Haematochezia (or hematochezia; also haemochezia or hemochezia) (from Greek αἷμα ("blood") and χέζειν ("to defaecate")) is the passage of fresh blood through the anus, usually in or with stools (contrast with melena). Haematochezia is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper GI bleed. The difference between haematochezia and rectorrhagia is that the latter rectal bleeding is not associated with defaecation. Instead, it is associated with expulsion of fresh red bright blood without stools.
In adults, most common causes are haemorrhoids 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, haematochezia 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, haematochezia 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 haematochezia that must be considered and excluded.
Haematochezia 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. Haematochezia 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 haematochezia.
- ^ Taber's Cyclopedic Medical Dictionary. Donald Venes. 20th Edition. Page 955.
- ^ Approach to lower gastrointestinal bleeding, Page2; http://www.omed.org/downloads/pdf/publications/how_i_doit/2009/omed_hid_lower_gastrointestinal_bleeding.pdf