What does it mean if my poop is lined with blood little?

A thin streak or small amount of blood on the stool's surface is often linked to a problem right at the anus or lower rectum, such as hemorrhoids or a small blood vessel issue, rather than bleeding higher up. It still deserves a doctor's look to make sure a polyp or something else isn't also there.

Is bright red blood in stool bad?

Bright red blood usually means the bleeding is coming from the rectum, anus, or lower colon, and in large hospital studies it was most often caused by hemorrhoids, small ulcers, or abnormal blood vessels rather than cancer. Still, cancer and polyps were also found in people with this symptom in some studies, so it's a reason to get checked, not something to assume is safe to ignore.

What causes bright red blood when you poop?

Studies point to hemorrhoids, small rectal ulcers, abnormal or fragile blood vessels, diverticulosis (small pouches in the colon), and polyps as common painless causes. Less often, case reports describe rarer causes such as vascular growths, benign tumors, or, rarely, a cancer.

Does blood in stool mean cancer?

Not usually — most people in these studies who had blood in their stool were found to have a benign cause, like hemorrhoids or blood vessel changes. But cancer and precancerous polyps were also found in some people with this symptom, and even in people with none, so blood in the stool should prompt a colonoscopy to rule cancer out, rather than rule it in.

What happens if there is blood in your poop?

It depends entirely on the cause, which only a doctor's exam or colonoscopy can find — outcomes in these studies range from a hemorrhoid needing no treatment, to a polyp removed during colonoscopy, to, less often, a cancer needing further care. Because the possible causes range from harmless to serious, the next step is getting it looked at, not waiting to see if it stops.

Why am I pooping blood with no pain?

Name: Why am I pooping blood with no pain?
Published: 2026-10-26
Keywords: why am i pooping blood no pain, why am i bleeding when i poop but no pain, what does it mean if my poop is lined with blood little, is bright red blood in stool bad, what causes bright red blood when you poop, does blood in stool mean cancer, why am i pooping blood no pain male, what happens if there is blood in your poop

In adults presenting with painless hematochezia (blood in or on the stool), what are the likely causes, and which features indicate a need for further evaluation or colonoscopy to exclude colorectal cancer or other serious pathology?

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Evidence review in plain language · compiled 2026-10-26 · checked 2026-10-26 · next 2026-11-26 · automated review, how it works

Bottom line

Painless blood in the stool is usually caused by something minor like hemorrhoids or a small blood vessel problem, but it's also how some polyps and cancers first show up, so it needs a doctor's look rather than a guess.

In the largest study of people hospitalized for sudden rectal bleeding, painless bleeding was most often traced to hemorrhoids, rectal ulcers, abnormal blood vessels, radiation damage, or diverticulosis rather than cancer. But other large studies found that colorectal cancer and precancerous polyps are also sometimes found in people who never bled at all, and that bleeding, when present, raises the odds of finding one. No study followed people with painless bleeding at home to see how many never needed treatment.

How well studied

Some evidence

Answered by 1 study following patients over time, of limited size or quality.

This question asks why something happens, not whether a treatment works, so there is no benefit-or-harm verdict. What can be shown is how well it has been studied.

answer it directly: 27answer it directly
studies found: 135studies found
randomised trials: 0randomised trials
people studied: 111,048people studied
reviews of trials: 3reviews of trials
years covered: 2020–2026years covered

What the research shows

Likely diagnosis (hemorrhoids, ulcers, vascular lesions, diverticulosis, polyps)
In the largest study of people admitted with sudden rectal bleeding, painless bleeding was significantly linked to hemorrhoids, rectal ulcers, abnormal blood vessels (angioectasia), radiation-related colitis, and diverticulosis. A separate review states hemorrhoids are the single most common cause of painless bleeding during bowel movements.[1,2]
Some evidence
Likely diagnosis when a serious cause is present (cancer, rare tumors)
Case reports describe painless bleeding as the first sign of rare cancers, including anorectal melanoma and small-bowel or rectal adenocarcinoma, and a case-control study links rectal bleeding to higher odds of colorectal cancer in adults under 50. Because almost all of these come from single-patient reports, how often a serious cause underlies painless bleeding overall is not established.[1,2,3,4]
Too little evidence
Likelihood that painless bleeding specifically means colorectal cancer
No study gave a clear rate for painless bleeding alone. A screening study of over 42,000 adults found most cancers and advanced polyps turn up in people with no bleeding at all, while bleeding, when present, raised the odds of a finding. A study of men screened yearly after prostate radiotherapy found that most of the cancers detected (8 of 12) had caused no bleeding at all. A small retrospective study found the same number of cancers, one each, whether bleeding had been painful or painless.[1,2,3]
Too little evidence
Need for colonoscopy or further workup
Multiple studies describe colonoscopy finding the cause of painless bleeding, ranging from benign lesions to, less often, cancer. A positive stool blood test was linked to more referrals for endoscopy. In screening studies, most cancers and precancerous polyps were found in people with no symptoms at all, though rectal bleeding, when present, was linked to higher odds of a cancer or polyp being found.[1,2,3]
Some evidence
Resolution or recurrence of bleeding over time without treatment
No study followed people with painless bleeding at home, untreated, over time to see how often it stops on its own or comes back. The available evidence only describes people who already sought care, had a procedure, or were further investigated.
Not studied

What the studies found

In the largest study of people hospitalized for sudden rectal bleeding, painless bleeding was more often linked to hemorrhoids, small rectal ulcers, abnormal blood vessels (angioectasia), radiation-related bowel damage, or diverticulosis than to other causes.[1]
A review of hemorrhoid disease states that hemorrhoids are the most common cause of painless bleeding during a bowel movement, with or without the anal tissue prolapsing.[1,2]
Case reports describe many benign, treatable sources of painless bleeding, such as small vascular growths, polyps, and fatty tumors, found on colonoscopy with bleeding resolving once removed.[1,2,3,4,5,6]
Large screening studies show that most colon cancers and precancerous polyps are actually found in people with no bleeding at all, meaning painless bleeding is neither required for, nor a guarantee of, a serious diagnosis.[1,2]

Important limitations

Nearly all specific causes described here come from single case reports of one patient each, so there is no way to know how common any one of them is among everyone with painless bleeding.[1,2,3,4,5,6,7,8]
The largest studies were done in people already hospitalized or referred for bleeding, who tend to be older and sicker than someone with mild bleeding noticed at home, so the mix of causes may not be the same.[1]
These studies measured rectal bleeding as a symptom without specifying whether it was painless or painful, so it is unclear how well their colorectal cancer risk findings apply specifically to painless bleeding alone.[1,2,3]

What kind of studies

Case series100 · 74%
Retrospective18 · 13%
Narrative review11 · 8%
Systematic review3 · 2%
Prospective cohort2 · 1%
Case-control1 · 1%

The key studies

Castro et al. 2026
Uncovering the Red Flags: A Cross-Sectional Retrospective Case-Control Study on Predictors of Early-Onset Colorectal Cancer in a Multistate Community Health System
Rectal bleeding linked to higher colon cancer oddsCase-controlModerate qualityRelated question
2,052 people2026
Rectal bleeding, along with abdominal pain, constipation, iron deficiency anemia, alcohol use, more health conditions, and certain medications, was linked to higher odds of being diagnosed with colorectal cancer
Who was studied
Adults aged 20 to 49 diagnosed with early-onset colorectal cancer compared with matched adults without colorectal cancer
Main outcome
Which symptoms, health history, and social factors predict a diagnosis of early-onset colorectal cancer
Quality
It is a reasonably large matched case-control study using medical records, but it relies on how symptoms were documented and cannot tell whether the bleeding it counted was painful or painless.
Limitations
Retrospective electronic medical record data that does not specify whether rectal bleeding was painless or painful, matching was only on age and sex, and symptom documentation may be incomplete or inconsistent.
Taken word for word from the abstract
- n Our final analysis included 684 EOCRC cases and 1,368 controls.
- population we compared adults ages 20 to 49 years diagnosed with EOCRC (2017-2023) to control patients without EOCRC who were 1:2 exact-matched based on age and sex
- primaryOutcome to predict the odds of EOCRC diagnosis
- result several predictors were significantly associated with higher EOCRC odds, including alcohol use history, higher number of comorbidities, abdominal pain, rectal bleeding, constipation, iron deficiency anemia, and prescriptions for metformin, non-steroidal anti-inflammatory drugs (NSAID), and multivitamins
Cancer Prev Res (Phila) · PMID 41384824 · Read it on PubMed ↗
Balhorn et al. 2022
Changing the routine: a move to patient initiated follow up to improve surgical outpatient clinic
Cancer still turned up despite new protocolRetrospectiveLow qualityRelated question
268 people5 year
The new pathway cut routine follow-up visits sharply, and over 5 years a single colorectal cancer was found in both the new-pathway group and the old-pathway group, regardless of how bleeding was managed
Who was studied
Adults referred to a surgical outpatient clinic for painful or painless rectal bleeding at a tertiary hospital in New Zealand
Main outcome
Rate of follow-up appointments needed after a new 'patient initiated follow up' clinic pathway for rectal bleeding
Quality
This is a small single-centre comparison to historical controls, not designed to measure how often bleeding of any type signals cancer, and it mixes painful and painless bleeding patients together rather than separating them.
Limitations
Primary purpose was comparing clinic follow-up workload, not cancer risk by symptom type; painful and painless bleeding patients are combined for the cancer finding; no breakdown of how many cancers occurred specifically in painless-bleeding patients.
Taken word for word from the abstract
- population patients referred with rectal bleeding at a large tertiary public hospital in South Auckland, New Zealand
- n There were 133 patients in the NC and 135 in the HC
- primaryOutcome The primary outcome was the rate of follow up appointments.
- result At 5 year follow up, there was a single colorectal malignancy found in both groups.
ANZ J Surg · PMID 35429226 · Read it on PubMed ↗
Nagata et al. 2021
Identifying Bleeding Etiologies by Endoscopy Affected Outcomes in 10,342 Cases With Hematochezia: CODE BLUE-J Study
Painless bleeding often from hemorrhoids, ulcers, diverticulosis, or vesselsRetrospectiveModerate quality
10,342 people2021
Painless bleeding at presentation was significantly more common with certain conditions: rectal ulcers, hemorrhoids, abnormal blood vessels (angioectasia), radiation-related colitis, and diverticulosis
Who was studied
Adults admitted to hospital with sudden rectal bleeding (hematochezia) in Japan, mostly elderly
Main outcome
Which bleeding sources (found by colonoscopy) are linked to painless versus painful bleeding, and how outcomes differ by cause
Quality
It is a large multicenter study with colonoscopy confirming causes in most cases, but it only included people sick enough to be hospitalized, and the design cannot prove cause and effect.
Limitations
Retrospective design, limited to outpatients who were admitted for acute hematochezia, so may not reflect people with milder painless bleeding who do not seek hospital care
Taken word for word from the abstract
- n analyzed 10,342 patients admitted for outpatient-onset acute hematochezia
- population Patients were mostly elderly population
- primaryOutcome whether presenting symptoms can differentiate the etiologies in patients with hematochezia
- result Higher rates of painless hematochezia at presentation were significantly associated with multiple diseases, such as rectal ulcer, hemorrhoids, angioectasia, radiation colitis, and diverticulosis.
Am J Gastroenterol · PMID 34388140 · Read it on PubMed ↗
Schult et al. 2021
Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study
Cancer often found without any bleedingRetrospectiveModerate qualityRelated question
42,554 people2021
Most cancers and advanced adenomas were found in people who had no symptoms at all (60% of cancers and 76.5% of advanced adenomas in the sigmoidoscopy group were in asymptomatic people). Rectal bleeding, when present, was linked to higher odds of a cancer or advanced adenoma being found, but it was not required for them to be present.
Who was studied
Adults aged 50 to 74 having colorectal cancer screening (colonoscopy or sigmoidoscopy), some with and some without bowel symptoms
Main outcome
Whether bowel symptoms, including rectal bleeding, were linked to finding cancer or advanced polyps
Quality
It is a large study from a randomised screening trial, but it is cross-sectional and looked at a general screening population rather than people specifically presenting with painless bleeding.
Limitations
Cross-sectional design cannot show cause and effect; symptoms were recorded by the endoscopist, which may introduce bias; the population is screening attendees, not people specifically seeking care for painless bleeding.
Taken word for word from the abstract
- population 42 554 men and women, aged 50-74 years, participating in a randomised CRC screening trial
- n 42 554 men and women, aged 50-74 years
- primaryOutcome Prevalence of bowel symptoms (rectal bleeding, change in bowel habits, diarrhoea, constipation, bloating, alternating bowel habits, general symptoms, other bowel symptoms) recorded by the endoscopist and their association with CRC and advanced adenomas
- result 120 (60%) out of 200 individuals with screen-detected CRC and 1301 (76.5%) out of 1700 with advanced adenoma were asymptomatic.
- result Rectal bleeding was associated with detection of CRC and advanced adenoma (OR 4.3, 95% CI 3.1 to 6.1 and 1.8, 95% CI 1.5 to 2.1, respectively)
- result However, the majority of individuals with these findings were asymptomatic.
BMJ Open · PMID 34210732 · Read it on PubMed ↗
Nakamura et al. 2021
Screening of chronic radiation proctitis and colorectal cancer using periodic total colonoscopy after external beam radiation therapy for prostate cancer
Cancer often found without any bleedingProspective cohortLow qualityRelated question
270 peopleup to 72 months
12 of 270 patients (4.4%) were diagnosed with colorectal cancer during follow-up; 8 of these 12 had not had any rectal bleeding
Who was studied
Men previously treated with radiation therapy for prostate cancer, undergoing repeated colonoscopy screening
Main outcome
How often colorectal cancer and radiation-related rectal inflammation were found on periodic colonoscopy
Quality
Single-center cohort with no comparison group and fewer and fewer patients returning for later colonoscopies, so the findings may not generalize well.
Limitations
Studied only men who had radiotherapy for prostate cancer, not the general population with painless rectal bleeding; number of patients completing later colonoscopies dropped sharply over time.
Taken word for word from the abstract
- population 270 patients who underwent external beam radiation therapy for prostate cancer were advised to receive periodic total colonoscopy screening annually
- n 270 patients who underwent external beam radiation therapy for prostate cancer
- primaryOutcome To investigate the incidence of colorectal cancer and chronic radiation proctitis after prostate radiotherapy using periodic total colonoscopy screening.
- result Twelve (4.4%) patients were diagnosed with colorectal cancer, including four invasive cancers, during a follow-up period. Eight of these 12 patients had not experienced rectal bleeding.
- followUp median of 14, 31, 42, 54 and 72 months after radiotherapy
Jpn J Clin Oncol · PMID 33889961 · Read it on PubMed ↗
Stratta et al. 2021
Conservative Treatment of Hemorrhoidal Disease
Hemorrhoids are the most common cause.Narrative reviewLow quality
size not given2021
Hemorrhoidal disease is identified as the most common cause of painless rectal bleeding during defecation, with or without prolapsing anal tissue
Who was studied
Adults with hemorrhoidal disease
Main outcome
Most common cause of painless rectal bleeding during defecation
Quality
This is a narrative review focused on treatment, not a dedicated study of causes of bleeding, and it provides no data or methodology to support how this conclusion about frequency was reached.
Limitations
Narrative review (not systematic), no original data presented on bleeding causes, authors note most underlying studies are uncontrolled case series.
Taken word for word from the abstract
- population patients complaining of early stages of the disease
- primaryOutcome the most common cause of painless rectal bleeding during defecation with or without prolapsing anal tissue
- result being the most common cause of painless rectal bleeding during defecation with or without prolapsing anal tissue
Rev Recent Clin Trials · PMID 33087033 · Read it on PubMed ↗

What actually helps, on this site

Treatments Dr. Kamrava performs for this:

Colonoscopy

More about the condition:

All 135 studiesEvery study that answered the question, with its design, size and result.

The other 129 studiesEverything else the search returned, including anything retracted.

