Rectal Bleeding

Rectal bleeding, or hematochezia, is a frequently encountered problem in the outpatient setting. It can herald a pathology in the proximal lower gastrointestinal tract, but it can also be from diseases specific to the rectal region, such as hemorrhoids, fissures, proctitis, and anorectal malignancy. Unfortunately, it has been reported that less than half the patients with rectal bleeding will ever seek medical help for their symptoms.  Rectal bleeding presents as frank red blood exiting from the anus. The presentation may range from mild to severe, depending on the etiology of the bleeding. Mild cases may appear as red blood streaking the patient's stool or toilet paper after wiping, and severe cases may present as a large volume, brisk bleed. The following review will discuss rectal bleeding with more focus on hemorrhoids as it is the most common cause of rectal bleeding in the middle-aged and elderly populations.