Causes of rectal bleeding include:
- Anal Fissures
- Anal Cancer
- Colon Cancer
- Colon Polyps
- Ulcerative Colitis/Crohn’s Disease
- Solitary Rectal Ulcer (ulcer in the rectum)
- Diverticulosis (bulging pouch that forms on wall of large intestine)
- Proctitis (inflammation of the rectum)
- Ischemic colitis (colon inflammation caused by reduced blood flow)
- Infectious Colitis (inflammation of the colon caused by infection)
- Sjögren’s syndrome: see below
The below is a reminder to always check for Sjögren’s syndrome in anyone who has dry eyes, dry mouth, and arthritis, especially if there is a history of new rectal bleeding. Though it is rare, it is important to check for Sjögren’s syndrome.
Rectal mucosal prolapse syndrome as an unusual gastrointestinal manifestation of Sjögren’s syndrome: a case report
Rectal mucosal prolapse syndrome, histologically characterized by fibromuscular obliteration in the lamina propria, hyperplastic glands and thickened muscularis mucosa, causes rectal bleeding. Sjögren’s syndrome is an autoimmune exocrinopathy that chiefly destroys the salivary and lacrimal glands by lympho-plasmacytic infiltration. Although various gastrointestinal manifestations have been reported in patients with Sjögren’s syndrome, there have not been to our knowledge any case reports to date of rectal mucosal prolapse syndrome in association with Sjögren’s syndrome.
A 68-year-old Japanese woman with Sjögren’s syndrome and long-term constipation consulted our hospital because of rectal bleeding. Because of dysphagia and xerostomia, she had consistently refused recommendations to take oral medicines including cathartics. Therefore, she frequently strained excessively during defecation. Colonoscopy and radiological examinations disclosed eroded flat protrusions of the rectum. Microscopic examination demonstrated inflamed mucosa with elongated tortuous glands and fibromuscular obliteration. Based on these findings, a diagnosis of rectal mucosal prolapse syndrome was made. Prohibition of straining during defecation and sulfasalazine suppository use were effective.