Rectal Bleeding during Pregnancy: Causes, Remedies & Prevention

Rectal bleeding, or anal bleeding, is usually a result of anal fissures. An anal fissure is a small tear in the tissue that lines the anus. It is quite common to see bright red blood after bowel movement during pregnancies and after birth, usually when passing hard stools. Blood in the stool due to anal fissures can cause a burning sensation after a bowel movement.

How Common It Is?

Towards the latter stages of pregnancy, experiencing rectal bleeding is relatively common. Approximately 25% of pregnant women develop haemorrhoids by the third trimester, while about 1% may experience an anal fissure during late pregnancy. The likelihood of encountering an anal fissure increases postpartum, with around one in seven mothers facing this issue after childbirth.

Symptoms

There are various symptoms of anus bleeding early pregnancy, a few of which are listed below:

• Fever
• Stomach pain
• Nausea
• Vomiting
• Changing bowel habits
• Prolonged or severe diarrhoea
• Irregular bowel movement (denoted by narrow and thin stools called ‘pencil-stools’)

Other noted symptoms that indicate the need to undergo emergency medical treatment for pregnancy rectal bleeding are:

• Black or maroon stools
• Large volumes of blood loss
• Rectal trauma accompanied by difficulty in breathing

Causes of Rectal Bleeding in Pregnant Women

Rectal bleeding mostly occurs due to anal fissures in the body. Pregnant women are often prone to constipation, due to which they pass hard stools. This can strain the rectum during bowel movements. Taking high-dosage vitamin medications can also cause constipation and irregular bowel movements in women. A lack of fibre in the diet can sometimes trigger problems with bowel movement, increasing chances of rectal bleeding.

Less common causes of anus bleeding during pregnancy include:

• Anal cancer
• Colon cancer
• Colon polyps (a condition where a clump of cells forms on the lining of the colon, i.e., the large intestine)
• Inflammation of the rectum
• Diverticulosis (a condition where pouches form in the wall of the large intestine)
• Crohn’s disease (an inflammatory bowel disease)
• Diarrhoea
• Rectal cancer
• Ulcerative colitis (a condition that causes inflammation and sores in the lining of the large intestine)

Rectal Bleeding Diagnosis

A physical examination is done to treat rectal bleeding and diagnose its origins. Low blood pressure and elevated heartbeat are major indicators of high-volume blood loss due to rectal bleeding, warranting emergency medical treatment. A vital diagnostic test involves passing a flexible tube into the stomach to check for signs of active bleeding. The anus is inspected to check for external sources of bleeding such as trauma, and a finger examination may entail assessing the characteristics of stool, tenderness, and checking for the presence of masses. Regarding blood loss volumes, blood samples are taken to the lab to assess blood clotting factor and check for signs of infection.

Other common diagnostic tests involve anoscopy, flexible sigmoidoscopy, Barium enema X-rays, CT scans, and angiography. Colonoscopy can be used to examine the inside of the rectum. These diagnostic tests involve checking for tumours in the anus and examine lower ends of the colon to check for brisk/active bleeding. Additionally, nuclear medicine studies can be used to tag red blood cells and pinpoint regions in the colon where slow bleeding occurs.

Rectal Bleeding Treatment and Remedies During Pregnancy

Minor rectal bleeding can be treated with home remedies while severe cases include medical treatment at the hospital. The most common home remedies for rectal bleeding during pregnancy are:

• Eating high-fibre foods that relieve constipation, such as green vegetables like beans, squash, prunes, figs, and nutrient-dense meals rich in Omega-3 fatty acids supplemented with probiotics. Warm bone broths and herbal teas also work. Avoid alcohol and spicy foods.
• Consuming adequate amounts of water throughout the day
• Getting enough exercise and jumping on a trampoline to relieve the lymphatic system also works. Light exercises like jogging, swimming, yoga, and low-impact routines can gently regulate bowel movements and enhance bowel function.
• Stress reduction techniques and incorporating relaxation routines in one’s daily life is also helpful. Reducing stress helps the rectum heal and allows the body to improve its inflammatory response naturally, thus reducing inflammation and chances of further complications.