Obata et al. 2026
Diffuse Cavernous Hemangioma of the Rectum Diagnosed after a 15-year History of Recurrent Gastrointestinal Bleeding: A Case Report
Rare benign vessel growth in rectumCase seriesVery low quality
1 people8 months after surgery
diagnosed with diffuse cavernous hemangioma of the rectum, a rare benign vascular lesion with dilated, tortuous vessels in the rectal wall
Who was studied
a 26-year-old woman with recurrent painless hematochezia since childhood
Main outcome
cause of long-standing painless rectal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or rule out other explanations.
Limitations
Only one patient was described, and the condition itself is described as rare, so findings may not generalize to most people with painless bleeding.
Taken word for word from the abstract
- population A 26-year-old woman was referred to our institution for the evaluation of microcytic anemia and recurrent painless hematochezia associated with defecation since childhood, persisting for over 15 years.
- primaryOutcome typically manifests in childhood with recurrent painless hematochezia
- result Lower gastrointestinal endoscopy revealed bluish-purple dilated and tortuous vessels throughout the rectum, accompanied by mucosal swelling and congestion.
- result leading to a diagnosis of DCHR
- n A 26-year-old woman was referred to our institution
- followUp Eight months after surgery, neither hematochezia nor anemia has recurred, and anorectal function has been well preserved.
Case Rep Gastroenterol · PMID 42924076 · Read it on PubMed ↗
Teeso et al. 2026
Incarcerated right inguinal Littre's hernia in a 30-year-old male: case report from a low-resource setting
Meckel's diverticulum can cause painless bleedingCase seriesVery low qualityRelated question
1 people2026
The abstract explains that Meckel's diverticulum, a congenital small-bowel pouch, can contain acid-producing tissue that erodes and bleeds, causing painless rectal bleeding, obstruction, inflammation or intussusception — but this particular patient's case presented as an incarcerated groin hernia, not with bleeding.
Who was studied
A 30-year-old man found to have Meckel's diverticulum (a congenital pouch in the small bowel) trapped in an inguinal hernia
Main outcome
Explaining why Meckel's diverticulum can cause painless rectal bleeding
Quality
This is a single case report whose only mention of painless bleeding is a general background statement about Meckel's diverticulum, not a finding from studying patients with that symptom.
Limitations
Single case report; the patient described did not present with painless rectal bleeding, so it cannot show how often or why bleeding occurs — it only restates general background knowledge about Meckel's diverticulum.
Taken word for word from the abstract
- n A 30-year-old male
- population A 30-year-old male with an incarcerated Littre's hernia in the right inguinal region was successfully treated with segmental ileal resection and primary anastomosis, followed by hernial repair.
- primaryOutcome complications such as painless rectal bleeding, intestinal obstruction, inflammation, and intussusception
- result Meckel's diverticulum typically presents in young men with symptoms arising from ectopic gastric mucosa, where acid-related ulceration leads to complications such as painless rectal bleeding, intestinal obstruction, inflammation, and intussusception.
Int J Surg Case Rep · PMID 42699895 · Read it on PubMed ↗
Ying et al. 2026
Clinical features of primary intestinal follicular lymphoma: A single-center retrospective study
Rare lymphoma can cause bleeding, usually with painRetrospectiveVery low qualityRelated question
8 people2026
Most patients (62.5%) had abdominal pain, and 62.5% had severe complications including gastrointestinal bleeding or bowel obstruction; patients without symptoms did well with watchful waiting, while those needing surgery for severe complications had worse outcomes
Who was studied
patients diagnosed with a rare type of intestinal lymphoma (primary intestinal follicular lymphoma), most with abdominal pain
Main outcome
clinical features, endoscopic findings, and outcomes of this lymphoma
Quality
This is a single-center case series of only 8 patients, which cannot reliably establish how common bleeding is or what causes it in the general population.
Limitations
Very small sample (8 patients), single-center, retrospective design, and most patients had abdominal pain rather than painless bleeding, so this does not directly address painless rectal bleeding.
Taken word for word from the abstract
- population We retrospectively analyzed the clinical, endoscopic, imaging, pathological, and long-term follow-up data of eight patients with primary intestinal follicular lymphoma who were admitted between January 2019 and August 2025.
- primaryOutcome To characterize the clinical features of primary intestinal follicular lymphoma and provide insights into its diagnosis and management.
- result Abdominal pain (62.50%) was the most common clinical manifestation, and 62.50% of patients presented with severe complications, including gastrointestinal bleeding or obstruction.
- result Asymptomatic patients were managed with a watch-and-wait strategy and had favorable outcomes, whereas patients requiring surgery because of severe complications associated with deeper infiltration had poorer outcomes.
- n eight patients with primary intestinal follicular lymphoma who were admitted between January 2019 and August 2025
J Int Med Res · PMID 42669783 · Read it on PubMed ↗
Gongloor et al. 2026
Imaging of ectopic gastric mucosa in Meckel's diverticulum: A case report and literature review
Painless bleeding from a bowel pouch (child)Case seriesLow qualityRelated question
1 people2026
A nuclear medicine scan identified Meckel's diverticulum (a pouch in the small intestine with stomach-type tissue) as the cause of painless rectal bleeding
Who was studied
a 10-year-old boy with painless rectal bleeding and vomiting/abdominal pain, not an adult
Main outcome
Cause of painless gastrointestinal bleeding
Quality
This is a single pediatric case report, so it cannot establish how common this cause is or apply broadly to adults.
Limitations
Single case in a child, not an adult; does not address prevalence or likelihood of this cause in the adult population asking about painless bleeding.
Taken word for word from the abstract
- population We report a case of a 10-year-old male who presented with painless hematochezia and melena
- intervention technetium-99m pertechnetate scintigraphy established the diagnosis of MD
- primaryOutcome the most common presentation being painless gastrointestinal bleeding in children under the age of 2 years
- result technetium-99m pertechnetate scintigraphy established the diagnosis of MD, which was confirmed surgically
- n a 10-year-old male
Radiol Case Rep · PMID 42656733 · Read it on PubMed ↗
Dasuki et al. 2026
Submucosal colonic hemangioma at the splenic flexure mimicking a neoplastic lesion: a rare case report and diagnostic challenge
Rare benign tumor mimicked cancerCase seriesLow quality
1 people2026
a rare benign blood vessel tumor (hemangioma) in the colon wall was found, which looked like a cancer on scans and biopsies but was confirmed benign after surgery
Who was studied
a 50-year-old man with a month of painless blood in his stool
Main outcome
what was causing the painless rectal bleeding
Quality
this is a single patient case report, so it cannot show how common this cause is, only that it can happen
Limitations
findings from one patient cannot be generalized to how common this cause is in people with painless bleeding
Taken word for word from the abstract
- population A 50-year-old male presented with a 1-month history of painless hematochezia.
- primaryOutcome highlighting the diagnostic challenges associated with this unusual location
- result Histopathology confirmed a benign submucosal hemangioma.
- n A 50-year-old male presented with a 1-month history of painless hematochezia.
Int J Surg Case Rep · PMID 42578095 · Read it on PubMed ↗
Wen et al. 2026
Transverse colon incarceration and necrosis in a hiatal hernia: a case report
Trapped hernia caused bowel death and bleedingCase seriesVery low qualityRelated question
1 peopledischarged on day 11
A CT scan showed a large hiatal hernia with part of the colon trapped and losing blood supply; surgery confirmed the trapped bowel had died, and bleeding was due to this strangulated, necrotic colon
Who was studied
an 80-year-old woman admitted with vomiting, abdominal distension, and acid reflux, who then developed blood in her stool
Main outcome
the underlying cause of her bloody stool
Quality
This is a single case report, so it cannot show how common this cause is or whether it applies to people without other symptoms.
Limitations
Single patient case report; the bleeding occurred alongside vomiting, abdominal distension, and acid reflux, not as an isolated painless symptom, so this does not describe painless rectal bleeding on its own.
Taken word for word from the abstract
- population An 80-year-old female was admitted with a 2-day history of vomiting, abdominal distension, and acid reflux.
- population Following admission, she developed hematochezia.
- n An 80-year-old female was admitted
- primaryOutcome An emergency contrast-enhanced CT scan revealed a Type IV hiatal hernia with the transverse colon herniated into the posterior mediastinum, accompanied by ischemic changes.
- result Emergency laparoscopic exploration confirmed necrosis of the incarcerated transverse colon.
- result the presence of hematochezia in this context is a distinct red flag for intestinal ischemia or necrosis
Int J Surg Case Rep · PMID 42578067 · Read it on PubMed ↗
Wu et al. 2026
Case Report: Progressive acquired ileal mesenteric venous malformation after right hemicolectomy: serial imaging evolution leading to delayed gastrointestinal bleeding
Rare vein abnormality after bowel surgeryCase seriesVery low qualityRelated question
1 peopleNot specified beyond resolution after surgery
A rare abnormal tangle of veins (acquired venous malformation) near the surgical site in the small intestine, developing years after right hemicolectomy, was found to be the source of painless rectal bleeding; surgery to tie off the abnormal vessels stopped the bleeding
Who was studied
50-year-old woman with painless rectal bleeding and anemia, years after right-sided colon cancer surgery
Main outcome
Cause of unexplained painless rectal bleeding
Quality
This is a single case report, so it cannot show how common this cause is or apply broadly to people with painless bleeding.
Limitations
Single patient case report; findings may not generalize; no comparison group; specific to a post-surgical anatomical situation.
Taken word for word from the abstract
- population A 50-year-old woman underwent curative right hemicolectomy for colon cancer in 2016. Four years later, she presented with recurrent painless hematochezia and anemia
- n A 50-year-old woman underwent curative right hemicolectomy
- primaryOutcome colonoscopy failed to identify the bleeding source
- result Exploratory surgery confirmed a localized venous plexus along the mesenteric border of the terminal ileum. Targeted ligation and suturing of the abnormal vessels resulted in complete resolution of bleeding.
Front Surg · PMID 42516499 · Read it on PubMed ↗
Mihailescu et al. 2026
Endovascular Treatment of an Iatrogenic Inferior Mesenteric Arteriovenous Fistula Presenting as Massive Lower Gastrointestinal Hemorrhage: A Case Report
Rare post-surgery vessel fistula caused bleeding; fixed by embolization.Case seriesVery low qualityRelated question
1 people4 years
The abnormal connection was successfully sealed; follow-up imaging at 8 months showed no recurrence, and the patient had no symptoms 4 years later
Who was studied
A 30-year-old woman who developed sudden heavy rectal bleeding one month after bowel surgery (left hemicolectomy)
What they received
Endovascular embolization (a glue mixture plus coils) to close an abnormal artery-to-vein connection in the lower bowel's blood vessels
Main outcome
Whether closing the abnormal vessel connection stopped the bleeding and prevented it from coming back
Quality
This is a report of a single patient, so it cannot tell us how common this cause is or how it compares to other causes of bleeding.
Limitations
Describes only one patient with a rare, surgery-related cause of bleeding (an iatrogenic arteriovenous fistula), and the bleeding described is massive rather than the mild, painless bleeding the question asks about.
Taken word for word from the abstract
- n a 30-year-old female
- population an iatrogenic inferior mesenteric artery arteriovenous fistula in a 30-year-old female, presenting with massive hematochezia 1 month after a left hemicolectomy
- intervention treated with n-butyl-2-cyanoacrylate mixed with ethiodized oil for arteriovenous connection occlusion followed by coil embolization of the feeding arteries
- primaryOutcome Follow-up imaging at 8 months showed no recanalization of the fistula, and she remains asymptomatic 4 years later
- result Follow-up imaging at 8 months showed no recanalization of the fistula, and she remains asymptomatic 4 years later
Case Rep Radiol · PMID 42488342 · Read it on PubMed ↗
Polachek et al. 2026
Reevaluating the rule of two's: Age and epidemiological variations in Meckel's diverticulum
In young children, painless bleeding often means Meckel's diverticulumRetrospectiveLow qualityRelated question
1,004 people2026
Children age 5 or younger with Meckel's diverticulum were more likely to present with painless rectal bleeding (38.9%), while children older than 5 more often had abdominal pain or vomiting and were diagnosed more often by CT scan
Who was studied
Children hospitalized with Meckel's diverticulum, from a national pediatric inpatient database and a single hospital's 20-year records
Main outcome
How symptoms, imaging, and hospital stay differed by age in children diagnosed with Meckel's diverticulum
Quality
This is a retrospective review of hospital records without a comparison group, so it can show patterns but not prove cause, and findings are in children, not adults.
Limitations
Retrospective design, pediatric population only, combines a national administrative database with a single-center cohort, no control group, and does not address adults or isolated painless bleeding without an underlying structural lesion
Taken word for word from the abstract
- population patients with a principal diagnosis of MD
- n A total of 1004 patients with a primary diagnosis of MD were identified in KID.
- primaryOutcome To evaluate the clinical characteristics, diagnostic modalities, and age-related variation of Meckel's diverticulum (MD)
- result patients ≤5 years more commonly presented with painless rectal bleeding (38.9%, p = 0.017) and underwent Meckel's scintigraphy more frequently (48.1%, p < 0.005). In contrast, patients >5 years more often presented with abdominal pain (61.3%) or vomiting (54.8%) and were more likely to undergo abdominal computed tomography (68.9%, p < 0.0001)
J Pediatr Gastroenterol Nutr · PMID 42487479 · Read it on PubMed ↗
Alswiket et al. 2026
An 18-Year-Old Man with Bleeding From a Meckel's Diverticulum of the Terminal Ileum Diagnosed by 99mTc-Pertechnetate Scintigraphy (Meckel's Scan)
Meckel's diverticulum found as causeCase seriesVery low quality
1 people2026
Diagnostic workup including CT, sigmoidoscopy, colonoscopy, EGD, and capsule endoscopy was normal; a Meckel's scan then identified a Meckel's diverticulum of the terminal ileum as the bleeding source, confirmed by surgery.
Who was studied
18-year-old man with painless rectal bleeding
Main outcome
cause of painless rectal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or rule out other causes in general.
Limitations
Only one patient; no comparison group; findings may not generalize to other people with painless rectal bleeding.
Taken word for word from the abstract
- n an 18-year-old male patient who presented to the emergency department
- population 4 episodes of fresh rectal bleeding, associated with dizziness, nausea, palpitations, and a loss of consciousness
- primaryOutcome A Meckel's scan eventually confirmed the presence of a Meckel's diverticulum
- result The patient underwent an extensive diagnostic workup, including computed tomography scan, sigmoidoscopy, colonoscopy, esophagogastroduodenoscopy, and capsule endoscopy, none of which revealed any abnormalities. A Meckel's scan eventually confirmed the presence of a Meckel's diverticulum on day 4 of admission, followed by a successful laparoscopic segmental resection on day 10 of admission.
Am J Case Rep · PMID 42430297 · Read it on PubMed ↗
Suleman et al. 2026
Schistosomal Colitis as an Uncommon Cause of Hematochezia in a School-Aged Boy: A Case Report
Parasite infection causing painless bleedingCase seriesVery low quality
1 people2026
Colonoscopy and biopsy showed colitis caused by schistosomal ova (a parasitic infection), and the boy improved after treatment with praziquantel
Who was studied
a 9-year-old boy presenting with painless hematochezia and a history of residence in a schistosomiasis-endemic region
Main outcome
identifying the cause of painless rectal bleeding in a child from an endemic region
Quality
This is a single case report, so it cannot show how common this cause is, only that it is possible.
Limitations
Only one patient was described, from a region where this parasite is common, so the finding may not apply elsewhere.
Taken word for word from the abstract
- n a 9-year-old boy
- population a 9-year-old boy presenting with painless hematochezia and a history of residence in a schistosomiasis-endemic region
- primaryOutcome Colonoscopy revealed evidence of colitis, and histopathological examination of colon biopsy confirmed schistosomal ova with eosinophilic infiltration in the colonic mucosa
