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Rectal bleeding refers to bleeding in the rectum, thus a form of lower gastrointestinal bleeding. There are many causes of rectal hemorrhage, including inflamed hemorrhoids (which are dilated vessels in the perianal fat pads), rectal varices , proctitis (of various causes), stercoral ulcers , and infections .
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. [6]
The stool guaiac test involves fasting from iron supplements, red meat (the blood it contains can turn the test positive), certain vegetables (which contain a chemical with peroxidase properties that can turn the test positive), and vitamin C and citrus fruits (which can turn the test falsely negative) for a period of time before the test.
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...