Colonoscopy.net.au

Many condition can cause rectal bleeding. It is important that you exclude a serious cause first by speaking to your doctor!  Risks symptoms for a more serious cause include having clots, blood being mixed with the stools, having lots of bleeding, bleeding frank blood, passage of mucus, increasing age(the older you are the higher your risk of bowel cancer), presence of anaemia and loss of weight

Causes include:

1. Bowel cancer – in particular a rectal cancer or cancer in the sigmoid colon

2. Polyps in the bowel – especially large ones in the rectum

3. Haemorroids – this is quite common but it is important to speak to your doctor about it and be examined throughly to exclude more serious cause

4. Inflammatory bowel disease eg proctitis, ulcerative colitis, Crohn’s disease

5. Anal fissure – usually there is a lot of pain when or after opening the bowels(but be warned : rectal cancer invading into the anal canal can also be painful)

6. Trauma to the perianal tissue

A most interesting case out of the textbook.

Patient in the 20s walked into the clinic. Has been referred to me for a colonoscopy.

First thing I noticed was the reddish nodules on the shins of both the legs. The patient says that these has been quite painful. The pain had thougth this was due to mosquito bites or some sort of reaction to insect bites. (Clinically on examination, this was consistent with erythema nodosum)

Further history taking reveals the patient has been having diarrhoea. The patient had also been feeling tired.

Colonoscopy was performed and it showed proctitis as well as distal colitis. Biospsies were taken – histology was initially reported as normal but when I queired it with the pathologist, a second opinion was sought and the consensus opinion was that is was consistent with ulcerative colitis.