Differential Diagnosis for Painless Blood Per Rectum
Single Most Likely Diagnosis
- Hemorrhoids: This is often the most common cause of painless bleeding per rectum, especially in adults. Hemorrhoids are swollen veins in the lowest part of the rectum or anus, and they can bleed when they become irritated or inflamed.
Other Likely Diagnoses
- Diverticulosis: A condition where small, bulging pouches (diverticula) develop in the digestive tract, most commonly in the colon. These pouches can bleed, leading to painless rectal bleeding.
- Angiodysplasia: A condition characterized by the presence of abnormal blood vessels in the colon, which can cause bleeding.
- Rectal Prolapse: A condition where the rectum loses its normal attachments inside the body, allowing it to protrude out through the anus, which can cause bleeding.
Do Not Miss Diagnoses
- Colorectal Cancer: Although less common than other causes, colorectal cancer is a critical diagnosis to consider due to its potential for severe outcomes if not caught early. Painless bleeding can be an early sign.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause rectal bleeding, among other symptoms. While they often present with additional symptoms like diarrhea and abdominal pain, the bleeding can sometimes be painless.
- Ischemic Colitis: Reduced blood flow to the colon can cause bleeding, and while it often presents with abdominal pain, the pain can be minimal or absent in some cases.
Rare Diagnoses
- Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause bleeding, especially in children and young adults.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially causing bleeding. It's more common in children but can occur in adults.
- Arteriovenous Malformations (AVMs): Abnormal connections between arteries and veins that can occur in the colon and cause bleeding.
- Solitary Rectal Ulcer Syndrome: A condition that can cause rectal bleeding, often associated with chronic constipation and straining during bowel movements.