- result histopathological examination of colon biopsy confirmed schistosomal ova with eosinophilic infiltration in the colonic mucosa. The patient responded well to treatment with oral Praziquantel (40 mg/kg)
Clin Med Insights Pediatr · PMID 42290952 · Read it on PubMed ↗
Pinto et al. 2026
Cytomegalovirus (CMV) Colitis Complicated by a Stricture in an Immunocompetent Adult
CMV stricture, not bleeding.Case seriesVery low qualityRelated question
1 people2026
The patient had a colonic stricture that was initially thought to be cancer, rather than the usual signs of CMV colitis such as bleeding, diarrhea, fever or abdominal pain; tissue biopsy was needed to make the diagnosis.
Who was studied
an immunocompetent woman with CMV colitis
Main outcome
diagnosis of CMV colitis presenting with a colonic stricture
Quality
This is a single case report, so it cannot show how common or predictive any symptom is.
Limitations
Only one patient; no bleeding was present in this case, so it does not describe painless rectal bleeding.
Taken word for word from the abstract
- population We report a case of CMV colitis in an immunocompetent woman presenting with a colonic stricture initially presumed to be malignant rather than with the more typical features of abdominal pain, diarrhea, fever, and hematochezia.
- primaryOutcome We report a case of CMV colitis in an immunocompetent woman presenting with a colonic stricture initially presumed to be malignant rather than with the more typical features of abdominal pain, diarrhea, fever, and hematochezia.
- result We report a case of CMV colitis in an immunocompetent woman presenting with a colonic stricture initially presumed to be malignant rather than with the more typical features of abdominal pain, diarrhea, fever, and hematochezia.
- n We report a case of CMV colitis in an immunocompetent woman presenting with a colonic stricture initially presumed to be malignant rather than with the more typical features of abdominal pain, diarrhea, fever, and hematochezia.
Cureus · PMID 42255849 · Read it on PubMed ↗
Napoles et al. 2026
An Uncommon Presentation of Heyde Syndrome: Absence of Visible Endoscopic Angiodysplasia With Resolution After Transcatheter Aortic Valve Replacement
Valve disease caused melena, not painless rectal bleedingCase seriesVery low qualityRelated question
1 people6 months
Her anemia and bleeding resolved after TAVR, supporting Heyde syndrome as the cause even though no bleeding source (angiodysplasia) was ever seen on endoscopy
Who was studied
an elderly woman with severe aortic stenosis who had melena (black, tarry stool from upper GI bleeding) and fatigue, not painless rectal bleeding
What they received
transcatheter aortic valve replacement (TAVR) for her aortic stenosis
Main outcome
whether gastrointestinal bleeding and anemia resolved after valve replacement
Quality
This is a single patient's case report, so it cannot show how common this cause is or whether it applies to people with painless rectal bleeding in general.
Limitations
Single case report with no comparison group; von Willebrand factor testing was never done to confirm the diagnosis; the bleeding described was melena (upper GI bleeding) with associated fatigue and anemia, not the painless rectal bleeding being asked about here.
Taken word for word from the abstract
- n A 73-year-old woman
- population A 73-year-old woman with a history of AS, coronary artery disease, hypertension, type 2 diabetes, and anemia presented with 2 weeks of melena and 1 week of fatigue.
- intervention The patient underwent transcatheter aortic valve replacement (TAVR).
- primaryOutcome This case underscores the importance of considering HS in patients with severe AS and recurrent gastrointestinal bleeding even when angiodysplasia is not visualized.
- result At 6-month follow-up, she was asymptomatic, with resolution of anemia (hemoglobin 14 g/dL) and negative fecal occult blood testing.
- followUp At 6-month follow-up
Am J Case Rep · PMID 42104596 · Read it on PubMed ↗
Swain et al. 2026
Advanced adenomas among young endurance runners: A prospective hypothesis-generating prevalence study
Precancerous polyps found, no cancers, bleeding not assessedProspective cohortLow qualityRelated question
94 people2026
Advanced adenomas were found in 15.0% of the runners and no cancers were detected; this was higher than a historical 1.2% rate reported in asymptomatic screening-age adults.
Who was studied
endurance runners aged 35-50 who had not had a colonoscopy in 10 years (symptom status for bleeding not specified)
Compared with
historical prevalence of advanced adenomas in asymptomatic, average-risk adults aged 40-49 undergoing screening colonoscopy
Main outcome
prevalence of advanced adenomas (precancerous colon polyps) found on colonoscopy
Quality
This is a small, single-arm study with no concurrent control group, compared only to a historical rate, so it cannot show whether bleeding predicts cancer or polyps.
Limitations
Single-center, single-arm design compared to a historical (not concurrent) control group; participants were endurance runners, not people selected for or without rectal bleeding; authors call findings hypothesis-generating only.
Taken word for word from the abstract
- population participants had completed at least 2 ultramarathons (50 km or longer) or at least 5 marathons and had no colonoscopy within 10 years
- comparator Prevalence was compared with a 1.2% historical rate reported in asymptomatic, average-risk adults aged 40-49 undergoing screening colonoscopy.
- primaryOutcome We therefore prospectively estimated the prevalence of advanced adenomas in endurance runners aged 35-50 years.
- result Adenomas were found in 39 participants (41.5%), and advanced adenomas in 14 (15.0%; 95% binomial CI, 8.4-23.7%); no cancers were detected.
- n 94 participants (54.3% female; median age, 42 years) underwent colonoscopy
Cancer Epidemiol · PMID 42066739 · Read it on PubMed ↗
Keleidari et al. 2026
Massive gastrointestinal bleeding in fulminant amebic colitis: a case report
Bleeding from gut infection, not painlessCase seriesVery low qualityRelated question
1 people2026
the bleeding was caused by fulminant amebic colitis with invasive infection eroding blood vessels in the gut wall, and the patient also had fever, abdominal pain, and diarrhea rather than painless bleeding
Who was studied
a 27-year-old man with fever, abdominal pain, and diarrhea who developed severe rectal bleeding
Main outcome
cause of massive lower gastrointestinal bleeding
Quality
this is a single patient case report, so it cannot show how common this cause is or apply broadly to people with painless bleeding
Limitations
single case report; the patient had fever and abdominal pain, not the painless bleeding this question is about, and findings from one person cannot be generalized
Taken word for word from the abstract
- population a 27-year-old Iranian male with no prior medical history who presented with fever, right upper quadrant abdominal pain, and diarrhea, later complicated by hematochezia exceeding one liter
- primaryOutcome Massive lower gastrointestinal (GI) bleeding is an exceptionally uncommon manifestation of FAC
- result The pathophysiology involves mucosal invasion and vascular erosion by E. histolytica trophozoites, leading to hemorrhage
- result presented with fever, right upper quadrant abdominal pain, and diarrhea, later complicated by hematochezia exceeding one liter
- n a 27-year-old Iranian male
J Med Case Rep · PMID 41992365 · Read it on PubMed ↗
Motoyoshi et al. 2026
Acute hemorrhagic rectal ulcer after cardiac surgery: a case report
Rectal ulcers from poor blood flow caused painless bleedingCase seriesVery low quality
2 people2026
both patients developed sudden, painless rectal bleeding due to acute hemorrhagic rectal ulcers, thought to be caused by reduced blood flow to the rectal lining from illness, dialysis, blood thinners, and prolonged bed rest
Who was studied
men in intensive care after cardiac surgery, with diabetes and kidney failure on dialysis
Main outcome
cause of sudden painless rectal bleeding (hematochezia) after cardiac surgery
Quality
this is a report of just two patients with no comparison group, so it cannot show how common this cause is or confirm the mechanism, only that it can occur.
Limitations
only two cases, both in a very specific high-risk postoperative setting, so findings may not generalize to otherwise healthy people with painless bleeding.
Taken word for word from the abstract
- population a 64-year-old man on chronic hemodialysis for diabetic nephropathy, and the second, a 71-year-old man with similar comorbidities
- n We report two cases of AHRU occurring in the intensive care unit after cardiac surgery.
- primaryOutcome both developed sudden, painless hematochezia and hemorrhagic shock within 1 week postoperatively
- result both developed sudden, painless hematochezia and hemorrhagic shock within 1 week postoperatively. Endoscopy revealed ulcerative lesions 3-10 cm above the dentate line.
- result The pathogenesis of AHRU may involve ischemic mucosal injury related to diabetes, hemodialysis, anticoagulation, and prolonged supine positioning.
Int J Surg Case Rep · PMID 41837035 · Read it on PubMed ↗
Hu 2026
Exsanguinating jejunal Dieulafoy's hemorrhage: how failed embolization guided life-saving resection - a case report
Rare vessel defect caused severe painless bleeding.Case seriesVery low quality
1 peopledischarged on the fifth postoperative day
The bleeding was caused by a rare blood vessel abnormality (Dieulafoy's lesion) in the small intestine; it was found by angiography after endoscopy missed it, and surgery was needed after an attempt to block the vessel failed.
Who was studied
31-year-old woman with no major health problems who suddenly had heavy painless rectal bleeding and shock
Main outcome
underlying cause of sudden painless, severe rectal bleeding
Quality
This is a single patient's case report, so it cannot tell you how common this cause is or what usually happens to people with painless bleeding.
Limitations
Only one patient; findings from a single rare case cannot be generalized to most people with painless rectal bleeding.
Taken word for word from the abstract
- population A 31-year-old female without significant medical comorbidities acutely developed recurrent, high-volume hematochezia and hypotensive shock.
- primaryOutcome typically causing sudden, painless, and massive gastrointestinal hemorrhage that may present with intermittent, recurrent bleeding episodes
- result endoscopy failed to localize the bleeding source, which was later identified in the jejunum by angiography
- result Selective arterial embolization was implemented but failed to achieve hemostasis. Consequently, exploratory laparotomy with segmental jejunal resection of the Dieulafoy's lesion was performed.
- n A 31-year-old female without significant medical comorbidities
Int J Surg Case Rep · PMID 41837015 · Read it on PubMed ↗
Ventura Antunes et al. 2026
Giant GIST: an uncommon cause of acute gastrointestinal bleeding
Rare tumor caused sudden painless bleedingCase seriesVery low qualityRelated question
1 people2026
The bleeding was caused by a large gastrointestinal stromal tumour (GIST) that had eroded through the gut lining, despite the patient having only a painless mass and no pain
Who was studied
A woman in her 50s with a painless abdominal mass who had sudden, severe gastrointestinal bleeding
Main outcome
Cause of acute gastrointestinal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or compare it with other explanations.
Limitations
Single case; the bleeding described was acute and severe (haemorrhagic shock) with a palpable mass, not the milder, ongoing painless rectal bleeding the question is about.
Taken word for word from the abstract
- n a woman in her 50s
- population a woman in her 50s who presented to the emergency department with acute gastrointestinal bleeding
- population Physical examination revealed a painless mass in the right lower abdomen.
- primaryOutcome acute gastrointestinal bleeding
- result Despite originating within the smooth muscle layers, GISTs may erode the mucosa and cause acute gastrointestinal bleeding, presenting as haemorrhagic shock and requiring urgent surgical intervention.
BMJ Case Rep · PMID 41713892 · Read it on PubMed ↗
Zhang et al. 2026
Human Intestinal Spirochetosis as a Cause of Chronic Diarrhea in an Immunocompetent Patient: A Case Report
Gut infection caused diarrhea, not bleedingCase seriesVery low qualityRelated question
1 people2026
The patient was found to have human intestinal spirochetosis (a bacterial colonization of the colon) confirmed by colon biopsy, and symptoms resolved completely after a 10-day course of metronidazole
Who was studied
An immunocompetent adult with chronic watery diarrhea and weight loss, not rectal bleeding
Main outcome
Diagnosis of the cause of chronic diarrhea and weight loss
Quality
This is a single patient case report with no control group, so it cannot show how common this cause is or whether it applies to people with painless bleeding.
Limitations
Only one patient was studied, and that patient presented with diarrhea and weight loss, not with painless rectal bleeding, so the findings do not directly address the question asked.
Taken word for word from the abstract
- population an immunocompetent patient without risk factors presented with chronic watery diarrhea and unintentional weight loss of 3.18 kilograms after two months
- intervention The patient was treated with a 10-day course of metronidazole (500 mg, three times a day) with complete remission of diarrhea.
- primaryOutcome HIS was confirmed by biopsy through colonoscopy.
- result HIS was confirmed by biopsy through colonoscopy. The patient was treated with a 10-day course of metronidazole (500 mg, three times a day) with complete remission of diarrhea.
- n an immunocompetent patient without risk factors presented with chronic watery diarrhea
Cureus · PMID 41658837 · Read it on PubMed ↗
Deborah et al. 2025
Rectosigmoid Endometrioma Mimicking Rectal Hematoma: A Diagnostic Dilemma Managed Conservatively
Endometriosis caused rectal bleedingCase seriesVery low quality
1 people2025
A rare case where painless rectal bleeding was caused by endometrial tissue growing into the rectal wall (rectal endometrioma), initially mistaken for a rectal hematoma on colonoscopy; it improved with hormonal therapy
Who was studied
a 38-year-old multiparous woman with painless rectal bleeding and cyclical bowel habit changes
Main outcome
underlying cause of painless rectal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is, only that it is possible.
Limitations
Only one patient; findings cannot be generalized to how often this cause occurs in people with painless rectal bleeding.
Taken word for word from the abstract
- population We report the case of a 38-year-old multiparous woman who presented with painless hematochezia, cyclical alteration of bowel habits, and lower abdominal cramping pain.
- primaryOutcome Colonoscopy revealed a large intraluminal rectal lesion initially interpreted as a rectal hematoma.
- result Following multidisciplinary evaluation, a diagnosis of rectal endometrioma was favored.
- n a 38-year-old multiparous woman
Cureus · PMID 41625871 · Read it on PubMed ↗
Stirrat et al. 2026
Colitis cystica profunda: a systematic review
Rare benign lesion can mimic cancer, cause bleeding.Systematic reviewVery low qualityRelated question
92 peoplea median follow-up of 8.4 months
Counted as a related question: This study describes what colitis cystica profunda is and how it is diagnosed and treated, but does not explain why painless rectal bleeding occurs in adults with this or other common causes of the symptom.
Rectal bleeding was the most common symptom (70%), with mucus discharge, diarrhea, and pain also reported; 12% had no symptoms at all. A small share (4%) had cancer already present alongside the CCP, and 10% had precancerous changes, but no new cancers developed during follow-up.
Who was studied
Adults with a rare benign colorectal lesion called colitis cystica profunda (CCP), confirmed by biopsy
Main outcome
How CCP presents, is diagnosed, and is managed, and what happens to patients over time
Quality
This pools 65 small case reports and series of a rare condition, which carries a high risk of bias and cannot show how common CCP is among people with bleeding in general.
Limitations
Evidence comes from case reports and small series rather than a cohort of bleeding patients; short follow-up (median 8.4 months) and reliance on tissue sampling that often missed the lesion limit the findings.
Taken word for word from the abstract
- n Sixty-five studies (92 patients) met criteria.
- population Colitis cystica profunda (CCP) is an uncommon, benign colorectal lesion that can mimic malignancy.
- primaryOutcome We conducted a systematic review of histologically confirmed CCP case reports and series to define epidemiology, presentation, diagnostic yield, management, and outcomes.
- result Rectal bleeding (70%), mucus discharge (32%), diarrhea (24%), and abdominal/rectal pain (26%) were most common; 12% were asymptomatic.
- result Dysplasia was reported in 10% and coexisting invasive adenocarcinoma in 4% at diagnosis; no subsequent malignant transformation was reported over a median follow-up of 8.4 months.
- followUp median follow-up of 8.4 months
Eur J Gastroenterol Hepatol · PMID 41604561 · Read it on PubMed ↗
Takahashi et al. 2026
Uncommon cause of hematochezia in older adults: a solitary juvenile polyp in the transverse colon
Benign polyp caused the bleeding.Case seriesVery low quality
1 people2026
colonoscopy found a 12 mm polyp in the transverse colon that was bleeding; it was removed and testing confirmed it was a benign juvenile polyp with no cancer cells, and bleeding did not return
Who was studied
78-year-old woman with painless rectal bleeding (hematochezia) and no history of colonoscopy
Main outcome
identifying the cause of painless rectal bleeding
