What is the risk of malignancy in a male in his 20s with recurrent episodes of hematochezia (bloody bowel movements)?

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Last updated: March 24, 2025View editorial policy

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Differential Diagnosis for Male in 20s with Multiple Episodes of Bloody Bowel Movements

  • Single Most Likely Diagnosis
    • Inflammatory Bowel Disease (IBD), specifically Ulcerative Colitis: This condition is characterized by chronic inflammation and ulceration of the colon, leading to symptoms such as bloody bowel movements, diarrhea, and abdominal pain. The age of onset and the presence of bloody stools make IBD a strong consideration.
  • Other Likely Diagnoses
    • Crohn's Disease: Another form of IBD that can affect any part of the gastrointestinal tract, leading to symptoms similar to ulcerative colitis, including bloody bowel movements.
    • Infectious Colitis: Infections caused by bacteria, viruses, or parasites can lead to bloody diarrhea. Common pathogens include Salmonella, Shigella, and Campylobacter.
    • Diverticulitis: Although more common in older adults, diverticulitis can occur in younger individuals, especially if they have a family history or other risk factors. It can cause bloody bowel movements, especially if there is a diverticular bleed.
  • Do Not Miss Diagnoses
    • Colorectal Cancer: Although rare in young adults, colorectal cancer can present with bloody bowel movements. It is crucial to rule out this diagnosis, especially if there is a family history of colorectal cancer or genetic syndromes like Familial Adenomatous Polyposis (FAP) or Lynch Syndrome.
    • Intussusception: A condition where a part of the intestine telescopes into another, which can cause bowel obstruction and bleeding. It is more common in children but can occur in adults, often associated with a lead point such as a tumor.
    • Meckel's Diverticulum: A congenital anomaly of the small intestine that can cause bleeding due to the presence of ectopic gastric mucosa. It typically presents in childhood but can be diagnosed later in life.
  • Rare Diagnoses
    • Hemangiomas or Vascular Malformations: Rare congenital conditions that can cause gastrointestinal bleeding.
    • Ehlers-Danlos Syndrome: A genetic disorder that can lead to gastrointestinal complications, including bowel perforation and bleeding, although this is less common.
    • Behçet's Disease: A rare form of vasculitis that can affect multiple parts of the body, including the gastrointestinal tract, leading to symptoms like bloody bowel movements.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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