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Hematochezia vs. Rectorrhagia: What's the Difference?

By Janet White || Updated on May 21, 2024
Hematochezia refers to the passage of fresh blood through the anus, typically in or with stools, indicating lower gastrointestinal bleeding, while rectorrhagia is the passage of bright red blood from the rectum, not necessarily related to bowel movements.

Key Differences

Hematochezia involves the presence of bright red blood in the stool, which typically indicates bleeding in the lower gastrointestinal tract. This condition often results from issues such as hemorrhoids, diverticulosis, or colorectal cancer. Rectorrhagia, on the other hand, is the passage of bright red blood from the rectum, independent of stool. This condition can be a sign of rectal or anal bleeding sources such as anal fissures, hemorrhoids, or rectal ulcers.
In hematochezia, the amount of blood can vary from small streaks to large volumes, potentially leading to significant blood loss and anemia. Rectorrhagia typically involves fresh blood, which may suggest that the bleeding is closer to the anal opening. The timing of the bleeding in relation to bowel movements can also help differentiate it from other types of gastrointestinal bleeding, making rectorrhagia more specific to conditions affecting the rectum or anus directly.
In clinical evaluation, hematochezia often prompts investigations such as colonoscopy or sigmoidoscopy to locate the bleeding source and determine the underlying cause. It is important to assess the severity and duration of bleeding to guide treatment decisions. For rectorrhagia, diagnosis may involve a detailed anorectal examination, anoscopy, or sigmoidoscopy to identify any lesions or tears causing the bleeding. Treatment typically focuses on addressing the specific cause, such as treating hemorrhoids or anal fissures.

Comparison Chart


Passage of fresh blood through the anus in stool
Passage of bright red blood from the rectum, not necessarily with stool

Common Causes

Hemorrhoids, diverticulosis, colorectal cancer
Anal fissures, hemorrhoids, rectal ulcers

Blood Appearance

Mixed with stool, bright red
Separate from stool, bright red

Diagnostic Tools

Colonoscopy, sigmoidoscopy
Anorectal examination, anoscopy, sigmoidoscopy

Treatment Focus

Identifying and addressing lower GI bleeding sources
Treating specific anorectal conditions

Hematochezia and Rectorrhagia Definitions


Often associated with conditions like hemorrhoids or colorectal cancer.
Hemorrhoids are a common cause of hematochezia.


Commonly results from anal fissures or hemorrhoids.
Anal fissures were identified as the cause of the rectorrhagia.


Presence of bright red blood in the stool.
The patient reported hematochezia, noticing bright red blood mixed with the stool.


Passage of bright red blood from the rectum.
The doctor noted rectorrhagia during the patient's examination.


May involve significant blood loss.
Severe hematochezia can lead to anemia.


Blood is often noticed on toilet paper or in the toilet.
Rectorrhagia was evident from the blood found on the toilet paper.


Requires diagnostic procedures to identify the source.
A colonoscopy was performed to determine the cause of hematochezia.


Occurs independently of bowel movements.
The patient experienced rectorrhagia without a recent bowel movement.


Indicator of lower gastrointestinal bleeding.
Hematochezia can often signal bleeding in the colon or rectum.


Requires anorectal examination for diagnosis.
An anoscopy was necessary to investigate the rectorrhagia.


(medicine) The presence of fresh (bright red) blood in stools, often due to lower gastrointestinal bleeding.


(medicine) rectal bleeding.


Passage of stools containing blood (as from diverticulosis or colon cancer or peptic ulcer)


How is hematochezia different from rectorrhagia?

Hematochezia involves blood in the stool, while rectorrhagia involves blood from the rectum that may not be associated with bowel movements.

What causes hematochezia?

Common causes include hemorrhoids, diverticulosis, and colorectal cancer.

How is rectorrhagia diagnosed?

Diagnosis often includes an anorectal examination, anoscopy, or sigmoidoscopy.

What is rectorrhagia?

Rectorrhagia is the passage of bright red blood from the rectum, not necessarily related to bowel movements.

How is hematochezia diagnosed?

Diagnosis typically involves colonoscopy or sigmoidoscopy.

What treatments are available for rectorrhagia?

Treatments often target the specific anorectal condition causing the bleeding.

Is hematochezia a medical emergency?

It can be, especially if there is significant blood loss.

What treatments are available for hematochezia?

Treatments focus on addressing the underlying cause of lower GI bleeding.

What causes rectorrhagia?

Rectorrhagia is often caused by anal fissures, hemorrhoids, or rectal ulcers.

What is hematochezia?

Hematochezia is the passage of fresh blood through the anus, typically in or with stools, indicating lower gastrointestinal bleeding.

What does the blood look like in hematochezia?

The blood in hematochezia is usually bright red and mixed with stool.

Can hematochezia lead to anemia?

Yes, significant blood loss from hematochezia can lead to anemia.

What is the role of anoscopy in rectorrhagia?

Anoscopy helps examine the rectum and anus for potential sources of bleeding.

What does the blood look like in rectorrhagia?

In rectorrhagia, the blood is bright red and separate from the stool.

Can dietary changes help with hematochezia?

Dietary changes can help manage conditions like hemorrhoids that cause hematochezia.

Can lifestyle changes help with rectorrhagia?

Yes, lifestyle changes can help prevent and manage conditions like anal fissures.

Is rectorrhagia a medical emergency?

It depends on the amount and cause of bleeding, but it often requires medical evaluation.

Can hemorrhoids cause both hematochezia and rectorrhagia?

Yes, hemorrhoids can cause both conditions.

Is rectorrhagia always related to bowel movements?

No, rectorrhagia can occur independently of bowel movements.

What is the role of colonoscopy in hematochezia?

Colonoscopy helps identify the source of lower GI bleeding in hematochezia.
About Author
Written by
Janet White
Janet White has been an esteemed writer and blogger for Difference Wiki. Holding a Master's degree in Science and Medical Journalism from the prestigious Boston University, she has consistently demonstrated her expertise and passion for her field. When she's not immersed in her work, Janet relishes her time exercising, delving into a good book, and cherishing moments with friends and family.

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