How To Handle Rectal Bleeding With UC

While ulcerative colitis may come with a ton of potential symptoms, rectal bleeding is a huge issue for many patients. Understandably, it is very troubling to see the toilet bowl completely red after a bowel movement which has led to a lot of our community members wanting to hear more about this topic.

Let me first start by letting you know that I, too, am an ulcerative colitis sufferer.I was diagnosed 19 years ago and unfortunately, feel like I have experienced it all. Although I am sure there are some things that thankfully, I haven't had to endure like I know a lot of you reading this. I also want to reiterate that anything shared in this article reflects my personal experiences and opinions, from a patient perspective, not a medical professional.

Some common questions related to rectal bleeding with ulcerative colitis include:

Why does rectal bleeding with UC happen?

Rectal bleeding usually occurs when there are inflamed ulcers within the large intestine. As things pass through, it can irritate the ulcers, which may make it so you need to use the restroom multiple times a day to either eliminate stool and/or blood from your anus. This can still happen even if the patient is not eating or drinking.

What can be done to help with rectal bleeding?

First and foremost, you need to call your doctor and let him/her know what is going on. Most GI’s take this symptom very seriously (if yours doesn’t, I advise you to see a new one) as it can also cause severe anemia and other potential issues.

Aside from any medical advice, your doctor gives you, here are some other tips:

Stay home and near a restroom

Staying home and near a restroom will likely ease some of the anxiety. For me, it always came on so suddenly where sometimes I had 30 seconds to get to the bathroom. Knowing I was in a safe place should I not make it comforted me.

Rectal bleeding is only temporary

Focusing on the fact that this is a temporary situation that is a known symptom of your disease will hopefully give you some peace of mind. Rectal bleeding is not this obscure symptom that no doctor knows what to do with. As a UC sufferer, it is extremely common and there are many treatment options. Knowing you will be okay can help manage your emotions during this time.

Choose comfort

For me, wearing comfortable pajamas and surrounding myself with blankets, stuffed animals (doesn’t matter how old you are!) and maybe watching TV or doing something distracting was helpful in allowing me to get through the day - or hour.

If you are an animal lover and have pet>, hold them close to you. Look at them often. Pet them.

Communicate with others

Let anyone in your life who is expecting something from you (a boss, coworkers, family, friends, etc) know that you are going through a difficult time with your disease. Go into as much or as little detail as you want. The important thing is that you cover your bases, let anyone who may be counting on you know that you are temporarily unavailable to be present and may be slow to respond to emails, texts, etc. This will hopefully take some of the pressure off of you so you can focus on yourself. I know it can be easier said than done sometimes.

Is bleeding just a “normal” part of life now with UC?

While it may be a common symptom of ulcerative colitis, this is NOT just a “normal” part of your life now that you have this chronic condition. Bleeding from your rectum and anus is anything but normal so trust me when I tell you, this isn’t going to be your “new normal.” This is a clear sign that your disease is active and in desperate need of treatment. Once you get the proper help, you will be okay. It may take some trial and error so please don’t be discouraged and know that is a normal process for those who suffer from UC. It is definitely not a one size fits all disease in any shape or form so understanding and possibly expecting things to not be so black and white will help you manage your expectations and emotions.

What will my doctor do if I tell him/her that I am experiencing bleeding?

Your doctor will likely want to either speak to you further to ask you more questions or if possible, have you come in for a check-up. If you are unable to drive or get to an appointment, I recommend being honest with your doctor about this. Ask if there is something short term that can be done in the meantime to possibly get you in a better place so you can meet face to face and discuss next steps. He/She may also want you to have blood work done to ensure your hemoglobin isn’t too low (losing blood can often cause anemia). During that blood work, I am sure your inflammatory markers will also be checked.

Will I always have to be in the hospital when rectal bleeding occurs?

No, it doesn’t mean that at all. Please don’t ignore this symptom because you are afraid of being admitted. While I completely understand and have omitted symptoms over the years because I was worried about that very thing, I have learned that it doesn’t serve me in the long run. Nothing will disappear on its own, so the sooner you let your care team know exactly what is going on, the sooner you can get the treatment you need and get back to the life you desire.

While rectal bleeding doesn’t always mean your doctor is going to admit you to the hospital, if there are other issues or concerns, it may be the best thing for you.

Some examples of this include: becoming so anemic you need a blood transfusion or being unable to eat or drink so IV fluids and nutrition are required. And if your body is too sick to handle or absorb the medications orally, you may need to be admitted for a short time in order to receive the medication intravenously.

Do you have any other questions or thoughts about rectal bleeding as either an ulcerative colitis patient, caregiver, or just someone looking to understand more? I know this is a very scary situation and one that may be embarrassing for some to discuss. Please know we are here to support you, we understand and you are not alone!

In your opinion, what is the worst symptom of Crohn's or colitis?