Differential Diagnosis for Continuous Rectal Bleeding due to Internal Hemorrhoids
- Single most likely diagnosis
- Internal Hemorrhoids: This is the most likely diagnosis given the presentation of continuous rectal bleeding, as internal hemorrhoids are a common cause of rectal bleeding, especially if they are large or prolapsed.
- Other Likely diagnoses
- Diverticulitis: Inflammation of a diverticulum in the colon can cause rectal bleeding, and while it's more common in the elderly, it should be considered in the differential diagnosis.
- Colitis (inflammatory or infectious): Conditions like ulcerative colitis or infectious colitis can cause continuous rectal bleeding and should be considered, especially if there are other symptoms like diarrhea or abdominal pain.
- Rectal Ulcer: A rectal ulcer can cause bleeding and should be considered, especially if there's a history of constipation or rectal trauma.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Colorectal Cancer: Although less likely in younger patients, colorectal cancer can present with rectal bleeding and must be ruled out, especially in patients over 50 or with a family history.
- Angiodysplasia: Vascular malformations in the colon can cause significant bleeding and are more common in the elderly.
- Ischemic Colitis: Reduced blood flow to the colon can cause bleeding and is a medical emergency.
- Rare diagnoses
- Rectal Varices: Enlarged veins in the rectum, often associated with liver disease, can cause bleeding.
- Solitary Rectal Ulcer Syndrome (SRUS): A condition characterized by a single ulcer in the rectum, often associated with chronic constipation or rectal prolapse.
- Dieulafoy's Lesion: A rare vascular anomaly that can cause significant gastrointestinal bleeding, including from the rectum.