Rectal Bleeding

Abstract

Noticeable rectal bleeding mandates an endoscopic exam, however, which test is performed depends on the character of the bleeding and whether or not there has been any change in bowel habits. Anoscopy is an examination of the anal canal, as such, only hemorrhoids can be assessed. Rigid proctoscopy examines the distal 25 centimeters of the colon and rectum and is the procedure of choice for a follow-up examination of a known lesion such as a rectal Cancer or ulcerative proctitis. Flexible sigmoidoscopy has become the accepted means of Screening asymptomatic patients (when combined with stool guaiac) for Cancer and there is a three-fold increase in yield when compared with rigid proctoscopy due to its longer length (60 centimeters). Colonoscopy is an examination of the entire colon and is used to screen patients at high risk for Cancer, to evaluate the colon in those instances where the source of bleeding is thought to be above the rectum and sigmoid, and to evaluate the proximal colon when sigmoidoscopy reveals a lesion.