Hematochezia
Encyclopedia
Hematochezia (from Greek αἷμα ("blood") and χέζειν ("to defecate")) is the passage of fresh blood per anus, usually in or with stools (contrast with melena
). Hematochezia is commonly associated with lower gastrointestinal bleeding
, but may also occur from a brisk upper GI bleed. The difference of hematochezia vs "rectorrhagia" is association of bright red blood with stool in hematochezia, but discharge of bright red blood non-related to defecation in rectorrhagia.
s and diverticulosis
, both of which are relatively benign; however, it can also be caused by colorectal cancer
, which is potentially fatal. In a newborn infant, hematochezia may be the result of swallowed maternal blood at the time of delivery, but can also be an initial symptom of necrotizing enterocolitis
, a serious condition affecting premature infants. In babies, hematochezia in conjunction with abdominal pain is associated with intussusception
. In adolescents and young adults, inflammatory bowel disease
, particularly ulcerative colitis
, is a serious cause of hematochezia that must be considered and excluded.
Hematochezia can be due to upper gastrointestinal bleeding. However, as the blood from such a bleed is usually chemically modified by action of acid
and enzyme
s, it presents more commonly as melena
. Hematochezia from an upper gastrointestinal source is an ominous sign, as it suggests a very significant bleed which is more likely to be life threatening.
Beeturia
can cause red colored feces after eating beets because of insufficient metabolism of a red pigment, and is a differential sign that may be mistaken as hematochezia.
Melena
In medicine, melena or melaena refers to the black, "tarry" feces that are associated with gastrointestinal hemorrhage. The black color is caused by oxidation of the iron in hemoglobin during its passage through the ileum and colon.-Melena vs...
). Hematochezia is commonly associated with lower gastrointestinal bleeding
Lower gastrointestinal bleeding
Lower gastrointestinal bleeding, commonly abbreviated LGIB, refers to any form of bleeding in the lower gastrointestinal tract. LGIB is a common ailment seen at emergency departments. It presents less commonly than upper gastrointestinal bleeding . It is estimated that UGIB accounts for 100-200 per...
, but may also occur from a brisk upper GI bleed. The difference of hematochezia vs "rectorrhagia" is association of bright red blood with stool in hematochezia, but discharge of bright red blood non-related to defecation in rectorrhagia.
Causes
In adults, most common causes are hemorrhoidHemorrhoid
Hemorrhoids or haemorrhoids , are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their physiological state they act as a cushion composed of arterio-venous channels and connective tissue that aid the passage of...
s and diverticulosis
Diverticulosis
Diverticulosis also known as "diverticular disease" is the condition of having diverticula in the colon, which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. These are more common in the sigmoid colon, which is a common place for...
, both of which are relatively benign; however, it can also be caused by colorectal cancer
Colorectal cancer
Colorectal cancer, commonly known as bowel cancer, is a cancer caused by uncontrolled cell growth , in the colon, rectum, or vermiform appendix. Colorectal cancer is clinically distinct from anal cancer, which affects the anus....
, which is potentially fatal. In a newborn infant, hematochezia may be the result of swallowed maternal blood at the time of delivery, but can also be an initial symptom of necrotizing enterocolitis
Necrotizing enterocolitis
Necrotizing enterocolitis is a medical condition primarily seen in premature infants, where portions of the bowel undergo necrosis .-Signs and symptoms:...
, a serious condition affecting premature infants. In babies, hematochezia in conjunction with abdominal pain is associated with intussusception
Intussusception
Intussusception may refer to:* Intussusception * Intussusception...
. In adolescents and young adults, inflammatory bowel disease
Inflammatory bowel disease
In medicine, inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis.-Classification:...
, particularly ulcerative colitis
Ulcerative colitis
Ulcerative colitis is a form of inflammatory bowel disease . Ulcerative colitis is a form of colitis, a disease of the colon , that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset...
, is a serious cause of hematochezia that must be considered and excluded.
Hematochezia can be due to upper gastrointestinal bleeding. However, as the blood from such a bleed is usually chemically modified by action of acid
Acid
An acid is a substance which reacts with a base. Commonly, acids can be identified as tasting sour, reacting with metals such as calcium, and bases like sodium carbonate. Aqueous acids have a pH of less than 7, where an acid of lower pH is typically stronger, and turn blue litmus paper red...
and enzyme
Enzyme
Enzymes are proteins that catalyze chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical reactions in a biological cell need enzymes in order to occur at rates...
s, it presents more commonly as melena
Melena
In medicine, melena or melaena refers to the black, "tarry" feces that are associated with gastrointestinal hemorrhage. The black color is caused by oxidation of the iron in hemoglobin during its passage through the ileum and colon.-Melena vs...
. Hematochezia from an upper gastrointestinal source is an ominous sign, as it suggests a very significant bleed which is more likely to be life threatening.
Beeturia
Beeturia
Beeturia is passing of red or pink urine after eating beets. It affects 10-14% of the population. While some believe it to be an autosomal recessive trait, it has been shown that individuals differ over time in having beeturia. Beeturia can appear and disappear in individuals...
can cause red colored feces after eating beets because of insufficient metabolism of a red pigment, and is a differential sign that may be mistaken as hematochezia.