Rectal bleeding
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Definition
Bleed per rectum/find blood in your poo. (If you put the blood in the poo afterwards, this does not count. That's just weird.)
Melaena is passage of black, tarry stools from bleeding higher up in the GI tract which has been digested.
Epidemiology
Pathophysiology
Clinical and Associated Features
- Bowel cancer, IBD - fresh red blood in stools (possibly melaena depending on how high up the lesion is) weight loss, tiredness, pallor, loss of appetite
- Intestinal ischaemia - blood in stool abdominal pain on digestion (couple of hours after eating), weight loss, nausea, vomiting, diarrhoea, tachycardia, constipation
- Angiodysplasia - just blood loss, sometimes melaena.
- Haemorrhoids - often accompanied with feeling of "grapes" out of the bum, with fresh blood on the toilet paper when wiping, and bum pain. Can be linked to portal hypertension
- Anal fissure - can cause excruciating pain and fresh blood.
Differential Diagnosis
- Serious - bowel cancer, IBD, intestinal ischaemia, meckel's diverticulum
- Less serious - angiodyslasia, haemorrhoids, anal fissure,