Dr Suhirdan Vivekanandarajah

Dr Suhirdan
Vivekanandarajah

Gastroenterologist and Hepatologist

Understanding rectal bleeding while pregnant: Causes, symptoms, and when to seek help

Seeing blood in your stool or on toilet paper during pregnancy from the rectum can be worrisome and requires prompt medical attention. Rectal bleeding is a common issue affecting around 40% of pregnant women, mostly due to benign conditions like haemorrhoids or anal fissures. These conditions result from increased pressure and are typically manageable with appropriate care and guidance from healthcare providers. Understanding these causes helps in effectively addressing symptoms and ensuring maternal comfort during pregnancy.

On this page, we will discuss the importance of understanding the causes, symptoms, and management, dietary changes, and topical treatments that can be useful.

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What are the causes of rectal bleeding while pregnant?

Rectal bleeding can occur for many reasons during pregnancy, so identifying the cause of rectal bleeding is important and needs prompt medical attention with suitable management techniques.

Haemorrhoids

These are swollen veins in the area of the rectum or anus, which usually come about due to extra pressure from a growing womb. Roughly 25–35% of pregnant individuals have haemorrhoids, and some investigations show rates as high as 75–85%.

Constipation

Hormones in the body during pregnancy and the uterus growing tend to slow bowel movements, causing constipation. Around 90% of cases develop by the middle of pregnancy, contributing to rectal bleeding due to straining during bowel movements.

Anal fissures

These are tiny cuts that occur in the skin covering the anus. Typically, they are caused by passing hard or large stools. The frequency of this condition in pregnant individuals is about 3%, and it can cause painful bowel movements and blood loss.

Other causes

Less frequent rectal bleeding while pregnant can be a result of issues like polyps or inflammatory bowel sickness. These need thorough medical assessment and handling from health experts to guarantee correct therapy and health of the patient.

Understanding these causes helps expectant mothers and healthcare providers manage symptoms effectively, ensuring both maternal comfort and overall health during pregnancy. Rectal bleeding in pregnancy may have different origins, each needing medical attention and proper intervention.

What are the symptoms of rectal bleeding?

Visible blood

Bright red blood in the toilet bowl, on toilet paper, or within the stool after a bowel movement. This is often the most noticeable sign and can be alarming.

Associated pain

Pain near the anus, particularly when passing bowel movements or afterwards, which can range from mild irritation to significant pain, depending on the underlying cause.

Discomfort

Before or after passing bowel movements one can experience itching, swelling, or a feeling of fullness in the rectum area, connected with haemorrhoids during pregnancy.

Changes in bowel movements

Constipation or extensive straining during bowel movements, or experiencing hard and dry stool, which tends to lead to or exacerbate rectal bleeding while pregnant.

Recognising these symptoms and seeking medical advice during pregnancy can help in effectively managing and treating rectal bleeding, ensuring both maternal comfort and health.

How to diagnose the cause of rectal bleeding while pregnant

When experiencing rectal bleeding during your pregnancy, a thorough diagnosis by a healthcare provider is essential to determine the underlying cause.

Physical examination

Medical evaluation

In a medical evaluation, the doctor will inquire about the history related to the patient’s health, signs they’ve experienced, and any elements that could lead to bleeding from the rectum like constipation or pushing too hard when passing stool.

Physical exam

A physical examination by the doctor might involve checking the rectum for haemorrhoids, fissures, or visible abnormalities, this may be done by inserting a gloved, lubricated finger into the rectum to feel for any irregularities or tenderness.

Tests and procedures

Anoscopy

This test uses an anoscope, which is a small tube-like tool that gets put into the anus to see inside the anal canal and lower part of the rectum, which helps diagnose rectal bleeding while pregnant like haemorrhoids and anal fissures.

Sigmoidoscopy

A sigmoidoscopy is a flexible and lighted tube called a sigmoidoscope to examine the lower part of the colon and rectum, which can aid in discovering conditions like polyps or inflammatory bowel disease found higher in the rectum or lower colon.

Diagnostic steps assist in finding out the real cause behind rectal bleeding and making up a suitable treatment strategy for expecting parents. This guarantees the safety and good health of both the mother and the developing baby.

What are the treatment options for rectal bleeding during your pregnancy?

Managing rectal bleeding during your pregnancy involves addressing the underlying causes through various treatment options, which may include lifestyle changes, medications, and specific treatments tailored to the diagnosed condition.

Lifestyle changes

Increase dietary fibre intake by consuming more fruits, vegetables, and whole grains to prevent constipation and reduce straining during bowel movements. Stay hydrated by drinking plenty of water throughout the day.

Medications

Over-the-counter topical treatments, such as creams or ointments containing hydrocortisone, can reduce inflammation and pain. Consider using stool softeners which can help make bowel movements easier and less painful.

FAQs

Are there any risks to the baby from rectal bleeding while pregnant?

Most causes of rectal bleeding, such as haemorrhoids and anal fissures, do not pose a direct risk to the baby. However, it is important to address and manage the condition to ensure the mother’s health and comfort.

When should you worry about rectal bleeding?

You should worry about rectal bleeding if it is accompanied by severe pain, significant blood loss, dizziness, fainting, or if the bleeding is persistent. These symptoms could indicate a more serious condition that requires medical attention.

Do haemorrhoids bleed during pregnancy?

Yes, haemorrhoids can bleed during pregnancy. They are swollen veins in the rectal area that can become irritated and bleed, especially during bowel movements. If the bleeding is frequent or heavy, it’s important to consult your healthcare provider.

Consult a gastrointestinal specialist for rectal bleeding

Consulting a gastrointestinal specialist ensures that rectal bleeding during pregnancy is accurately diagnosed and gastrointestinal symptoms are effectively managed, promoting both maternal health and comfort. Are you experiencing rectal bleeding during your pregnancy?

You’re not alone—about 40% of pregnant women face this issue, often due to conditions like haemorrhoids, anal fissures, or constipation. While these causes are usually benign, it’s essential to address them promptly to ensure your comfort and health.