One stop rectal bleeding clinic: the coventry experience

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Diagnostic Medicine

Background:

• Rectal bleeding is a frequent symptom in patients visiting rectal clinics, often due to benign conditions.
• Neoplastic causes, though less common, necessitate thorough investigation due to their severity.
• Left-sided colorectal tumors are prevalent and accessible via flexible sigmoidoscopy.

Purpose of the Study:

• To evaluate the diagnostic accuracy and performance of a one-stop rectal bleeding clinic.
• To assess the spectrum of conditions diagnosed in patients presenting with rectal bleeding.
• To determine the yield of detecting significant colorectal pathology in a dedicated clinic setting.

Main Methods:

• A prospective study of 250 consecutive patients presenting to a one-stop rectal bleeding clinic.
• Data collection included patient history, digital rectal examination, proctoscopy, and rigid sigmoidoscopy.
• Further investigations comprised colonoscopy or flexible sigmoidoscopy with barium enema.

Main Results:

• Colorectal cancer was diagnosed in 1.6% of patients (n=4).
• Adenomatous polyps were found in 14.4% (n=36), and ulcerative colitis in 3.2% (n=8).
• No abnormality was detected in 39.2% (n=98), while diverticulosis (24%) and hemorrhoids (17.6%) were common findings.

Conclusions:

• The one-stop rectal bleeding clinic demonstrated effective diagnostic capabilities for a range of colorectal conditions.
• The clinic successfully identified both benign and malignant pathologies, including colorectal cancer.
• This model provides efficient evaluation for patients with rectal bleeding, aiding timely diagnosis and management.