alterations, such as mutations or abnormalities, faecal DNA testing can identify early signs of gastrointestinal bleeding that may indicate underlying health issues like colorectal cancer or inflammatory bowel disease.
Faecal DNA Testing Cost: $400-$800
A barium enema is a diagnostic procedure used to examine the lower gastrointestinal tract. The procedure uses X-rays to produce images of the colon and rectum.
A barium solution is used to coat the lining of the bowel, which allows the radiologist to see the structure of the bowel more clearly. The procedure may be performed with or without air contrast. When air contrast is used, a small amount of air is introduced into the colon before administering the barium solution.
This helps to distend the bowel and improve the quality of the images. The procedure is generally well-tolerated, but some people may experience cramping or bloating during or after the procedure. Generally, a barium enema is considered a safe and effective option to detect bleeding in the colon and rectum.
Barium Enema Cost: $300-$500
A colonoscopy is a medical procedure in which a doctor inserts a long, flexible tube equipped with a tiny camera into the rectum and colon. This allows the doctor to view the entire length of the colon.
Colonoscopies are considered one of the most preferred methods of colorectal cancer screening because they allow doctors to detect cancer and remove precancerous growths called polyps.
Polyps are small, abnormal growths that can develop into cancer over time. During a colonoscopy, doctors can surgically remove polyps before they have a chance to turn into cancer. In addition, colonoscopies can be used to diagnose other colon conditions, such as inflammatory bowel disease. Through the investigations, doctors will be able to assess the cause of the bleeding and suggest if further tests or treatment are necessary.
Colonoscopy Cost: $2,958
The pricing information provided serves as a guideline from the Ministry of Health and is accurate at the time of publication. However, please note that prices may be subject to change without notice. Consult your insurance provider to understand your coverage and any potential out-of-pocket expenses. For more enquiries, contact G&L Surgical and we will gladly assist you.
If there is acute bleeding, the treatment of significant blood loss will start with stabilising the patient’s condition. Oxygen will be provided and the patient’s heart rate will be monitored. An IV will be used to administer fluids to the patient and possibly for a blood transfusion.
Endoscopic therapy may be used for moderate to massive bleeding of the colon or rectum. During endoscopy, clips, chemicals, thermal probe or adrenaline infusion may be directly applied. For instance, an endoscope may be used to guide the needle injecting chemicals into the affected area. Your doctor may also use heat to treat or cauterise the area that is bleeding and the surrounding tissue via the endoscope, or place a clip onto a bleeding blood vessel.
Most cases of bleeding can be treated. Once the cause of bleeding has been identified via colonoscopy, you may be required to undergo surgery to cure the underlying condition which causes the bleeding.
