Etiology, Diagnosis and Treatment Options in Chronic Hematochezia

  • Muraba Co.


Background: Chronic hematochezia is recurrent, intermittent, small amount of blood loss
per rectum, either bright red or mixed with the stool for more than 3 months duration. It is
important symptom of lower gastrointestinal diseases, early endoscopic diagnosis and
treatment is mandatory for those patients, even if there is no alarming sign like anemia or
weight loss.
Objective: To determine the causes, treatment and the indication of colonoscope or
sigmoidoscope for patient complaining of chronic hematochezia in all age group patient
and in patient with (low and average risk group) of colorectal cancer (CRC).
Methods: A cross-sectional descriptive study for 400 patients (260 males, 140 females)
with chronic hematochezia, their ages was from 20-80years were enrolled in this study
from January 2011 to January 2014, patient with chronic hematochezia for more than 3
months duration referred to the GIT center of Al- Imamain Al-Kadhimain Medical City. All
patients investigated and examined and divided to two group above 45 years (average
risk), and below 45 years (low risk) for CRC, and detail history was taken for any family
history of CRC, and for alarming signs than, patient examined either by sigmoidoscope or
colonoscope according to the type of risk.
Results: Diagnosis confirmed in 93% (370) patients, while no cause was detected in
(7.5%) 30 patients. Non-serious lesion was seen in 218 patients (54.5%), and the
hemorrhoid was the commonest non-serious lesion and was seen in (192) patients. Other
non- serious lesion was angiodysplasia, solitary rectal ulcer (SRU) and diverticulosis was
seen in 26 patients (6.5%). While serious lesion was detected in 152 patients represent
(38%) as follow (63) patients (15.7%) with colonic malignancy and FAP, polyp seen in (40)
patients (10%) and (49) patients (12.3%) has IBD. Sixteen patients (4%) the lesion was in
the proximal colon.
Conclusion: Any patient with chronic hematochezia at all age group advised for early
medical consultation. Hemorrhoid is the commonest cause of chronic hematochezia in all
age group, but because of increased risk of CRC in young patient, colonoscopy is strongly
indicated for patient less than 45 years old patient with alarming signs and all patients
above 45 years old, irrespective to the alarming signs (anemia, weight loss and anorexia)
which may appear later.

How to Cite
CO., Muraba. Etiology, Diagnosis and Treatment Options in Chronic Hematochezia. Iraqi Medical Journal, [S.l.], p. 172.179, aug. 2017. ISSN 0304-4564. Available at: <>. Date accessed: 14 aug. 2018.

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