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Monday, 2 December 2013

Hemorrhaging: Hematochezia (rectal bleeding) - The Risk Factors

Hemorrhaging is also known as bleeding or abnormal bleeding as a result of blood loss due to internal.external leaking from blood vessels or through the skin.
Hematochezia (rectal bleeding)
Hematochezia is defined as a condition of the passage of bright red, bloody stool. In most cases it is an indication of hemorrhoids (swollen veins in and around the rectum) or diverticulitis, a common digestive disease particularly found in the large intestine, as a result of infection or inflammation.
Risk Factors
3.1. Aging
Risk of rectal bleeding increase with age as  the result of weakened intestinal blood vessels. In the study of the group consisted of 102 patients (50 years of age or less)  with a flexible endoscope and an anoscopethat presented for evaluation of rectal bleeding, showed that six patients had colitis; all but one of these patients were less than 40 years of age. Flexible endoscopy and anoscopy provide complimentary information in middle-aged adults with rectal bleeding(10)

3.2. Family history of gastrointestinal disease
People with the family of ulcerative colitis and Crohn’s disease, are at increased risk of rectal bleeding

3.3. Others, according to American Journal of Gastroenterology (1998) 93, 2179–2183; doi:10.1111/j.1572-0241.1998.00530.x

FROM: Self-reported rectal bleeding in a United States community: prevalence, risk factors, and health care seeking by Nicholas J Talley and Michael Jones(11)

Table 1. Association of Rectal Bleeding With Potential Risk Factors Based on Univariate Logistic Regression

Figure and tables index

Any Rectal BleedingBlood Coating the StoolsBlood on Toilet PaperDark Blood Viewed in Stools

OR95% CIOR95% CIOR95% CIOR95% CI
  Age greater than or equal to 45 yr0.54* 0.41–0.721.190.67–2.121.640.43–6.230.600.29–1.23
  Sex (male)0.950.72–1.260.560.32–0.981.300.40–4.221.100.58–2.11
  Marital status0.820.55–1.223.0* 1.11–8.113.260.92–11.510.430.19–0.98
  Employment (yes vs no)0.550.31–0.960.590.16–2.180.550.06–4.721.670.50–5.63
  Education (< HS vs HS + tertiary)1.190.93–1.521.140.69–1.872.460.86–7.060.330.18–0.62
  Aspirin (none, some)1.080.82–1.421.060.61–1.841.520.47–4.940.750.39–1.44
  Ulcer history (yes)1.120.72–2.021.610.62–4.180.420.09–2.091.470.50–4.32
  Gastric surgery1.580.89–2.791.640.55–4.920.290.06–1.482.360.75–7.41
  IBS (yes)1.48* 1.04–2.101.060.54–2.051.070.28–4.151.650.78–3.50
  Constipation (yes)3.09* 2.33–4.101.510.86–2.670.240.05–1.142.30* 1.14–4.65
  Diarrhea (yes)2.08* 1.51–2.850.710.38–1.332.080.44–9.754.12* 2.10–8.11
  Urgency (yes)1.55* 1.11–2.151.240.66–2.350.940.25–3.603.25* 1.68–6.48
  Dyspepsia (yes)1.310.83–2.041.480.63–3.470.590.12–2.861.290.49–3.45
  Smoking (never vs current)0.960.67–1.390.410.18–0.970.740.18–3.093.67* 1.65–8.12
  Alcohol (0–6 vsgreater than or equal to 7 drinks wk)1.340.92–1.931.020.49–2.110.550.14–2.153.511.67–7.38
  Bowel surgery1.030.60–1.761.170.42–3.300.810.10–6.731.360.42–4.42
  Physician visits (bowel trouble)5.26* 3.19–8.651.170.53–2.570.820.17–3.932.93* 1.30–6.61
*  p < 0.05.
 HS = high school; IBS = irritable bowel syndrome; CI = confidence interval; OR = odds ratio.

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Sources
(10) http://www.ncbi.nlm.nih.gov/pubmed/7628276
(11) http://www.nature.com/ajg/journal/v93/n11/fig_tab/ajg1998500t1.html#figure-title