Quality
this is a single patient case report, so it cannot tell us how common this cause is or apply broadly to others with painless bleeding
Limitations
only one patient; findings cannot be generalized to other causes of painless rectal bleeding
Taken word for word from the abstract
- population A 78-year-old woman presented with hematochezia. She denied experiencing abdominal pain
- intervention the lesion was removed via endoscopic mucosal resection
- primaryOutcome To report a rare case of a solitary juvenile polyp in the transverse colon causing hematochezia in an older patient
- result Histological examination revealed the typical features of juvenile polyps, including stromal expansion, edema, inflammatory cell infiltration, and crypt dilation without cytological atypia. The surgical margins were negative. The patient remained asymptomatic after the procedure and experienced no recurrence of bleeding.
- n A 78-year-old woman presented with hematochezia.
J Rural Med · PMID 41568119 · Read it on PubMed ↗
Rahim et al. 2025
Duodenal metastases from lung adenocarcinoma causing gastrointestinal bleeding: a rare aetiology
Rare lung cancer spread caused bleedingCase seriesVery low qualityRelated question
1 people2025
the duodenal ulcer causing the bleeding was found to be a metastatic lesion from a primary lung adenocarcinoma, not a primary gastrointestinal cancer
Who was studied
an adult patient with gastrointestinal bleeding from a duodenal ulcer, cause not yet known
Main outcome
underlying cause of the gastrointestinal bleeding
Quality
this is a single case report, so it cannot show how common this cause is or apply broadly to people with rectal bleeding
Limitations
single case, bleeding source was the duodenum (upper gastrointestinal tract) rather than the rectum, and the abstract does not say whether the bleeding was painful or painless
Taken word for word from the abstract
- n We present a case of gastrointestinal bleeding secondary to a duodenal ulcer found to be a metastatic lesion from primary lung adenocarcinoma.
- population We present a case of gastrointestinal bleeding secondary to a duodenal ulcer found to be a metastatic lesion from primary lung adenocarcinoma.
- primaryOutcome found to be a metastatic lesion from primary lung adenocarcinoma
- result We present a case of gastrointestinal bleeding secondary to a duodenal ulcer found to be a metastatic lesion from primary lung adenocarcinoma.
- result patients are usually asymptomatic, presenting in advanced stages
BMJ Case Rep · PMID 41469173 · Read it on PubMed ↗
Naito et al. 2025
Bladder Herniation through the Obturator Foramen Treated with Laparoscopic Transabdominal Preperitoneal Repair Using a Contralateral 3D Max Mesh: A Case Report
Not relevant: bleeding was from colitisCase seriesVery low qualityRelated question
size not given2025
Her bleeding was explained by ischemic colitis (a painful bowel condition), not by the incidentally found bladder hernia; this case does not describe painless bleeding
Who was studied
74-year-old woman who had blood in her stool
Main outcome
cause of the rectal bleeding
Quality
A single case report where the bleeding was due to an excluded painful condition (ischemic colitis), not the painless bleeding this question asks about.
Limitations
Single patient; the bleeding symptom was attributed to ischemic colitis, which involves abdominal pain and is explicitly a different cause than the painless bleeding in question; the hernia itself was asymptomatic.
Taken word for word from the abstract
- population A 74-year-old female was diagnosed with an obturator bladder hernia.
- result The patient initially presented to the hospital with hematochezia and was diagnosed with ischemic colitis.
- result although she had no symptoms related to an obturator bladder hernia
- primaryOutcome The patient initially presented to the hospital with hematochezia and was diagnosed with ischemic colitis.
Surg Case Rep · PMID 41431606 · Read it on PubMed ↗
Román-Colón et al. 2025
The Use of the Fecal Immunochemical Test in the Acute-Care Hospital Setting
Blood-test misuse in sick patients, not a painless-bleeding study.RetrospectiveLow qualityRelated question
1,354 people2025
A positive stool blood test was linked to rectal bleeding, weakness, and diarrhea, and these patients were more likely to get gastroenterology referrals and endoscopy; most of these tests had been ordered inappropriately (not for cancer screening)
Who was studied
Patients who had a stool blood test (FIT) done in the emergency department or while admitted to a VA hospital
Main outcome
Whether a positive stool blood test was linked to symptoms and led to further testing
Quality
This is a retrospective single-center chart review of tests that were ordered outside their intended use, so it cannot reliably show what causes painless bleeding in healthy screening populations.
Limitations
Retrospective, single VA center (mostly men), tests were ordered off-label rather than for screening, and the population includes many symptomatic or acutely ill inpatients rather than people with isolated painless bleeding.
Taken word for word from the abstract
- population analyzing patients who underwent the FIT in the ED or while admitted to the VA Hospital from September 2013 through December 2016
- n Of the 1,354 patients included, most were men.
- primaryOutcome This study aimed to evaluate the clinical impact of FIT results when the test is used for purposes other than routine screening.
- result Positive FIT results were statistically significantly associated with rectal bleeding, weakness, and diarrhea.
- result Patients with positive tests often received gastroenterology consultations and were more likely to undergo endoscopic procedures.
- result None of the evaluated FITs were used for screening, confirming that they had been ordered inappropriately.
P R Health Sci J · PMID 41401088 · Read it on PubMed ↗
Han et al. 2025
Utilizing the EyeMax direct visualization system for the treatment of colonic diverticular bleeding: A case report
Diverticulum caused the bleedingCase seriesVery low qualityRelated question
1 people2025
Counted as a related question: This study tests a treatment for colonic diverticular bleeding (a specific cause of painless rectal bleeding), rather than investigating why painless rectal bleeding occurs or what causes it in adults generally.
Colonoscopy found the bleeding was coming from a small pouch (diverticulum) in the colon, and it was successfully treated, with no further bleeding seen
Who was studied
a 70-year-old man with sudden painless blood in the stool
Main outcome
finding and stopping the source of the bleeding
Quality
This is a single patient's case report, so it cannot tell us how common this cause is or compare it with other explanations.
Limitations
Only one patient; no comparison group; cannot be generalized to all people with painless rectal bleeding.
Taken word for word from the abstract
- n We present the case of a 70-year-old male with acute painless hematochezia.
- population a 70-year-old male with acute painless hematochezia
- primaryOutcome Colonoscopy is commonly performed in patients with colonic diverticular bleeding to identify and treat the source of bleeding
- result Colonoscopy showed active bleeding originating from a diverticulum, and the EyeMax direct visualization system was used in the treatment of the colonic diverticular bleeding. No further evidence of bleeding was observed at the end of the procedure.
World J Gastroenterol · PMID 41358171 · Read it on PubMed ↗
Mureb et al. 2025
Rectal Arteriovenous Malformations: A case report of a rare cause of Lower Gastrointestinal Bleeding
Rare vascular cause of bleedingCase seriesVery low quality
1 people2025
a rare vascular abnormality in the rectum (arteriovenous malformation) was found to be causing the bleeding, and the case report notes this condition often causes painless rectal bleeding
Who was studied
a 37-year-old man with rectal bleeding and blood in urine
Main outcome
identifying the cause of painless rectal bleeding
Quality
this is a single patient's case report, so it cannot tell you how common this cause is or how likely it is to explain your symptoms.
Limitations
only one patient described; findings cannot be generalized to how often this explains painless rectal bleeding in the wider population.
Taken word for word from the abstract
- population a case of a 37-year-old male with hematuria and recurrent rectal bleeding
- primaryOutcome detailing clinical presentation, diagnosis, and treatment strategies
- result Rectal arteriovenous malformation (AVMs) are a rare cause of lower gastrointestinal bleeding
- result symptoms often include painless rectal bleeding
- n a case of a 37-year-old male
Int J Surg Case Rep · PMID 41332049 · Read it on PubMed ↗
Kuhara et al. 2026
Delayed anastomotic leakage after short-course radiotherapy in a 91-year-old patient with rectal cancer
Bleeding plus malaise signaled a surgical leak, not painless bleeding aloneCase seriesVery low qualityRelated question
1 people17 months
The patient developed general tiredness and bloody stools together with a raised inflammation marker, and was found to have a late leak at the surgical join 17 months after surgery
Who was studied
A 91-year-old man who had surgery for rectal cancer after radiotherapy
Main outcome
Diagnosis of a delayed leak at the surgical bowel joint
Quality
This is a single patient's case report, so it cannot show how common this cause is or compare it to other causes.
Limitations
Single case; the bleeding occurred alongside general malaise and was tied to a specific postoperative complication in an elderly surgical patient, not painless bleeding alone in a general population.
Taken word for word from the abstract
- n A 91-year-old man with rectal cancer underwent preoperative SCRT
- population A 91-year-old man with rectal cancer underwent preoperative SCRT
- primaryOutcome colonoscopy identified an anastomotic posterior fistula, leading to DAL diagnosis
- result he presented with general malaise and hematochezia. C-reactive protein was elevated to a higher level than postoperative, and colonoscopy identified an anastomotic posterior fistula, leading to DAL diagnosis
- followUp Seventeen months postoperatively, he presented with general malaise and hematochezia
Clin J Gastroenterol · PMID 41273541 · Read it on PubMed ↗
Brown et al. 2025
An incidental finding of mesenteric hematoma in a patient with a new diagnosis of inflammatory bowel disease
Painless bleeding revealed new bowel diseaseCase seriesVery low qualityRelated question
1 people2025
workup for the painless bleeding uncovered a new diagnosis of ulcerative colitis, and surgery incidentally found a rare mesenteric hematoma thought to be caused by the bowel inflammation
Who was studied
a 10-year-old patient with painless rectal bleeding of unknown cause
Main outcome
cause of painless rectal bleeding
Quality
this is a single pediatric case report, so it cannot show how common this cause is or apply reliably to adults
Limitations
only one patient, a child rather than an adult, and the mesenteric hematoma itself is an extremely rare incidental finding not typical of most painless bleeding cases
Taken word for word from the abstract
- population The patient presented with painless hematochezia with unknown etiology
- n a 10-year-old patient with a new diagnosis of ulcerative colitis (UC)
- primaryOutcome presented with painless hematochezia with unknown etiology
- result colonoscopy with biopsy confirmed a diagnosis of UC
- result underwent an exploratory laparotomy when a mesenteric hematoma was incidentally found
- result We propose that the MH was a result of inflammation which caused microvascular bleeding/thrombotic events.
JPGN Rep · PMID 41245020 · Read it on PubMed ↗
Kanaya et al. 2025
Robotic-Assisted Resection of a Giant Sigmoid Colonic Lipoma: A Case Report
A colon lipoma caused the bleedingCase seriesVery low qualityRelated question
1 peopleeight-month follow-up
After years of asymptomatic surveillance, the lipoma became symptomatic, causing rectal mucosal prolapse together with bloody stool, which led to surgical removal; pathology confirmed it was a benign lipoma.
Who was studied
an elderly man with a large (about 5 cm) benign fatty tumor (lipoma) in the sigmoid colon
Main outcome
cause of the patient's bloody stool and rectal prolapse
Quality
This is a single case report of one patient, so it cannot show how often colon lipomas cause bleeding or how typical this presentation is.
Limitations
Only one patient; the abstract never states whether the bleeding was painless, and the tumor type (lipoma) is a specific, uncommon cause of bleeding, not representative of painless rectal bleeding generally.
Taken word for word from the abstract
- population An 85-year-old man with a history of open distal gastrectomy and chronic heart failure initially presented with rectal mucosal prolapse four years prior.
- n An 85-year-old man
- primaryOutcome accompanied by bloody stool
- result he experienced a recurrence of rectal mucosal prolapse accompanied by bloody stool, prompting the decision for elective surgery.
- result pathological analysis confirmed the diagnosis of a benign submucosal lipoma.
Cureus · PMID 41216047 · Read it on PubMed ↗
Tan et al. 2025
A rare case of primary transverse colon adenocarcinoma penetrating the abdominal wall
Cancer can grow without causing bleedingCase seriesVery low qualityRelated question
1 peopleone year
the abstract notes that colorectal cancer can progress from no symptoms at all to advanced symptoms such as rectal bleeding, and this particular patient's cancer was found not through bleeding but through an unusual external mass on the abdominal wall
Who was studied
a 78-year-old man with colon cancer that had grown through the abdominal wall
Main outcome
how colorectal cancer typically shows itself, from no symptoms to advanced symptoms like bleeding
Quality
this is a report of a single unusual patient, so it cannot tell us how often cancer causes bleeding or how often it doesn't.
Limitations
single case report of a rare presentation; does not specifically study or quantify painless rectal bleeding as a symptom of cancer
Taken word for word from the abstract
- population a 78-year-old male who had primary invasive transverse colon adenocarcinoma penetrating the abdominal wall
- result Its clinical presentation varies by stage, progressing from asymptomatic early disease to advanced symptoms (e.g., rectal bleeding, bowel habit alterations), while unusual manifestations may signal locally advanced disease.
- primaryOutcome Its clinical presentation varies by stage, progressing from asymptomatic early disease to advanced symptoms (e.g., rectal bleeding, bowel habit alterations)
- n a 78-year-old male
- followUp one year follow-up after the operation
Discov Oncol · PMID 41148446 · Read it on PubMed ↗
Kose 2025
Relapsing Chronic Immune Thrombocytopenia and Thrombosis: A Case Report
Low platelets (ITP) can cause bloody stoolCase seriesVery low qualityRelated question
1 people2025
The abstract describes ITP as a disease that can cause bruising, petechiae, purpura, nosebleeds, gum bleeding, heavy periods, blood in urine, and hematochezia (bloody stool), among other bleeding signs; the specific patient described presented with bruising and heavy menstrual bleeding, not painless blood in the stool alone, and her disease later caused blood clots.
Who was studied
a 21-year-old woman with immune thrombocytopenia (ITP), a disorder causing low platelet counts
Main outcome
what symptoms and complications occur in immune thrombocytopenia (ITP)
Quality
This is a single patient's case report, not a study of people with painless rectal bleeding, so it cannot show how common this cause is or how it compares to other causes.
Limitations
Single case report; the patient did not present with hematochezia specifically, and ITP typically causes multiple bleeding sites (bruising, gum bleeding) rather than isolated painless rectal bleeding, so this case does not represent the symptom in question.
Taken word for word from the abstract
- population a 21-year-old female who presented to the Emergency Room after experiencing several days of intermittent bruising and menorrhagia
- primaryOutcome others may experience easy bruising, petechiae, purpura, epistaxis, bleeding from the gums, menorrhagia, hematuria, melena, or hematochezia
- result others may experience easy bruising, petechiae, purpura, epistaxis, bleeding from the gums, menorrhagia, hematuria, melena, or hematochezia
- result She was found to have a platelet count of 16,000/μL and hemoglobin of 9.7 g/dL with a normal white blood cell count
- result This case was complicated by a recurrence of thrombocytopenia with bleeding despite corticosteroid treatment, followed by thrombosis in the setting of possible antiphospholipid syndrome
- n This is a case of a 21-year-old female
Cureus · PMID 41069887 · Read it on PubMed ↗
Zheng et al. 2025
Massive Gastrointestinal Hemorrhage in an Adult Caused by Meckel's Diverticulum: A Case Report
Rare bowel defect caused bleedingCase seriesVery low qualityRelated question
1 people2025
The bleeding was eventually traced to a Meckel's diverticulum with ectopic gastric tissue, found only after CT, endoscopy, and angiography failed to clearly localize it; combined laparoscopic and endoscopic surgery identified and removed it.
Who was studied
an adult man with sudden rectal bleeding (hematochezia), not stated whether painful or painless
Main outcome
finding the source of the gastrointestinal bleeding
Quality
This is a single patient's case report, so it cannot show how often this cause explains rectal bleeding in general.
Limitations
Single case only; the abstract does not state whether the bleeding was painless, and the presentation involved a large, rapid blood loss rather than the mild painless bleeding the question describes.