Note: Make sure to check with your doctor before starting any new foods or exercises during pregnancy.

Prevention

The most common ways to prevent rectal bleeding in pregnancy are:

• Allow yourself to go to the bathroom when the urge arises and do not forcefully withdraw from discharging stool when needed
• Make sure your diet is loaded with high-fibre content, vitamins, minerals, and essential fatty acids. This can help prevent rectal bleeding
• Get regular exercise and relaxation
• Stay hydrated, and make sure you drink fluids every day to reduce chances of constipation
• Avoid medications with high-doses of iron since they can cause constipation. Ask your healthcare provider to replace them with safe, over-the-counter fibre supplements

Will This Bleeding Harm Your Baby?

No. Rectal bleeding can occur weeks after the baby’s birth too. It does not harm babies in any way during either pregnancy or childbirth.

When to Call the Doctor

If you’re experiencing the following symptoms then calling the doctor is recommended. These signs should be evaluated by a doctor.

• Vaginal bleeding
• Low blood pressure
• Elevated heart rates
• Experiencing rectal bleeding despite following home treatment protocols
• Signs of bleeding accompanied by back pain
• Pain in the abdomen

You may be prescribed a laxative to take during pregnancy. Discomfort caused by rectal bleeding can be eased by gently wiping the anus-area with a fragrance-free and alcohol-free toilet wipe rather than using conventional bathroom tissues.

Healing of anal fissures automatically occurs weeks after the pregnancy. Experiencing Piles, which leads to added pressure on the rectum area and causes inflammation, is common during pregnancies. Consider taking paracetamol if the pain in the rectum persists despite having frequent bowel movements and taking multiple trips to the bathroom.

Rectal bleeding that occurs from haemorrhoids and anal fissures automatically goes away as the body heals itself after pregnancies. If you are not sure where the bleeding originates from, be it from the rectum, or vagina, you should consider making a call to the doctor.

While rectal bleeding while pregnant is usually no cause for serious concern, it is always best to take the required precautions. Also, pay a visit to the doctor if the symptoms are intense and persistent.

References/Resources:

1. Constipation During Pregnancy; americanpregnancy.org; https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/constipation-during-pregnancy/

2. My body changes during pregnancy were rectal cancer symptoms; mdanderson.org; https://www.mdanderson.org/cancerwise/my-body-changes-during-pregnancy-were-rectal-cancer-symptoms.h00-159385890.html

3. Constipation in pregnancy, haemorrhoids and anal fissures; nct.org.uk; https://www.nct.org.uk/pregnancy/worries-and-discomforts/common-discomforts/constipation-pregnancy-haemorrhoids-and-anal-fissures

4. What can I do to treat hemorrhoids during pregnancy?; pregnancybirthbaby.org.au; https://www.pregnancybirthbaby.org.au/haemorrhoids-during-pregnancy

5. Hemorrhoids and Varicose Veins in Pregnancy; stanfordchildrens.org; https://www.stanfordchildrens.org/en/topic/default?id=hemorrhoids-and-varicose-veins-in-pregnancy-134-9

6. Bleeding in Early Pregnancy; aafp.org; https://www.aafp.org/pubs/afp/issues/2019/0201/p166-s1.html

7. Rectal Bleeding; yalemedicine.org; https://www.yalemedicine.org/conditions/rectal-bleeding

8. Prentice R, Al-Ani A, Cherry T, et.al; Evaluation and management of rectal bleeding in pregnancy.; https://europepmc.org/article/med/34601746; October 2021

Also Read:

Vomiting Blood in Pregnancy
Symptoms of Implantation Bleeding
Causes of Watery Discharge while Pregnant