Hematochezia

Hematochezia
Classification and external resources
ICD-9	578.1
DiseasesDB	19317

Hematochezia (or haematochezia; also hemochezia or haemochezia) (from Greek αἷμα ("blood") and χέζειν ("to defecate")) is the passage of fresh blood per anus, usually in or with stools (contrast with melena). Hematochezia is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper GI bleed. The difference between hematochezia and rectorrhagia is that the latter rectal bleeding is not associated with defecation, Instead, it is associated with expulsion of fresh red bright blood without stools.

Causes

In adults, most common causes are hemorrhoids and diverticulosis, both of which are relatively benign; however, it can also be caused by colorectal cancer, which is potentially fatal. In a newborn infant, hematochezia may be the result of swallowed maternal blood at the time of delivery, but can also be an initial symptom of necrotizing enterocolitis, a serious condition affecting premature infants. In babies, hematochezia in conjunction with abdominal pain is associated with intussusception. In adolescents and young adults, inflammatory bowel disease, particularly ulcerative colitis, is a serious cause of hematochezia that must be considered and excluded.

Hematochezia can be due to upper gastrointestinal bleeding. However, as the blood from such a bleed is usually chemically modified by action of acid and enzymes, it presents more commonly as melena. Hematochezia from an upper gastrointestinal source is an ominous sign, as it suggests a very significant bleed which is more likely to be life threatening.

Beeturia can cause red colored feces after eating beets because of insufficient metabolism of a red pigment, and is a differential sign that may be mistaken as hematochezia.

See also

• Blood in stool

External links

• Case presentation
• 13 pages at medicinenet.com