Taken word for word from the abstract
- population We report the case of a 41-year-old man presenting with hematochezia for one day.
- n a 41-year-old man
- primaryOutcome Mesenteric angiography successfully localized the bleeding vessels, but multiple embolization attempts were unsuccessful.
- result Laparoscopic intestinal resection was then performed, and postoperative pathological examination confirmed Meckel's diverticulum with ectopic gastric tissue.
Int Med Case Rep J · PMID 41036417 · Read it on PubMed ↗
Habte et al. 2025
Large colonic lipomas presenting as a rare cause of adult bowel obstruction and intussusception: A two-case surgical series
Colon lipoma caused pain, bleeding, blockageCase seriesVery low qualityRelated question
2 people2025
Both patients had large benign colon lipomas causing intussusception and obstruction; one man also had chronic abdominal pain along with blood in the stool, and surgery removed the lipomas with good recovery
Who was studied
two adult men with large colon lipomas causing bowel blockage
Main outcome
cause of bowel obstruction and intussusception
Quality
This is a report of just two patients with no comparison group, so it can only suggest a possible cause, not prove how common it is.
Limitations
Only two cases reported; the patient with bleeding also had chronic abdominal pain, so this does not describe painless bleeding specifically.
Taken word for word from the abstract
- population two cases of symptomatic colonic lipomas presenting with features of intussusception and bowel obstruction
- n We report two cases of symptomatic colonic lipomas
- primaryOutcome colonoscopy and CT imaging revealed a large lipoma of the ascending colon causing ileocolic intussusception
- result a 70-year-old male with chronic abdominal pain, hematochezia, and obstructive symptoms, in whom colonoscopy and CT imaging revealed a large lipoma of the ascending colon causing ileocolic intussusception
- result Postoperative courses were uneventful, with complete resolution of symptoms.
Int J Surg Case Rep · PMID 41027379 · Read it on PubMed ↗
Katunin et al. 2026
Presence of alarm symptoms at coeliac disease diagnosis is not associated with poorer long-term treatment outcomes
Not about painless bleeding causesRetrospectiveLow qualityRelated question
814 people9.7 years
Patients who had alarm symptoms (including rectal bleeding) at diagnosis ended up with similar long-term outcomes to those without, except they had more osteopenia/osteoporosis
Who was studied
Adults with coeliac disease, grouped by whether they had alarm symptoms (including rectal bleeding) at the time of diagnosis
What they received
Having alarm symptoms (anaemia, weight loss, dysphagia, vomiting, melaena, or rectal bleeding) at coeliac disease diagnosis
Compared with
Not having alarm symptoms at coeliac disease diagnosis
Main outcome
Long-term outcomes after years on a gluten-free diet, including symptoms, quality of life, bone health, and other complications
Quality
This looks at coeliac disease patients with a mix of alarm symptoms lumped together, not people with painless rectal bleeding specifically, so it barely speaks to this question.
Limitations
Retrospective record review combined with a single cross-sectional interview/blood draw, and rectal bleeding was not analyzed separately from other alarm symptoms like anaemia or weight loss.
Taken word for word from the abstract
- n 814 adult patients with CeD
- population Patients were grouped by the presence or absence of alarm symptoms.
- intervention Alarm symptoms included anaemia, weight loss, dysphagia, vomiting, melaena, and rectal bleeding.
- comparator Patients were grouped by the presence or absence of alarm symptoms.
- primaryOutcome We studied the prevalence of alarm symptoms at diagnosis and their association with outcomes.
- result patients with alarm symptoms had a higher incidence of osteopenia/osteoporosis, but generally did not demonstrate poorer long-term outcomes compared to those without alarm symptoms.
- followUp a median of 9.7 years on a gluten-free diet (GFD)
Eur J Gastroenterol Hepatol · PMID 40991679 · Read it on PubMed ↗
Mendil et al. 2025
[Ileal diverticulitis, a rare etiology of digestive bleeding]
Rare bowel diverticulitis caused bleedingCase seriesVery low qualityRelated question
size not given2025
a rare condition called small bowel (ileal) diverticulitis was identified as the cause of the bleeding, diagnosed with CT angiography
Who was studied
older adults with small bowel diverticulosis (a condition that is usually symptom-free)
Main outcome
cause of gastrointestinal bleeding
Quality
this is a single case report, so it cannot show how common or how likely this cause is for people in general.
Limitations
single case report; small bowel diverticulosis is described as 'predominantly asymptomatic' but this case involved diverticulitis (inflammation), which is usually associated with pain, not the painless bleeding being asked about here.
Taken word for word from the abstract
- population Small bowel diverticulosis is a rare and predominantly asymptomatic condition that mainly affects elderly individuals.
- primaryOutcome In cases of suspected bleeding, CT angiography is recommended to diagnose, localize, and assess the severity of the hemorrhage.
- result Hemorrhagic complications, though rare, can be life-threatening.
Rev Med Liege · PMID 40931729 · Read it on PubMed ↗
Zhong et al. 2025
Rare primary anorectal malignant melanoma presenting with painless hematochezia: a case report
Rare cancer caused the bleedingCase seriesVery low quality
1 people3 months
the bleeding was caused by a rare anorectal malignant melanoma, a type of cancer, found at the anorectal junction
Who was studied
a 51-year-old woman with painless blood in her stool
Main outcome
underlying cause of persistent painless rectal bleeding
Quality
this is a single patient case report with no comparison group, so it cannot show how often this cause occurs, only that it can happen
Limitations
only one patient; findings cannot be generalized to typical causes of painless rectal bleeding
Taken word for word from the abstract
- n a 51-year-old woman
- population presenting with persistent bright red blood in her stool
- primaryOutcome a high suspicion of rectal cancer was initially raised
- result histopathological evaluation of biopsy specimens revealed immunohistochemical positivity for MelanA, S100, and Ki-67 (~30%), suggesting a probable diagnosis of malignant melanoma
Front Oncol · PMID 40909963 · Read it on PubMed ↗
Srisan et al. 2025
Meckel's diverticulum: differences in clinical features between children and adults
Meckel's diverticulum can cause bleeding, especially in kidsRetrospectiveLow qualityRelated question
123 people2025
In children, lower GI bleeding was the most common symptom of Meckel's diverticulum (52.1% of symptomatic cases), while in adults diverticulitis (often painful) was the most common presentation (46.7%), with bleeding seen in only 20%
Who was studied
Patients with Meckel's diverticulum, both children and adults, from two tertiary hospitals
Main outcome
Clinical presentation (bleeding, obstruction, diverticulitis, etc.) of Meckel's diverticulum, compared between children and adults
Quality
Retrospective chart review from two hospitals without control group or information on whether bleeding was painless, so it can only loosely support reasoning about causes of painless bleeding.
Limitations
Retrospective design, mixed pediatric and adult population, does not specify whether bleeding was painless, and includes painful presentations like diverticulitis and obstruction.
Taken word for word from the abstract
- population Patients with MD were retrospectively reviewed from two tertiary hospitals (2002-2021).
- n A total of 123 cases with MD (69 children vs 54 adults) were studied.
- primaryOutcome The objectives were to describe and to compare the clinical features of patients with MD in terms of demographic data, clinical presentation, investigations, treatment, histopathology, and postoperative complications between children and adults.
- result Lower GI bleeding was the most common presentation (52.1%), followed by obstruction (29.1%), umbilical problems (10.4%), and diverticulitis (8.3%).
- result Diverticulitis was the most common presentation (46.7%), followed by obstruction (30.0%), GI bleeding (20.0%), and umbilical problems (3.3%).
Pediatr Surg Int · PMID 40906021 · Read it on PubMed ↗
Ren et al. 2025
Case Report: Surgical management and prognostic factors in primary anorectal melanoma: a retrospective analysis of nine cases
Rare cancer can cause bleeding or no symptomsCase seriesLow qualityRelated question
9 peoplemedian 19 months
Only about 44% had blood in the stool, about 22% had a feeling of needing to strain, and about 11% had no symptoms at all; the cancer often looked like common benign anorectal problems and was frequently misdiagnosed at first
Who was studied
Adults with primary anorectal melanoma (a rare cancer) who had surgery
Main outcome
What symptoms patients had when first diagnosed with this rare anorectal cancer
Quality
This is a very small retrospective case series of only 9 patients with a rare cancer, so it cannot reliably show how common bleeding is as a symptom.
Limitations
Very small sample (9 patients), retrospective design, and it studies a specific rare cancer type rather than the general causes of painless rectal bleeding; pain status of the bleeding is not specified.
Taken word for word from the abstract
- n 9 patients (1 male, 8 females; median age 59 years)
- population A retrospective analysis was conducted on 9 patients (1 male, 8 females; median age 59 years) with histopathologically and immunohistochemically confirmed ARMM who underwent surgical resection
- primaryOutcome Common presenting symptoms were hematochezia (44.4%), tenesmus (22.2%), altered bowel habits, anal mass protrusion, or were asymptomatic (11.1% each).
- result Primary Anorectal malignant melanoma (pARMM) often presents with symptoms mimicking common benign anorectal conditions, leading to frequent diagnostic errors.
- followUp median 19 months, up to May 2025
Front Med (Lausanne) · PMID 40672835 · Read it on PubMed ↗
Jha et al. 2025
Unveiling the hidden cause behind painless lower gastrointestinal bleeding in an adult - Meckel's Diverticulum: A case report
Meckel's Diverticulum found as hidden causeCase seriesVery low quality
1 people2025
CT scan found Meckel's Diverticulum as the cause; normal blood tests, endoscopy, colonoscopy and ultrasound had missed it
Who was studied
a 30-year-old man with painless rectal bleeding for two weeks, with similar episodes over three years
Main outcome
identifying the cause of painless rectal bleeding
Quality
This is a single patient's case, so it cannot show how common this cause is or apply broadly to others with the same symptom.
Limitations
Single case report; findings from one patient cannot be generalized to show how often this cause explains painless rectal bleeding.
Taken word for word from the abstract
- population A 30-year-old male presented with painless per rectal bleeding for 2 weeks.
- primaryOutcome Contrast Enhanced Computed Tomography (CECT) of the abdomen and pelvis confirmed the diagnosis of Meckel's Diverticulum, for which wedge resection was done.
- result Routine baseline blood investigations, endoscopy, colonoscopy, and abdominal ultrasonography were normal.
- result Contrast Enhanced Computed Tomography (CECT) of the abdomen and pelvis confirmed the diagnosis of Meckel's Diverticulum, for which wedge resection was done.
- n A 30-year-old male presented with painless per rectal bleeding for 2 weeks.
Int J Surg Case Rep · PMID 40627878 · Read it on PubMed ↗
Merchan et al. 2025
Cavernous Hemangioma of the Anal Canal Mimicking a Neoplasm: A Rare Cause of Lower Gastrointestinal Bleeding Successfully Treated With Transanal Excision
Rare vascular growth caused bleeding.Case seriesVery low quality
1 peoplethree-month follow-up
the bleeding was caused by a rare benign vascular growth (cavernous hemangioma) in the anal canal, which resolved after surgical removal
Who was studied
a 75-year-old woman with a one-year history of painless rectal bleeding
Main outcome
identifying the cause of painless rectal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or apply broadly to people with painless bleeding.
Limitations
Only one patient was described, so findings may not generalize.
Taken word for word from the abstract
- population a 75-year-old female patient with a one-year history of painless rectal bleeding
- primaryOutcome Histopathological examination after biopsy confirmed the diagnosis of cavernous hemangioma.
- result Definitive treatment was achieved through transanal full-thickness excision, with complete resolution of symptoms and no recurrence at the three-month follow-up.
- n a 75-year-old female patient
Cureus · PMID 40525030 · Read it on PubMed ↗
Liu et al. 2025
Acute Hemorrhagic Rectal Ulcer in a Uremic Patient: A Case Report and Literature Review
Rare ulcer caused bleeding in dialysis patientCase seriesVery low quality
1 people2025
The bleeding was caused by a rare acute hemorrhagic rectal ulcer, worsened by uremia (kidney failure) and blood-thinning from dialysis
Who was studied
An elderly woman with kidney failure on dialysis who had painless rectal bleeding
Main outcome
What caused the painless rectal bleeding
Quality
This is a report of a single patient, so it cannot show how common this cause is or apply broadly.
Limitations
Only one patient was described, she had many other health problems, and she ultimately died of unrelated heart and organ failure, making it hard to draw general conclusions.
Taken word for word from the abstract
- population A 78-year-old female with ESRD presented with rectal bleeding.
- primaryOutcome Acute hemorrhagic rectal ulcer (AHU) is a rare but severe cause of painless lower GI bleeding, mainly in elderly patients with comorbidities.
- result Uremia, anticoagulation, and comorbidities fueled bleeding.
- n A 78-year-old female with ESRD presented with rectal bleeding.
Hemodial Int · PMID 40506688 · Read it on PubMed ↗
Prager et al. 2025
Jejunal Ectopic Pancreas: A Case Report and Literature Review
Painful abdominal mass case, not painless bleeding.Case seriesVery low qualityRelated question
1 people2025
Surgery removed a jejunal mass that turned out to be benign ectopic pancreatic tissue; the abstract notes that in general, ectopic pancreas can sometimes cause hematochezia, but this particular patient's presenting symptoms were pain and nausea, not painless bleeding.
Who was studied
a 53-year-old man undergoing chemotherapy and radiation for a nasopharyngeal cancer, who had abdominal pain, nausea, and loss of appetite
Main outcome
cause of a small bowel mass found during work-up of abdominal pain and nausea
Quality
A single case report of one patient with painful symptoms cannot establish what causes painless bleeding in the general population.
Limitations
Single case report; the patient's presentation was painful abdominal symptoms, not the painless rectal bleeding this question asks about.
Taken word for word from the abstract
- n The patient is a 53-year-old Caucasian male undergoing chemotherapy and radiation for a nasopharyngeal Epstein-Barr virus-positive carcinoma.
- population The patient is a 53-year-old Caucasian male undergoing chemotherapy and radiation for a nasopharyngeal Epstein-Barr virus-positive carcinoma.
- population He presented to the urgent care with two days of sharp upper abdominal pain and nausea without association of symptoms to prior chemotherapy treatments.
- primaryOutcome This case report describes a rare etiology of a symptomatic small bowel mass that had been causing our patient spontaneous abdominal pain, nausea, and loss of appetite.
- result Pathology demonstrated benign ectopic pancreatic tissue invading through the serosa into the muscularis propria with the sampled lymph nodes negative for malignancy.
- result Most cases are asymptomatic, but epigastric pain is the most common symptom, followed by nausea, vomiting, and hematochezia.
Cureus · PMID 40443604 · Read it on PubMed ↗
Gu et al. 2025
Rectal arterial embolization for hemostasis of acute hemorrhagic rectal ulcers: A case series
Rectal ulcers can cause sudden painless bleedingCase seriesLow qualityRelated question
6 people2025
The abstract describes acute hemorrhagic rectal ulcer (AHRU) as a cause of sudden, painless, massive rectal bleeding, and reports that rectal arterial embolization achieved clinical success in stopping bleeding in all 6 patients, with rebleeding in 2 of 6 cases.
Who was studied
adults with acute hemorrhagic rectal ulcer causing sudden, painless, massive rectal bleeding
Main outcome
identifying and treating the source of painless rectal bleeding
Quality
This is a small case series of only six patients from a single center describing a treatment, so it offers weak evidence about causes of painless bleeding in general.
Limitations
Very small sample (6 patients), single-center, case series design, and the focus is on a treatment procedure rather than systematically explaining causes of painless rectal bleeding.
Taken word for word from the abstract
- population sudden onset, painless, massive, and fresh rectal bleeding
- n six patients with massive AHRU-related bleeding
- result Technical success was achieved in 83% (5/6) of cases, with clinical success was achieved in 100% cases (6/6).
- result Rebleeding after initial RAE procedure occurred in 33% (2/6) of cases
- primaryOutcome Acute hemorrhagic rectal ulcer (AHRU), though a relatively rare etiology of lower gastrointestinal bleeding, represents a critical clinical emergency characterized by sudden onset, painless, massive, and fresh rectal bleeding.
Sci Prog · PMID 40388936 · Read it on PubMed ↗
Weissman et al. 2025
Cytomegalovirus-Associated Septic Shock Leading to Disseminated Intravascular Coagulation
