From the Guidelines
Bright red blood per rectum (BRBPR) requires immediate medical attention if it is accompanied by severe abdominal pain, significant blood loss, dizziness, fainting, rapid heart rate, or low blood pressure, as these may indicate a life-threatening condition. Other concerning red flags include persistent bleeding lasting more than a few days, blood mixed with stool, black or tarry stools, unexplained weight loss, fever, recent changes in bowel habits, or a personal or family history of colorectal cancer or inflammatory bowel disease 1. Age is also an important factor, with bleeding in individuals over 50 warranting prompt evaluation due to increased cancer risk. The bright red color typically suggests a lower gastrointestinal source such as hemorrhoids, anal fissures, or diverticulosis, but can also indicate more serious conditions like colorectal cancer, inflammatory bowel disease, or angiodysplasia.
Key Red Flags
- Severe abdominal pain
- Significant blood loss
- Dizziness or fainting
- Rapid heart rate or low blood pressure
- Persistent bleeding
- Blood mixed with stool or black/tarry stools
- Unexplained weight loss or fever
- Recent changes in bowel habits
- Personal or family history of colorectal cancer or inflammatory bowel disease
- Age over 50
Importance of Medical Evaluation
Anyone experiencing BRBPR should seek medical evaluation to determine the cause, as early diagnosis and treatment can significantly improve outcomes, especially for potentially serious underlying conditions 1. A complete medical history, physical examination, and laboratory tests such as hemoglobin and hematocrit, and coagulation assessment are essential to evaluate the severity of the bleeding and to rule out other causes of lower gastrointestinal bleeding 1. In case of severe bleeding, blood typing and cross-matching may also be necessary 1.