van Pinxteren Bart, Kurver Miranda J, Damoiseaux Roger A M J, Boukes Froukje S, Goudswaard A N Lex
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A121.
Rectal bleeding is often caused by a harmless disorder such as haemorrhoids or an anal fissure, but may be a symptom of colorectal cancer or inflammatory bowel disease. Risk factors for colorectal cancer are: older age (arbitrary > 50 years), a first-degree relative aged < 70 years with colorectal cancer, change in bowel habit, blood mixed with stools and the absence of anal or perianal symptoms. Colonoscopy should be performed when colorectal cancer is suspected. Treatment of haemorrhoids and anal fissures by the general practitioner especially includes education, treatment of comorbidity and, if necessary, local treatment. Proctoscopy is feasible in general practice.
直肠出血通常由诸如痔疮或肛裂等无害病症引起，但也可能是结直肠癌或炎症性肠病的症状。结直肠癌的风险因素包括：年龄较大（通常>50岁）、有一位年龄<70岁的患结直肠癌的一级亲属、排便习惯改变、粪便带血以及无肛门或肛周症状。怀疑患有结直肠癌时应进行结肠镜检查。全科医生对痔疮和肛裂的治疗尤其包括健康教育、合并症治疗以及必要时的局部治疗。直肠镜检查在全科医疗中是可行的。