Severe infection caused bleeding, not painless on its ownCase seriesVery low qualityRelated question
1 peopleThree weeks of antiviral therapy with improvement before discharge
The bleeding occurred alongside a severe cytomegalovirus (CMV) infection that caused septic shock and a bleeding/clotting disorder (disseminated intravascular coagulation); treating the CMV infection with antiviral therapy and supportive care led to recovery
Who was studied
A 58-year-old woman with chronic kidney disease, kidney inflammation (membranous glomerulonephritis), and diabetes who had weakness, watery diarrhea, and rectal bleeding
Main outcome
What caused the rectal bleeding and the patient's rapid deterioration
Quality
This is a single patient case report, so it cannot show how common this cause is or apply broadly.
Limitations
Single case report in an immunosuppressed patient with multiple serious comorbidities and other symptoms (confusion, fever, diarrhea, hypotension) alongside the bleeding, not an otherwise well person with painless bleeding alone.
Taken word for word from the abstract
- population a 58-year-old woman with stage IIIb chronic kidney disease, membranous glomerulonephritis, and diabetes mellitus who presented with profound weakness, watery diarrhea, and rectal bleeding
- n a 58-year-old woman
- primaryOutcome First managed for suspected infectious colitis, urinary tract infection, and acute kidney injury, she deteriorated quickly with confusion, hypotension, and fever.
- result CMV viral load was elevated, confirming the diagnosis of CMV-associated septic shock with DIC; the patient had an improved clinical response followed ganciclovir in conjunction with broad-spectrum antibiotics and extensive supportive care
- limitations Cytomegalovirus (CMV) is typically asymptomatic in the immunocompetent but can cause deadly complications in the immunosuppressed.
Cureus · PMID 40376379 · Read it on PubMed ↗
Ávalos-Herrera et al. 2025
[Jejunal diverticular disease: a rare cause of gastrointestinal bleeding]
Rare cause of massive, not painless, bleedingCase seriesVery low qualityRelated question
1 people2025
jejunal diverticular disease was identified as the cause of massive bleeding during exploratory laparotomy
Who was studied
48-year-old male patient with massive digestive bleeding of unknown origin
Main outcome
identifying the cause of the gastrointestinal bleeding
Quality
This is a single case report, so it cannot show how common this cause is or whether it applies to people without pain.
Limitations
Single case report of massive, symptomatic bleeding requiring embolization and emergency surgery, not the painless bleeding this question asks about; small bowel (jejunal) source rather than rectal bleeding.
Taken word for word from the abstract
- population A 48-year-old male patient presented with massive digestive bleeding of unknown origin
- primaryOutcome the objective of this study was to explore the approach to jejunal diverticular disease (JDD) with gastrointestinal bleeding
- result during which jejunal diverticular disease (JDD) of the small intestine was identified
- n A 48-year-old male patient presented with massive digestive bleeding of unknown origin
Rev Med Inst Mex Seguro Soc · PMID 40279471 · Read it on PubMed ↗
Zhang et al. 2025
Clinical diagnosis and treatment of abdominal inflammatory myofibroblastic tumors
Rare tumor can cause blood in stool.RetrospectiveLow qualityRelated question
26 people2025
colon and rectal IMT cases presented with intermittent blood in the stool, while bleeding in other locations was linked to other tumor sites; pain status for the hematochezia cases was not specified
Who was studied
adults with rare abdominal tumors (inflammatory myofibroblastic tumors), including some with colon or rectal tumors
Main outcome
clinical presentation and symptoms associated with abdominal IMT, including gastrointestinal bleeding
Quality
small, single-center, retrospective case series of only 26 patients with no comparison group, so it can only suggest a rare possible cause rather than prove how common it is.
Limitations
Single-center retrospective series with small numbers; does not specifically address whether the bleeding was painless, and the tumor type (IMT) is a rare cause rather than representative of typical painless rectal bleeding.
Taken word for word from the abstract
- population This retrospective cohort study included clinical data of 26 patients with abdominal IMT admitted to the First Hospital of Jilin University between January 2015 and December 2023.
- result The colon and rectal cases presented with intermittent hematochezia.
- primaryOutcome The clinical manifestations, pathological features, treatment methods, and prognoses were analyzed.
- n This retrospective cohort study included clinical data of 26 patients with abdominal IMT
Discov Oncol · PMID 40244559 · Read it on PubMed ↗
Saleem et al. 2025
Colonic malakoplakia
Rare condition found with no symptoms.Case seriesVery low qualityRelated question
1 people2025
a rare inflammatory colon condition (malakoplakia) was found incidentally in a woman with no symptoms at all during a routine screening colonoscopy, and the authors note it can sometimes be linked to colon cancer
Who was studied
an otherwise healthy woman undergoing a screening colonoscopy for colorectal cancer, found to have no symptoms
Main outcome
diagnosis of colonic malakoplakia and its association with colon cancer
Quality
this is a single patient case report, so it cannot show how common or predictive any symptom is in general.
Limitations
single case report with no comparison group; the patient had no symptoms at all, so this does not describe people with painless bleeding specifically.
Taken word for word from the abstract
- population an otherwise healthy woman undergoing a screening colonoscopy for colorectal cancer
- n We present a case report of asymptomatic colonic malakoplakia in an otherwise healthy woman
- primaryOutcome Colonic malakoplakia is a rare granulomatous inflammatory condition that can cause abdominal pain, diarrhoea and rectal bleeding and be associated with colon adenocarcinoma.
- result we emphasise the importance of thorough diagnostic and therapeutic evaluation even in asymptomatic patients
BMJ Case Rep · PMID 40132942 · Read it on PubMed ↗
Agarwal et al. 2025
Imaging and interventions in vascular malformations of the gastrointestinal tract
Vascular malformations are a possible cause of GI bleedingNarrative reviewLow qualityRelated question
size not given2025
Vascular malformations are a cause of GI bleeding; most are asymptomatic and found incidentally on imaging, but they can also cause anemia from occult blood loss, acute bleeding, or intussusception
Who was studied
People with gastrointestinal vascular malformations, not specifically defined by age or symptom status
Main outcome
Causes, imaging findings, and treatment of GI tract vascular malformations
Quality
This is a narrative review describing imaging and treatment of a rare condition in general, not a study designed to compare people with and without painless bleeding.
Limitations
It is a general review, not focused specifically on painless rectal bleeding, and does not separate painless from painful presentations or report original data on a defined population.
Taken word for word from the abstract
- population Vascular malformations of the gastrointestinal (GI) tract are a rare yet significant cause of GI bleeding, that can present at any age
- primaryOutcome we describe the various imaging findings of GI tract vascular malformations and available treatment options
- result While the majority of lesions may be asymptomatic and detected incidentally on imaging, they may also present with anemia if there is occult blood loss, as acute GI bleeding, or as lead points for intussusception.
Abdom Radiol (NY) · PMID 40095013 · Read it on PubMed ↗
Abboud et al. 2025
Large Friable Rectal Neuroendocrine Tumor Complicated by Hemorrhagic Shock: A Rare Case Report and Review of the Literature
rare tumor caused severe bleedingCase seriesVery low qualityRelated question
1 people2025
a large, high-grade rectal neuroendocrine tumor was found causing the bleeding and leading to shock
Who was studied
an 87-year-old man with chronic diarrhea who then had severe rectal bleeding
Main outcome
identifying the cause of the severe rectal bleeding
Quality
this is a single rare case report, so it cannot show how often this cause explains rectal bleeding in general.
Limitations
only one patient, bleeding was severe and associated with shock and cardiac arrest rather than the mild painless bleeding the question is about, and there was no comparison group.
Taken word for word from the abstract
- population an 87-year-old male who presented with chronic diarrhea and subsequently had severe hematochezia complicated by hemorrhagic shock and cardiac arrest and was diagnosed with a 7-cm high-grade friable rectal NET
- n an 87-year-old male
- primaryOutcome diagnosed with a 7-cm high-grade friable rectal NET
- result was diagnosed with a 7-cm high-grade friable rectal NET
JGH Open · PMID 39911296 · Read it on PubMed ↗
De Francesco et al. 2025
Chronic intestinal spirochaetosis and Giardia lamblia infection mimicking eosinophilic enterocolitis
Rare gut infection, not bleeding-focusedCase seriesVery low qualityRelated question
1 people2025
The abstract lists rectal bleeding as one of several possible symptoms of this gut infection, but the patient described in this case report had chronic watery diarrhea, not bleeding, and his symptoms and infection cleared after a course of metronidazole
Who was studied
an adult with a normal immune system who had long-term watery diarrhea, first caused by a spirochete infection of the gut and then by Giardia lamblia
Main outcome
symptom resolution and clearing of the infection after treatment
Quality
This is a single patient case report with no comparison group, so it cannot show how often or why bleeding happens in general.
Limitations
Single case report of one immunocompetent patient with diarrhea, not painless rectal bleeding; findings cannot be generalized to people with painless bleeding.
Taken word for word from the abstract
- population an immunocompetent patient with chronic watery diarrhoea caused by intestinal spirochaetosis followed by infection with Giardia lamblia
- primaryOutcome A full course of metronidazole led to the remission of symptoms and to the complete eradication of pathogens as shown by the follow-up histological assessment.
- result ranging from asymptomatic colonisation to symptoms such as chronic mucosal diarrhoea, rectal bleeding, and abdominal pain
- n an immunocompetent patient
Lancet Infect Dis · PMID 39855237 · Read it on PubMed ↗
Lu et al. 2024
Predictors of active and recurrent bleeding in upper gastrointestinal angiodysplasia: Results from 10-year esophagogastroduodenoscopy of a tertiary center in Taiwan
Not directly relevant: this is about upper-gut bleeding, not painless rectal bleedingRetrospectiveLow qualityRelated question
112 peoplenot clearly stated (described only as 'during the follow-up period')
Diabetes, chronic kidney disease, and lesions located in the duodenum were linked to a higher chance of active bleeding; about one in five patients who had bleeding treated went on to bleed again
Who was studied
patients found to have a vascular lesion (angiodysplasia) in the upper digestive tract during endoscopy in Taiwan
Main outcome
what predicts active or repeat bleeding from these upper gut vascular lesions
Quality
single-center retrospective chart review of a small group (112 patients) with no control group, so it mainly shows associations, not proof of cause
Limitations
retrospective design, single hospital, small number of cases, and this concerns upper gastrointestinal bleeding (vomiting blood or black stool) rather than painless blood from the rectum, which is the question asked
Taken word for word from the abstract
- population UGIA was diagnosed in 112 patients, and the data from these patients were comprehensively analyzed.
- n UGIA was diagnosed in 112 patients
- primaryOutcome We investigated the predictors of active and recurrent bleeding among patients with UGIA.
- result Multivariate analysis identified diabetes mellitus (DM), chronic kidney disease (CKD), and lesions in the duodenum as significant risk factors for active bleeding (P = .019; P = .006; P = .004).
- result rebleeding occurred in 6 (21.4%) patients during the follow-up period
- limitations Upper gastrointestinal angiodysplasia (UGIA) is a unique mucosal vascular lesion that causes acute or recurrent gastrointestinal bleeding.
Medicine (Baltimore) · PMID 39686487 · Read it on PubMed ↗
Gao et al. 2025
Meckel's diverticulum as a cause of gastrointestinal bleeding
Meckel's diverticulum caused painless bleedingCase seriesVery low quality
1 peoplenot specified beyond 'during follow-up'
a Meckel's diverticulum with a surface ulcer was found in the small intestine and was the source of the bleeding; bleeding stopped after it was surgically removed
Who was studied
a 32-year-old man with 4 years of intermittent painless blood in the stool
Main outcome
the cause of unexplained gastrointestinal bleeding
Quality
This is a single patient case report, so it cannot tell you how common this cause is, only that it is possible.
Limitations
Single case; findings may not generalize; diagnosis took years and multiple tests before the source was found.
Taken word for word from the abstract
- population A 32-year-old male was admitted to the Department of Gastroenterology due to a 4-year history of intermittent hematochezia.
- primaryOutcome Gastrointestinal (GI) bleeding is a major complication of Meckel's diverticulum.
- result Double-balloon enteroscopy via anal route was performed, and found a large diverticulum in the middle part of the ileum, which was marked by two metal clips, with a superficial ulcer on its inner wall. Thus, Meckel's diverticulum was diagnosed.
- result He did not develop any recurrent hematochezia during follow-up.
- n A 32-year-old male was admitted
Rev Esp Enferm Dig · PMID 39588961 · Read it on PubMed ↗
Bathobakae et al. 2024
Novelty in the gut: a review of the gastrointestinal manifestations of syphilis
Syphilis can sometimes cause rectal bleeding.Narrative reviewLow qualityRelated question
size not given2024
The review states that syphilis can spread to any part of the GI tract and can cause hematochezia (blood in stool) along with other symptoms like painless esophageal ulcers, melena, diarrhea, dyschezia, or anorectal ulcers, depending on which part of the gut is affected.
Who was studied
People infected with syphilis, especially those with gastrointestinal involvement
Main outcome
Gastrointestinal symptoms caused by syphilis, including rectal bleeding
Quality
This is a narrative review summarizing prior case reports and literature rather than a study that measured how often syphilis causes painless bleeding, so it offers limited, non-quantified evidence.
Limitations
It is a descriptive review, not a study of people presenting specifically with painless rectal bleeding; it does not say how often hematochezia from syphilis is painless or how common this cause is.
Taken word for word from the abstract
- population Syphilis is a systemic infection caused by the spirochete Treponema pallidum.
- primaryOutcome T. pallidum can seed to any part of the GI tract, resulting in esophagitis, gastritis, hepatitis, pancreatitis, or proctocolitis.
- result Depending on the affected part of the GI tract, syphilis can present with nausea, vomiting, painless esophageal ulcers, dysphagia, abdominal pain, weight loss due to early satiety, diarrhea, melena, hematochezia, dyschezia, or anorectal ulcers.
Scand J Gastroenterol · PMID 39540599 · Read it on PubMed ↗
Tasato et al. 2026
The volcano sign and mucus outflow by colonoscopy - Low grade appendiceal mucinous neoplasm
Painless bleeding traced to appendix tumorCase seriesVery low quality
1 people2026
colonoscopy found a cecal mass with the 'volcano sign' and mucus discharge from the appendix opening, diagnosed as a low grade appendiceal mucinous neoplasm
Who was studied
an 82-year-old woman with painless rectal bleeding
Main outcome
finding the cause of painless rectal bleeding on colonoscopy
Quality
This is a single patient case report, so it cannot show how often this cause explains painless bleeding in general.
Limitations
Only one patient was described, so the findings cannot be generalized to other people with painless rectal bleeding.
Taken word for word from the abstract
- population An 82-year-old woman presented with painless hematochezia.
- result The appendiceal orifice was identified in the center of the prominence, showing the volcano sign.
- result The pathological diagnosis was low grade appendiceal mucinous neoplasm, that is a clinical entity characterized by absence of infiltrative growth or destructive invasion.
- primaryOutcome Colonoscopy revealed a submucosal tumor-like mass in the cecum.
- n An 82-year-old woman presented with painless hematochezia.
Rev Esp Enferm Dig · PMID 39446110 · Read it on PubMed ↗
Wong et al. 2024
An uncommon case of anorectal malignant melanoma (ARMM): Clinical presentation and surgical outcome
Rare case: anal melanomaCase seriesVery low qualityRelated question
1 peopledischarged well on day 8 post-operatively
she was found to have a rare anorectal malignant melanoma, treated with extensive surgery; one lymph node was involved and she was referred for immunotherapy
Who was studied
a 61-year-old woman with anal pain for a year plus painless rectal bleeding after bowel movements and changed bowel habits
Main outcome
diagnosis and surgical outcome for the cause of her symptoms
Quality
this is a single patient case report, so it cannot show how common this cause is or confirm what explains painless bleeding in general
Limitations
Only one patient, who also had anal pain for a year (not painless bleeding alone), so it does not directly address painless bleeding without pain; a case report cannot establish frequency or causation.
