Differential Diagnosis for Rectal Bleeding
The following is a differential diagnosis for rectal bleeding, categorized for clarity and emphasis on potential severity.
- Single Most Likely Diagnosis
- Hemorrhoids: This is the most common cause of rectal bleeding, especially in adults. Hemorrhoids are swollen veins in the rectum or anus that can cause bleeding, pain, and discomfort.
- Other Likely Diagnoses
- Anal Fissure: A tear in the lining of the anus can cause pain and bleeding during bowel movements.
- Diverticulosis: A condition where small, bulging pouches (diverticula) develop in the digestive tract, most commonly in the colon, which can bleed.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation and bleeding in the digestive tract.
- Gastrointestinal Infections: Infections such as gastroenteritis can cause rectal bleeding, especially in children and immunocompromised individuals.
- Do Not Miss Diagnoses
- Colorectal Cancer: Although less common, rectal bleeding can be a symptom of colorectal cancer, making it crucial not to miss this diagnosis, especially in older adults or those with a family history.
- Angiodysplasia: Vascular malformations in the colon can cause bleeding, often in older adults.
- Ischemic Colitis: Reduced blood flow to the colon can cause bleeding and is a medical emergency.
- Intussusception: A condition where a part of the intestine slides into an adjacent part, potentially cutting off blood supply and causing bleeding, more common in children but can occur in adults.
- Rare Diagnoses
- Rectal Ulcer: An open sore in the rectum can cause bleeding and pain.
- Solitary Rectal Ulcer Syndrome: A condition causing rectal bleeding and pain due to a ulcer in the rectum, often associated with chronic constipation.
- Dieulafoy's Lesion: A rare cause of gastrointestinal bleeding due to a small mucosal defect with an exposed artery.
- Vasculitis: Inflammation of the blood vessels can cause rectal bleeding, among other symptoms, and is associated with various autoimmune conditions.
Each of these diagnoses has distinct characteristics and risk factors, and a thorough medical history, physical examination, and diagnostic tests are necessary to determine the cause of rectal bleeding in an individual.