Investigation of rectal bleeding

Rectal bleeding in children is often transient, benign, and simply treated. The age at which rectal bleeding occurs is important in determining the cause of the bleeding. Rectal bleeding is often associated with necrotizing enterocolitis (a disorder characterized by inflammation of the intestines and colon associated with tissue death) in premature and newborn infants Structural abnormalities of the anus, such as fissures or invagination, are often the cause of rectal bleeding in young infants. Lymphoid hyperplasia (the overgrowth of lymphoid tissue) and inflammatory bowel disease may be responsible for this symptom in older child. The patient's medical history is important in determining the diagnosis. The consistency of the stool, pain, defecate patterns, diet, the amount and color of blood, family medical history, and drug history provide important clues. The abdomen, areas surrounding the anus, and the rectum should be examined thoroughly. The examination of the anus and rectum and important physical findings are discussed in detail. Stool samples should be analyzed if rectal bleeding is associated with infection. Imaging methods used to assess rectal bleeding include X-rays; sonography, which involves the use of sound waves; and endoscopy, the insertion of a tube-like structure with an optical system into the intestinal cavity. Although endoscopy is often difficult to perform and uncomfortable for the child, it can be used to obtain a biopsy and examine any changes in tissue structure. More radical medical methods to assess rectal bleeding include use of radioactive technetium-labelled red blood cells that accumulate at sites of bleeding in the intestine; angiography, X-ray of blood vessels; and laparotomy, the surgical opening of the abdomen. (Consumer Summary produced by Reliance Medical Information, Inc.)