Taken word for word from the abstract
- population A 61 years old lady presented with anal pain for 1 year, associated with painless fresh per rectal bleeding post defecation and altered bowel habit.
- n A 61 years old lady presented with anal pain for 1 year
- primaryOutcome CASE PRESENTATION
- result HPE came back as malignant melanoma, with 1 out 12 lymph nodes involved. She was subsequently referred to oncology, started on pembrolizumab immunotherapy.
Int J Surg Case Rep · PMID 39368308 · Read it on PubMed ↗
Fiordaliso et al. 2024
Colonic lipoma, a rare cause of intestinal intussusception: A narrative review and how to diagnose it
Rare colon tumor, usually causes pain tooNarrative reviewLow qualityRelated question
size not given2024
Rectal bleeding occurred in about 23% of reported colonic lipoma cases, but most patients also had abdominal pain (79%) and other symptoms like altered bowel habits; this review was not focused on bleeding without pain specifically.
Who was studied
people found in the medical literature to have colonic lipomas, a rare type of colon tumor
Main outcome
what symptoms colonic lipomas cause and how they are diagnosed
Quality
It is a narrative review of case reports and small series on a rare tumor, not a study designed to test whether painless bleeding points to this cause.
Limitations
Narrative (not systematic) review pooling case reports; most described patients had abdominal pain alongside bleeding, so it doesn't isolate painless bleeding as a symptom.
Taken word for word from the abstract
- population Colonic lipomas (CLs) are benign tumors of the adipose tissue of the gastrointestinal tract that are often asymptomatic.
- primaryOutcome Occasionally, patients present with intestinal bleeding or obstructive symptoms.
- result Symptoms included abdominal pain (79.2%), alterations in bowel habits (45.8%), rectal bleeding (22.9%), colocolic intussusception (50%), weight loss (6.2%), vomiting (14.6%), and nausea (12.5%).
Medicine (Baltimore) · PMID 39331924 · Read it on PubMed ↗
Pospisilova et al. 2024
Anorectal hemangioma, a rare cause of lower gastrointestinal bleeding, treated with selective embolization: A case report
Rare vascular lesion caused bleedingCase seriesVery low quality
1 people2024
the painless bleeding was caused by a rare vascular lesion (anorectal hemangioma) rather than ulcerative colitis, diagnosed with imaging showing specific vascular features
Who was studied
a 21-year-old man with painless rectal bleeding since childhood, initially misdiagnosed as ulcerative colitis
Main outcome
identifying the cause of painless lower GI bleeding
Quality
this is a single patient's case report, so it cannot show how common this cause is or apply broadly to others with painless bleeding
Limitations
only one patient, so findings may not generalize; diagnosis was initially missed and treatment for colitis given before the true cause was found
Taken word for word from the abstract
- population A 21-year-old male patient experienced painless rectal bleeding since childhood and was treated for ulcerative colitis.
- n A 21-year-old male patient
- primaryOutcome Anorectal hemangioma is a rare and frequently misdiagnosed cause of lower gastrointestinal (GI) bleeding.
- result Diagnostic studies later revealed specific characteristics for vascular lesions-anorectal hemangiomas.
World J Gastrointest Surg · PMID 39220052 · Read it on PubMed ↗
Chakroun et al. 2024
Non-specific presentation of metastatic small bowel adenocarcinoma with diagnostic challenges
Rare case: painless bleeding hid bowel cancer.Case seriesVery low quality
1 people2024
After extensive work‑up, his painless rectal bleeding and other non‑specific symptoms were eventually traced to a metastatic small bowel adenocarcinoma that was missed by standard gastroscopy and colonoscopy
Who was studied
a man in his 80s who had a single episode of painless rectal bleeding, anemia, weight loss and diarrhea without abdominal pain
Main outcome
eventual diagnosis of the underlying cause of his symptoms
Quality
This is a single patient case report with no comparison group, so it cannot show how common this cause is or prove cause and effect.
Limitations
Only one patient; retrospective case description; diagnosis delayed and cause of bleeding not directly visualized on endoscopy.
Taken word for word from the abstract
- n a man in his 80s
- population a man in his 80s who had asymptomatic mild iron-deficiency anaemia 1 year before diagnosis, with no active bleeding found on endoscopies
- primaryOutcome Push enteroscopy confirmed jejunum adenocarcinoma. CT scans detected liver and peritoneal metastases.
- result He experienced a single rectal bleeding episode 9 months prediagnosis, with subsequent severe iron-deficiency anaemia and no clear gastrointestinal source identified on gastroscopy.
- result Push enteroscopy confirmed jejunum adenocarcinoma. CT scans detected liver and peritoneal metastases.
BMJ Case Rep · PMID 39214581 · Read it on PubMed ↗
Hassine et al. 2024
Prostate carcinoma mimicking rectal cancer: a case report
Prostate cancer mimicking rectal cancerCase seriesVery low qualityRelated question
1 people2024
the bleeding and diarrhea were caused by prostate cancer that had spread into the rectum, mimicking rectal cancer
Who was studied
an 86-year-old man with diarrhea and occasional rectal bleeding, no urinary symptoms
Main outcome
identifying the cause of the rectal bleeding and diarrhea
Quality
this is a single patient case report with no comparison group, so it cannot show how common this cause is or confirm a general pattern.
Limitations
single case, patient also had diarrhea rather than painless bleeding alone, and the cause (prostate cancer invading the rectum) is a rare mimic rather than a typical cause of painless rectal bleeding.
Taken word for word from the abstract
- population an 86-year-old male, with no significant personal pathological history, who presented with diarrhea and occasional rectal bleeding without any lower urinary tract symptoms
- primaryOutcome Investigations concluded to a PC invading the rectum
- result Investigations concluded to a PC invading the rectum and the patient was referred to urology department.
- n an 86-year-old male
J Surg Case Rep · PMID 39211376 · Read it on PubMed ↗
Mallabar-Rimmer et al. 2024
Colorectal cancer risk stratification using a polygenic risk score in symptomatic primary care patients-a UK Biobank retrospective cohort study
Genetic plus symptom score helps flag cancer riskRetrospectiveModerate qualityRelated question
50,387 peoplewithin 2 years
A model combining a polygenic risk score, age, sex and reported symptoms predicted colorectal cancer diagnosis within 2 years with an AUC of 0.76 (95% CI 0.71-0.81) in the test group
Who was studied
Adults aged 40 and older with a colorectal cancer symptom recorded in their primary care record (not specifically limited to painless rectal bleeding)
Main outcome
Diagnosis of colorectal cancer within 2 years of first symptom presentation, predicted using a combined genetic and clinical risk model
Quality
Large UK Biobank cohort with a trained and tested model, but it is retrospective, relies on coded primary-care symptom data rather than confirmed painless bleeding, and shows only moderate predictive accuracy.
Limitations
The population includes people with any recorded CRC symptom, not specifically painless rectal bleeding, so it cannot show whether bleeding itself predicts cancer; it is a retrospective data study, not a symptom-focused clinical evaluation.
Taken word for word from the abstract
- population We conducted a retrospective cohort study of 50,387 UK Biobank participants with a CRC symptom in their primary care record at age 40+.
- n 50,387 UK Biobank participants
- primaryOutcome to predict CRC diagnosis within 2 years
- result An integrated risk model combining PRS, age, sex, and patient-reported symptoms was predictive of CRC development in a testing cohort (receiver operating characteristic area under the curve, ROCAUC: 0.76, 95% confidence interval: 0.71-0.81).
Eur J Hum Genet · PMID 39090236 · Read it on PubMed ↗
Boix Clemente et al. 2024
Intestinal spirochetosis: four cases with different clinical presentations
Rare gut infection caused bleeding and ulcer.Case seriesVery low qualityRelated question
4 people2024
One of four patients had rectal bleeding with a colonoscopy-visible ulcer linked to intestinal spirochetosis; two other patients were asymptomatic despite having the infection, and one had chronic diarrhea without bleeding
Who was studied
Adults undergoing colonoscopy, including some HIV-positive men, found to have intestinal spirochetosis
Main outcome
Cause of gastrointestinal symptoms, including rectal bleeding, in patients found to have intestinal spirochetosis
Quality
This is a report of only four cases, so it cannot show how common this cause is or whether the bleeding was painless.
Limitations
Very small case series, pain status not described for the bleeding case, and population mostly HIV-positive men who have sex with men rather than general adults with painless bleeding
Taken word for word from the abstract
- n We present 4 clinical cases of intestinal spirochetosis.
- population The second is homosexual, HIV+, presents rectal bleeding, colonoscopy shows a straight ulcer and spirochete biopsies show negative treponema PCR.
- primaryOutcome The majority are asymptomatic cases but could cause lesions including ulcerations and symptoms.
- result presents rectal bleeding, colonoscopy shows a straight ulcer and spirochete biopsies show negative treponema PCR
- result The third was also homosexual, HIV+, asymptomatic, with a chance finding of spirochetosis.
Rev Esp Enferm Dig · PMID 39087657 · Read it on PubMed ↗
Kim et al. 2024
An Asymptomatic Sigmoid Colonic Fistula Arising from a Large Aneurysm of the Internal Iliac Artery Was Discovered during a Medical Examination
Rare artery-colon fistula caused silent bleedingCase seriesVery low qualityRelated question
1 peopleapproximately one week post-operative
A large artery aneurysm had formed a fistula into the colon, causing silent blood loss; the man had no pain and did not notice blood in his stool because he used a bidet
Who was studied
77-year-old man with no symptoms, found to have severe anemia on routine exam
Main outcome
cause of unexplained severe anemia found on a routine check-up
Quality
This is a single case report of one patient, so it cannot show how common this cause is.
Limitations
Single case; the patient specifically did not notice hematochezia (he used a bidet, masking visible blood), so this case does not represent the population of people who notice painless blood in the stool.
Taken word for word from the abstract
- n A 77-year-old man presented at a local hospital for a general medical examination.
- population Although the blood reports revealed severe anemia, the patient did not complain of any associated symptoms including dizziness and hematochezia.
- primaryOutcome computed tomography (CT) revealed a large right internal iliac artery aneurysm
- result there was no evidence of hematochezia, as the patient had been using a bidet
- result a fistula tract, devoid of any infectious bacteria such as tuberculosis, was found in the specimen after colon resection
Medicina (Kaunas) · PMID 39064481 · Read it on PubMed ↗
Flamm 2024
Key Insights and Clinical Pearls in the Identification and Management of Cirrhosis and Its Complications
Not relevant to painless rectal bleedingNarrative reviewLow qualityRelated question
size not given2024
This review describes clinical clues for recognizing cirrhosis and discusses management of its complications, including variceal bleeding, hepatic encephalopathy, and ascites; it does not address painless rectal bleeding or hematochezia as a presenting symptom in people without known liver disease.
Who was studied
Adults with cirrhosis, including those in an asymptomatic compensated phase
Main outcome
Identifying and managing cirrhosis and its complications such as hepatic encephalopathy, ascites, and variceal bleeding
Quality
It is a narrative review of cirrhosis care and does not study or report on painless rectal bleeding, so it cannot answer this question.
Limitations
Topic is cirrhosis and its complications generally; variceal bleeding discussed is an upper GI bleeding complication of advanced liver disease, not the painless lower GI bleeding this question asks about.
Taken word for word from the abstract
- population Cirrhosis is a prevalent, chronic condition with an asymptomatic compensated phase, in which patients may feel well
- primaryOutcome Early recognition and management of cirrhosis-related complications (eg hepatic encephalopathy, ascites, and/or variceal bleeding) are important, given their association with hospitalization and poor prognosis (eg increased odds of short-term mortality).
- result Early recognition and management of cirrhosis-related complications (eg hepatic encephalopathy, ascites, and/or variceal bleeding) are important, given their association with hospitalization and poor prognosis (eg increased odds of short-term mortality).
Am J Med · PMID 38788826 · Read it on PubMed ↗
Do et al. 2024
Mucosal prolapse syndrome mimicking Peutz-Jeghers syndrome in a pediatric patient
Benign prolapse mimicked a polyp syndrome.Case seriesVery low qualityRelated question
1 people1 year
The bleeding and polyps were due to mucosal prolapse syndrome, a benign condition that can mimic Peutz-Jeghers syndrome on initial biopsy
Who was studied
A 15-year-old boy with painless rectal bleeding
Main outcome
Cause of painless rectal bleeding and rectal polyps
Quality
A single pediatric case report cannot establish how common any cause of painless bleeding is in the general population.
Limitations
Single case, pediatric patient, initial misdiagnosis before a repeat colonoscopy a year later clarified the diagnosis.
Taken word for word from the abstract
- population a 15-year-old male who presented with painless rectal bleeding
- n a 15-year-old male
- primaryOutcome He was found to have four rectal polyps thought to be due to Peutz-Jeghers syndrome.
- result A repeat colonoscopy with biopsies a year later revealed a diagnosis of MPS.
JPGN Rep · PMID 38756112 · Read it on PubMed ↗
Sekarsari et al. 2024
The significance of Meckel's scan in pediatric gastrointestinal bleeding cases: A case report
Painless bleeding caused by Meckel's diverticulum.Case seriesVery low quality
1 people2024
A Meckel's diverticulum was found to be the cause of his painless rectal bleeding, confirmed by imaging and surgery
Who was studied
a 13-year-old boy with painless rectal bleeding
Main outcome
cause of unexplained painless gastrointestinal bleeding, found using a Meckel's scan
Quality
This is a single patient case report, so it cannot show how common this cause is or apply broadly to others with painless bleeding.
Limitations
Only one patient described, so findings cannot be generalized.
Taken word for word from the abstract
- population A 13-year-old male was admitted with a 5-day history of rectal bleeding.
- population The patient continued to experience painless gastrointestinal bleeding
- primaryOutcome indicating the performance of a Tc-99m pertechnetate scintigraphy or Meckel's scan
- result Planar images revealed focal uptake within the right hemiabdomen, suggestive of the presence of a Meckel's diverticulum.
- result Subsequent laparotomy surgery confirmed the presence of a Meckel's diverticulum located 50 cm from the ileocecal valve.
- n A 13-year-old male was admitted with a 5-day history of rectal bleeding.
Radiol Case Rep · PMID 38680747 · Read it on PubMed ↗
Alharbi et al. 2024
Colonic Angiolipoma: A Rare Cause of Chronic Anemia and Rectal Bleeding
Rare colon tumor caused the bleeding.Case seriesVery low quality
1 people2024
A rare benign tumor called an angiolipoma in the colon was found to be the cause of her painless bleeding and iron-deficiency anemia; symptoms resolved after surgical removal
Who was studied
52-year-old woman with no major health history who had painless rectal bleeding for six months
Main outcome
underlying cause of painless rectal bleeding and anemia
Quality
This is a single patient case report, so it cannot show how common this cause is, only that it is possible.
Limitations
Only one patient described; findings cannot be generalized to how often this cause occurs in people with painless rectal bleeding.
Taken word for word from the abstract
- population a 52-year-old woman with no significant medical history who presented with generalized weakness, fatigue, and intermittent, painless rectal bleeding over six months
- primaryOutcome significant iron-deficiency anemia was diagnosed through laboratory tests
- result Histopathological analysis following surgical resection confirmed the diagnosis of a colonic angiolipoma
- result The patient's recovery, marked by the resolution of symptoms and normalization of hemoglobin levels, underscores the effectiveness of surgical treatment
- n This case involves a 52-year-old woman
Cureus · PMID 38646340 · Read it on PubMed ↗
Huang et al. 2024
Distal Duodenal Stricture Secondary to Mesenteric Fibromatosis (Intra-Abdominal Desmoid Tumor) of the Jejunum
Rare tumor found, incidental polyp bledCase seriesVery low qualityRelated question
1 people2024
Colonoscopy found a 4-mm rectal polyp and internal hemorrhoids, but further work-up revealed a separate mesenteric mass (desmoid tumor) causing a severe duodenal stricture; the bleeding was ultimately attributed to incidental polyp/hemorrhoids rather than the tumor itself
Who was studied
52-year-old West African male with a 1-year history of intermittent hematochezia and intermittent bloating
Main outcome
cause of the patient's intermittent hematochezia
Quality
This is a single patient case report, so it cannot show how often or why painless bleeding happens in general, only that it happened once alongside an unrelated rare tumor.
