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hematochezia

The passage of fresh blood through the anus, usually in or with stools. It is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper gastrointestinal bleed. If it has been occurring for a long time, it may lead to excess loss of blood, resulting in anemia, which can lead to palpitations, shortness of breath, and syncope. Excessive and rapid blood loss can also cause hypovolemia and shock. (Comparison) • hematochezia: The rectal bleeding is associated with expulsion of fresh bright red blood in or with stools. • rectorrhagia: The rectal bleeding is associated with expulsion of fresh bright red blood without stools. • melena: Black "tarry" feces. The blood is from upper gastrointestinal bleeding, usually chemically modified by action of acid and enzymes. (Causes) • hemorrhoids, diverticulosis: Relatively benign. Most common in adults. Diverticulosis can be complicated to diverticulitis. • colorectal cancer • salmonellosis: Increased risk of colon cancer development in the ascending and transverse parts. • intussusception: With abdominal pain. • angiodysplasia • radiation proctitis • upper gastrointestinal bleeding: Very significant bleed which is more likely to be life-threatening, because it is usually seen as melena. • not bleeding: Harmless red or black discoloration of the stool, after eating food like beetroot, dragon fruit, or blackberries due to insufficient metabolism of a red pigment. In newborn infants: • swallowed maternal blood at the time of delivery • necrotizing enterocolitis (initial symptom) In adolescents and young adults: • inflammatory bowel disease (esp. ulcerative colitis) (Diagnosis) • complete blood count and hemoglobin test • colonoscopy: If there is suspicion of bleed from colon particularly in the elderly to look for the site and many causes of bleed (e.g. carcinoma, ulcerative colitis, rectal varices) • esophagogastroduodenoscopy (upper gastrointestinal endoscopy): To look for any rapid and massive fresh bleed from upper gastrointestinal tract when there may not be sufficient time for the change of color of blood to occur.