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What is the differential diagnosis for hematochezia?
The differential diagnosis for hematochezia includes colorectal carcinoma,vascular disorders,anatomical disorders,anorectal disorders,and other abdominal disorders. One of the most serious causes of hematochezia in adults is colorectal cancer and this diagnosis must be considered when GI bleeding presents. Cancer may present insidiously with asymptomatic bleeding,vague symptoms such as fatigue,or weight loss. Colitis is an acute cause of hematochezia that often presents with abdominal pain among other symptoms. The three major etiologies of colitis are infectious,ischemic,and inflammatory. Differentiation between specific types of colitis is reliant on clinical context,colonoscopy findings,laboratory data,and histological findings. Relatively benign causes of hematochezia are hemorrhoids. Presentation of hemorrhoids is variable and largely dependent on location relative to the dentate line. Internal hemorrhoids proximal to the dentate line are typically less symptomatic due to visceral innervation and those distal typically cause pain and irritation due to somatic innervation. Causes of relatively asymptomatic gastrointestinal bleeding includes diverticulosis and angiodysplasia. Diverticulosis ranges widely in its presentation; often it is asymptomatic and found incidentally. Other common presentations include hematochezia,abdominal pain,constipation,or diarrhea. Angiodysplasia results from malformation of mucosal and submucosal vessels in the right colon. It is a less common diagnosis but is responsible for a significant portion of heavy GI bleeding. Other diagnoses to be considered are the inflammatory bowel diseases,Crohn disease,and ulcerative colitis. Ulcerative colitis is most often associated with hematochezia and both diseases may present with greater symptoms such as abdominal pain,bloating,diarrhea,or fever.","department":"
