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Related Experiment Videos

Colonoscopy for intermittent rectal bleeding: impact on patient management

D J Graham1, T J Pritchard, A D Bloom

  • 1Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106.

The Journal of Surgical Research
|February 1, 1993
PubMed
Summary

Rectal bleeding evaluation often requires colonoscopy. This study found colonoscopy frequently identifies significant gastrointestinal pathology, even with normal rectal exams, changing patient management.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Diagnostic Endoscopy

Background:

  • Rectal bleeding is a common symptom with diverse causes, ranging from benign anorectal conditions to serious gastrointestinal pathology.
  • Full colonic evaluation is often recommended for intermittent bright red rectal bleeding due to its potential as a warning sign.

Purpose of the Study:

  • To assess the diagnostic utility of colonoscopy in evaluating patients presenting with intermittent bright red rectal bleeding.
  • To determine the rate of significant gastrointestinal findings during colonoscopy in this patient group.

Main Methods:

  • Prospective data collection of 125 colonoscopies performed over two years.
  • Focus on 33 patients undergoing colonoscopy specifically for intermittent bright red rectal bleeding.

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  • Analysis of findings in relation to rectal examination results.

    • Main Results:

    • Colonoscopy revealed significant pathology in 79% (26/33) of patients.
    • Common findings included polyps (14 patients), cancer (3 patients), diverticula (9 patients), and hemorrhoids (4 patients).
    • Rectal examination findings did not correlate with endoscopic results; 52% of patients with normal rectal exams had abnormal colonoscopies.

    Conclusions:

    • Colonoscopy is highly effective in evaluating intermittent rectal bleeding, detecting significant pathology irrespective of rectal exam findings.
    • Full colonic evaluation via colonoscopy is crucial for patients with intermittent rectal bleeding to identify concomitant gastrointestinal issues.
    • Findings at colonoscopy led to a change in management for 48% of patients.