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bright red blood per rectum (BRBPR)

Etiology: - see hematochezia Pathology: 1) red blood in the stool generally originates in the colon, rectum or anus 2) less frequently brisk bleeding from the small intestine may result in red blood in the stool Special laboratory: 1) see lower gastrointestinal hemorrhage 2) anoscopy (hemmorhoids) 3) see hematochezia Management: - additional investigation (beyond anoscopy) indicated in patients > 50 years of age [2] - visualization of hemorrhoid or other source of bleed in patient < 40 years of age may obviate need for lower GI endoscopy [2] - see lower gastrointestinal hemorrhage

General

hematochezia; bloody stool, maroon stool

References

  1. Guide to Physical Examination & History Taking, 4th edition, Bates B, JB Lippincott, Philadelphia, 1987
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, 16. American College of Physicians, Philadelphia 1998, 2012
  3. Journal Watch 22(5):38, 2002 Lewis JD et al, Initial evaluation of rectal bleeding in young persons: a cost-effectiveness analysis. Ann Intern Med 136:99, 2002 PMID: 11790061