What are the causes of per rectal bleeding?
Common causes of blood in the stools include:
a. Haemorrhoids: commonly known as piles. They are enlarged and engorged blood vessels in and around the anus, and may be associated with pain, itching or sensation of a lump.
b. Diverticular disease: sac-like protusions of the intestinal wall that usually do not cause any symptoms. However, bleeding from diverticular disease may sometimes be massive and life-threatening in nature.
c. Colitis: inflammation of the wall of the large intestines, that can be due to infection or insufficient blood flow (ischaemia). The elderly are most often the ones affected by ischaemic colitis, due to their underlying medical conditions.
d. Angiodysplasia: a vascular abnormality of the gastrointestinal tract that is due to degeneration of blood vessels. The bleeding is painless, and can sometimes be massive. Though the bleeding stops spontaneously in more than 90% of patients, it is often recurrent.
e. Colorectal cancer: the most common cancer in Singapore. It may also be associated with a change in bowel habits or loss of weight and appetite. The diagnosis of this may sometimes be confounded by the presence of haemorrhoids, another common occurrence in the Singapore population.
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