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Updated: Feb 1, 2026

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[Management of anorectal bleeding].

Nadia Fathallah1, Amélie Barre1, Élise Crochet1

  • 1Service de proctologie médico-chirurgicale, institut Léopold-Bellan, groupe hospitalier Paris-Saint-Joseph, Paris, France.

La Revue Du Praticien
|December 5, 2018
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Anorectal bleeding is common, often caused by hemorrhoids or anal fissures. Colonoscopy is recommended for patients over 45 or with diagnostic uncertainty due to potential tumor risks.

Keywords:
Urgences proctologiquessaignement anorectal

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Anorectal bleeding is a frequent clinical presentation.
  • Bleeding is often scant and bright red, suggesting an ano-rectal source.
  • Hemorrhoids and anal fissures are the most common causes.

Purpose of the Study:

  • To outline the diagnostic approach to anorectal bleeding.
  • To highlight the importance of considering colorectal tumors.
  • To define indications for colonoscopy in patients with anorectal bleeding.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for anorectal bleeding.
  • Assessment of differential diagnoses including benign and malignant conditions.
  • Evaluation of the role of colonoscopy in management.

Main Results:

  • Medical history and physical examination are often sufficient for diagnosing common causes like hemorrhoids and anal fissures.
  • Colorectal tumors represent a significant risk (approximately 10%) in patients with anorectal bleeding.
  • Colonoscopy is indicated for any diagnostic doubt and universally for patients over 45 years.

Conclusions:

  • A systematic approach is crucial for managing anorectal bleeding.
  • Early consideration of malignancy and appropriate use of colonoscopy are vital for patient outcomes.
  • Age and diagnostic certainty are key factors in deciding on colonoscopy.