Hematochezia

                The passage of bright red stools is called Hematochezia. Is usually indicative of bleeding from the rectum & anus, however 50% are due to proximal lesions (mainly in the colon) that are profuse enough that they avoid remaining in the gut for 8hrs & are not expressed as blood intermixed with stools.

Assessment
Assessment includes PR examination if nothing is found then order an anoscopy, proctosigmoidoscopy and lastly colonoscopy.

Sources 
1. Colonic cancer
2. Colonic polyps
3. Diverticula
4. Colitis
5. Vascular ectasia
6. Large hemorrhoids only
7. Ulcer tear (rectum)
8. Upper gastrointestinal or small bowel source
9. No site identified

Symptoms
Along with hematochezia, there are other symptoms in gastrointestinal bleeding. This includes:
- Abdominal cramping
- Abdominal distention
- Constipation or diarrhea
- Dizziness
- Fatigue
- Fever
- Body weakness
- Dizziness
- Difficulty breathing
- Severe abdominal pain
- Vomiting of blood

Treatment
 Hematochezia should be treated according to the underlying condition however, before the start of treatment; the disease should be diagnosed clearly. Upon admission, the physicians and other health care personnel will get a thorough medical history and physical examination should be done. Blood samples will be taken and a small piece of the stool specimen should also be submitted for evaluation. An example of stool test is the fecal occult blood. According to experts, submitting for a fecal occult blood test every 1 or 2 years should be done to decrease the incidence of colorectal cancer.

other diagnostic exams would include having a digital rectal exam wherein the doctor will insert their gloved fingers in the rectum to check for abnormalities in the surrounding areas. With this exam, they will notice tumor which are large and palpable. Having a sigmoidoscopy or colonoscopy would also help them to further see abnormalities like polyps in the colon and sigmoid area which can be indicative of cancer.

If the problem is diagnoses, the treatment should be done as soon as possible. If the hematochezia is caused by hemorrhoids, there are home remedies that can be done like doing a hot sitz bath and some dietary changes. Patients with hemorrhoids should increase their fluid intake and take foods high in fiber to avoid constipation and much straining which can cause pain. They should also refrain from sitting too long in the comfort room because it adds pressure on the site. Doctors would also recommend some over-the-counter creams, ointment and suppositories which will relieve the pain and discomfort caused by hemorrhoids.

For patients with diverticulitis, medications to alleviate the abdominal spasm like hyoscyamine, diclomine as well as antibiotics like ciprofloxacin, metonidazole, cephalexin and others. But for furthere treatment, surgery is needed especially when medications won’t work. The bleeding diverticula will be removed to stop the bleeding.

For patients diagnosed with colorectal cancer, the treatment would depend on the staging on the cancer. If the detection is early and there is no metastasis, prognosis is good. But if the condition is worse, then palliative treatment would be given. Chemotherapy is still done to reduce the likelihood of metastasis of the cancer cells. Sometimes, surgery is done but it is only for palliative treatment to remove the polyps in the colon or in the rectal area. This can be done through colonoscopy or by the abdominoperineal excision. Cancer patients would also need to modify their lifestyle. They need to modify their diet and avoid high caloric foods and meaty products. Also, they need to stop smoking, avoid alcoholic beverages and instead take the recommended amount of fiber.