ABSTRACT
This chapter outlines the extent of investigation required for the diagnosis of rectal bleeding in each clinical setting and the proper sequencing of studies in the search for a bleeding site. Rectal bleeding is one of the commonest symptoms related to the large bowel. The approach to the patient with massive rectal bleeding is considerably different than for smaller amounts of blood loss. Immediate resuscitative efforts must be directed toward sustaining life simultaneously with the institution of plans to identify the location of the bleeding site. The most common complaint regarding rectal bleeding is that of recurrent small amounts either staining the toilet tissue or seen in the bowl following defecation. The sight of a streak of blood on one side of a normally formed stool, or spots of blood mixed in with the stool is less dramatic than free-flowing bright bleeding, but of considerably greater diagnostic importance.
