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1-10 HISTORY OF VISIBLE RECTAL BLEEDING IN A
PRIMARY CARE POPULATION
Initial Assessment and 10-year Follow-up Self-reported
rectal bleeding detected by a review of systems was
associated with a high likelihood of important pathology.
Physicians should ask all adults about visible rectal
bleeding and should visualize the entire colon in those
who report bleeding. JAMA January 1, 1997; 277: 44-48 1-10 HISTORY OF VISIBLE RECTAL
BLEEDING IN A PRIMARY CARE POPULATION
Initial Assessment and
10-year Follow-up This was a study of over 200 patients
who reported blood in the stool or on the toilet paper,
but had not sought medical attention for this problem.
All received rigid sigmoidoscopy and double contrast
barium enema. Follow-up—10 years.
Serious disease was diagnosed in 24%: 26 patients had
polyps, 9 inflammatory bowel disease, and 13 had colon
cancer. Neither rigid sigmoidoscopy nor double-contrast
barium enema was sufficiently sensitive to be used alone,
but the combination had a sensitivity of 0.96 and a
specificity of 0.76 for the diagnosis of polyps, cancer
or inflammatory bowel disease.
Self-reported rectal bleeding detected by a review of
systems was associated with a high likelihood of
important pathology. Physicians should ask all adults
about visible rectal bleeding and should visualize the
entire colon in those who report bleeding.
JAMA January 1, 1997; 277: 44-48 Original investigation,
first author from Oregon Health Sciences University,
Portland
Comment:
This is not to say that
the reported bleeding was always caused by the
subsequently discovered lesions. RTJ
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