Limitations
Single case; patient also had bloating, so bleeding was not reported as an isolated painless symptom; findings (rare desmoid tumor) are not generalizable to typical painless rectal bleeding.
Taken word for word from the abstract
- population 52-year-old West African male with a 1-year history of intermittent hematochezia and intermittent bloating
- n 52-year-old West African male
- primaryOutcome Colonoscopy revealed a 4-mm rectal polyp and internal hemorrhoids. Esophagogastroduodenoscopy revealed a severe duodenal stricture 4-5 cm distal to the ampulla.
- result Colonoscopy revealed a 4-mm rectal polyp and internal hemorrhoids. Esophagogastroduodenoscopy revealed a severe duodenal stricture 4-5 cm distal to the ampulla. Further work-up with contrast-enhanced computed tomography of the abdomen and pelvis revealed a 5.0 × 3.7 × 4.3-cm mass within the mesentery, encasing the distal portion of the duodenum.
Case Rep Gastroenterol · PMID 38645406 · Read it on PubMed ↗
Eberly et al. 2024
Unusual Upper Gastrointestinal Bleeding Due to a Neuroendocrine Tumor Arising in Meckel Diverticulum
Rare tumor found as bleeding causeCase seriesVery low qualityRelated question
1 people2024
A tumor (neuroendocrine tumor) was found growing inside a Meckel diverticulum and was the cause of the bleeding
Who was studied
a 38-year-old adult with blood in the stool (hematochezia)
Main outcome
finding the cause of the gastrointestinal bleeding
Quality
This is a single case report, so it cannot tell you how common this cause of bleeding is or how it compares with other causes.
Limitations
Only one patient; described as upper gastrointestinal bleeding rather than clearly painless lower rectal bleeding, and pain status is not explicitly reported.
Taken word for word from the abstract
- population a 38-year-old patient with hematochezia in whom Meckel diverticulum was diagnosed
- n a 38-year-old patient
- primaryOutcome A mass was identified within the diverticulum.
- result Histopathological and immunohistochemical studies revealed a well-differentiated neuroendocrine tumor.
ACG Case Rep J · PMID 38638202 · Read it on PubMed ↗
Shao et al. 2024
A case report of refractory amebic colitis and literature review
Parasite infection caused bloody diarrhea.Case seriesVery low qualityRelated question
1 peopleannual follow-up
Blood in stool and diarrhea were caused by amebic colitis (a parasitic infection) that mimicked inflammatory bowel disease; it resolved after amebicide treatment
Who was studied
a man with ongoing diarrhea and blood in stool, first thought to be inflammatory bowel disease
Main outcome
identifying the cause of diarrhea and bloody stool, and response to treatment
Quality
This is a single patient case report, which cannot show how common this cause is or apply broadly.
Limitations
Single case report; patient also had diarrhea, not painless bleeding alone, and diagnosis took two years, limiting generalizability.
Taken word for word from the abstract
- population A 31-year-old male who exhibited intermittent diarrhea and hematochezia was highly suspected as IBD initially.
- primaryOutcome amebic cysts were detected in stool microscopy and trophozoites were found on the surface of cecal ulcers
- result The patient remained asymptomatic, and the mucosa of colon was normal during the annual follow-up.
- n A 31-year-old male
- followUp during the annual follow-up
Medicine (Baltimore) · PMID 38335414 · Read it on PubMed ↗
Aryal et al. 2024
A rare case report of patent vitellointestinal duct presenting as a periumbilical pain in an adult
Rare congenital cause found, but patient had painCase seriesVery low qualityRelated question
1 people2024
he was found to have a rare congenital condition (a patent vitellointestinal duct) diagnosed by imaging and confirmed by surgery and tissue testing
Who was studied
a 30-year-old man with pain around the belly button
Main outcome
diagnosis of the underlying cause of his symptoms
Quality
this is a single patient case report, so it cannot show how common or likely any cause is in people with painless bleeding.
Limitations
single case, and this patient's presenting symptom was pain, not painless bleeding, so it does not directly address painless rectal bleeding.
Taken word for word from the abstract
- population a 30-year-old adult male presenting with acute periumbilical pain
- intervention Imaging findings guided the diagnosis, and surgical resection with histopathological examination further confirmed the condition.
- primaryOutcome Imaging findings guided the diagnosis
- result We present a rare case of complete patency of the VID in a 30-year-old adult male presenting with acute periumbilical pain. Imaging findings guided the diagnosis, and surgical resection with histopathological examination further confirmed the condition.
- n a 30-year-old adult male
Radiol Case Rep · PMID 38312749 · Read it on PubMed ↗
Yan et al. 2024
Meckel's diverticulum mimicking acute appendicitis in children: a retrospective cohort study
Usually painless bleeding, but can cause painRetrospectiveLow qualityRelated question
20 people2024
These 20 children with complicated Meckel's diverticulum actually presented with acute abdominal symptoms mimicking appendicitis (pain), not painless bleeding; the abstract separately notes that painless rectal bleeding is the most common presentation of Meckel's diverticulum in general
Who was studied
Children with complicated Meckel's diverticulum who were thought to have appendicitis before surgery
Main outcome
Clinical presentation and tissue findings of complicated Meckel's diverticulum
Quality
Small retrospective single-center case series of only 20 children, so it cannot reliably establish how often painless bleeding versus pain occurs with this condition.
Limitations
Retrospective design, very small sample (20 patients), single institution, and the actual cohort studied had painful acute-abdomen presentations rather than painless bleeding, so it does not directly address the painless-bleeding population.
Taken word for word from the abstract
- population 20 complicated MD admitted to our institution who were preoperatively diagnosed with acute appendicitis
- n 20 cases of complicated Meckel diverticulum (MD) who were presumed to have acute appendicitis before surgery
- result The most common presentation of symptomatic MD is painless rectal bleeding; however, it can present symptoms of acute abdomen mimicking acute appendicitis.
- primaryOutcome to summarize the clinical presentation and histological results of 20 cases of complicated Meckel diverticulum (MD)
BMC Surg · PMID 38291433 · Read it on PubMed ↗
Gómez Otero et al. 2024
Jejunal gastrointestinal stromal tumor: a diagnostic challenge
Rare small-bowel tumor caused hidden bleeding.Case seriesVery low qualityRelated question
size not given2024
A rare small-bowel tumor (jejunal GIST) was found as the cause of unexplained GI bleeding, which had delayed diagnosis
Who was studied
Adults with gastrointestinal bleeding of unclear cause, in this case from a small bowel tumor
Main outcome
What causes obscure gastrointestinal bleeding
Quality
This is a single case report, which cannot show how common this cause is or whether it applies to painless rectal bleeding in general.
Limitations
Single case report of a jejunal (small bowel) tumor, not clearly described as painless or as rectal bleeding; findings cannot be generalized.
Taken word for word from the abstract
- population These tumors usually affect people over 50 years of age and they exhibit a wide range of clinical manifestations, including asymptomatic patients, nonspecific symptoms, obstruction or bleeding, which may delay diagnosis.
- primaryOutcome This case highlights the importance of considering GISTs in the differential diagnosis of obscure gastrointestinal bleeding.
- result Gastrointestinal stromal tumors (GIST) are rare mesenchymal tumors of the gastrointestinal tract and a rare cause of gastrointestinal bleeding.
Rev Esp Enferm Dig · PMID 38205691 · Read it on PubMed ↗
Sovadinová et al. 2024
Meckel's diverticulum as a cause of gastrointestinal bleeding in an adolescent patient
Rare gut pouch caused bleeding in one teenCase seriesVery low qualityRelated question
size not given2024
Describes a teenager with life-threatening acute GI bleeding caused by a Meckel's diverticulum, and mentions a follow-up retrospective review of other patients treated for the same condition, but no bleeding rates or outcome numbers are given
Who was studied
A 17-year-old boy with severe gastrointestinal bleeding, plus a small retrospective group of children treated for Meckel's diverticulum
Main outcome
Cause of gastrointestinal bleeding
Quality
This is a single case report plus an unquantified small retrospective series, so it cannot establish how common this cause is or support broader claims.
Limitations
Very small, pediatric/adolescent population with acute, severe bleeding rather than adults with painless bleeding; no quantitative results reported.
Taken word for word from the abstract
- population a 17-year-old male patient with life-threatening acute gastrointestinal bleeding due to MD
- population a retrospective study of a small group of patients admitted to the Department of Pediatric Surgery and Traumatology
- primaryOutcome Meckel's diverticulum (MD) is one of the most common malformations of the gastrointestinal tract
- result we present the case report of a 17-year-old male patient with life-threatening acute gastrointestinal bleeding due to MD
- result we performed a retrospective study of a small group of patients admitted to the Department of Pediatric Surgery and Traumatology, Third Faculty of Medicine, Charles University and Thomayer University Hospital in Prague (KDCHT FTN) between January 2012 and March 2023 with the primary or secondary diagnosis of MD
Rozhl Chir · PMID 39928522 · Read it on PubMed ↗
Seo et al. 2023
Small Bowel Variceal Bleeding in Patients with Liver Cirrhosis Treated with Transarterial Embolization: Case Series
Rare variceal bleeding treated with embolizationCase seriesVery low qualityRelated question
size not given2023
the abstract states only that local studies on outcomes are limited and does not report specific results or patient numbers
Who was studied
patients diagnosed with small bowel variceal bleeding, a rare condition not the same as typical painless rectal bleeding
What they received
transarterial embolization (TAE), a procedure to block the bleeding blood vessel
Main outcome
outcomes of treatment with TAE for small bowel variceal bleeding
Quality
this is a small case series with no patient count or outcome data given, about a rare and different condition than ordinary painless rectal bleeding
Limitations
no number of patients or outcome results are reported in the abstract, and it concerns a specific rare condition (small bowel variceal bleeding in cirrhosis) rather than painless rectal bleeding in general
Taken word for word from the abstract
- population This paper reports patients diagnosed with small bowel variceal bleeding and treated with TAE.
- intervention Trans-arterial embolization (TAE) is a secure and straightforward method for treating ectopic varices.
- primaryOutcome there have been limited local studies on the outcomes of TAE for patients with small bowel variceal hemorrhage
- result there have been limited local studies on the outcomes of TAE for patients with small bowel variceal hemorrhage
Korean J Gastroenterol · PMID 38130001 · Read it on PubMed ↗
Pichioni et al. 2023
A Colonic Lipoma Causing Obstruction: A Case Report and Review of Literature
Rare benign tumor caused blockage, bleeding.Case seriesVery low qualityRelated question
1 people2023
she had a large benign fatty tumor (lipoma) in the colon that was almost completely blocking it, along with a separate polyp; the lipoma was removed surgically
Who was studied
a 65-year-old woman with rectal bleeding, loss of appetite, and changed bowel habits
Main outcome
what was causing her symptoms, found via colonoscopy, CT scan, and surgery
Quality
this is a single patient's case report, so it cannot show how common this cause is or whether it applies to people with bleeding alone.
Limitations
single case report of one patient who had rectal bleeding plus loss of appetite and altered bowel habits, not bleeding alone, so it does not isolate painless bleeding as a symptom; findings cannot be generalized.
Taken word for word from the abstract
- population a 65-year-old female patient reporting rectal bleeding, loss of appetite, and alteration in bowel habits
- intervention Laparoscopic intervention ensued, and following a conclusive intraoperative diagnosis of a submucosal lipoma via frozen biopsy, a successful laparoscopic segmental resection of the descending colon with primary anastomosis was executed.
- primaryOutcome she was submitted to colonoscopy which revealed a sizable ulcerative polypoid lesion in the descending colon
- result An abdominal computed tomography followed which showed diffuse thickening of the colonic wall in the descending colon, resulting in nearly complete luminal obstruction and also a submucosal lipoma measuring 2.6 centimeters at the same location.
- n a 65-year-old female patient
Cureus · PMID 38111811 · Read it on PubMed ↗
Gao et al. 2023
A case report and literature review of rectal lipoma
Benign tumor caused bloody stool.Case seriesVery low qualityRelated question
1 people6 months
The bleeding and prolapsing mass were found to be caused by a benign rectal lipoma; symptoms resolved after surgical removal of the tumor.
Who was studied
Adult man with a prolapsing rectal mass and bloody stool for one day
Main outcome
cause of the bloody stool and rectal mass
Quality
This is a single case report with no comparison group, so it cannot show how often this cause explains painless bleeding in general.
Limitations
Single case report; the abstract does not state whether the bleeding was painless, and a mass prolapse may itself be symptomatic, so it does not cleanly match a painless-bleeding population.
Taken word for word from the abstract
- n A 65-year-old male developed rectal mass prolapse with bloody stool for 1 day.
- population A 65-year-old male developed rectal mass prolapse with bloody stool for 1 day.
- primaryOutcome DIAGNOSES: The pathological findings were rectal lipoma.
- result DIAGNOSES: The pathological findings were rectal lipoma.
- result After resection of the anal tumor, the patient postoperative symptoms quickly disappeared.
Medicine (Baltimore) · PMID 37904353 · Read it on PubMed ↗
Acevedo Forero et al. 2023
[Videocapsule Endoscopy as a Diagnostic Tool for Meckel's Diverticulum in Pediatrics: a Case Report]
Meckel's diverticulum can cause painless bleedingCase seriesVery low qualityRelated question
size not given2023
Counted as a related question: This study presents a case report of using video capsule endoscopy to diagnose Meckel's diverticulum as a cause of bleeding, rather than answering why painless rectal bleeding occurs in adults — it focuses on a pediatric diagnostic case instead of addressing the underlying reasons for the symptom in the adult population asked about.
Painless rectal bleeding is described as the most common symptom of Meckel's diverticulum, and video capsule endoscopy is reported as a useful way to find the source of the bleeding
Who was studied
People with Meckel's diverticulum, who most often have painless rectal bleeding
Main outcome
identifying the cause of bleeding from Meckel's diverticulum using video capsule endoscopy
Quality
This is a single case report with background information, not a study that can show how common this cause is.
Limitations
Only a case report; no patient numbers or outcomes data beyond general statements about the condition.
Taken word for word from the abstract
- population The most common symptom is painless rectal bleeding; however, the presentation can be varied.
- primaryOutcome a useful tool to clarify the etiology of bleeding in the small intestine
- result The most common symptom is painless rectal bleeding; however, the presentation can be varied.
- result direct visualization is the way to make an accurate diagnosis, which can be done through video capsule endoscopy, a useful tool to clarify the etiology of bleeding in the small intestine
Acta Gastroenterol Latinoam · PMID 41341644 · Read it on PubMed ↗
Takiguchi et al. 2023
A case of fulminant amoebic colitis during systemic chemotherapy for gastric cancer
Amoeba infection caused painful bloody diarrhea during chemoCase seriesVery low qualityRelated question
1 people2023
The patient developed diarrhea, fever and bloody stool from a chemotherapy-activated Entamoeba histolytica infection, causing amoebic colitis with rectal invasion, treated with metronidazole; emergency surgery was later needed for suspected perforation
Who was studied
A patient receiving chemotherapy for gastric cancer
Main outcome
Cause of bloody stool and colitis during chemotherapy
Quality
This is a single case report, so it cannot show how common or predictive any cause of bleeding is in general.
Limitations
Single patient; bleeding occurred alongside diarrhea, fever and suspected perforation, not as a painless, isolated symptom; findings may not generalize.
Taken word for word from the abstract
- population a case of fulminant amoebic colitis resulting from an asymptomatic Entamoeba histolytica infection, which was activated by chemotherapy for gastric cancer
- primaryOutcome A colonoscopy and biopsy were performed because of the bloody stool.
- result The patient developed diarrhea and fever after three courses of chemotherapy for gastric cancer and was diagnosed with acute enteritis.
- result Histopathological findings revealed amoebic invasion of the rectum.
- result Emergency surgery was performed because intestinal perforation was suspected after which his general condition improved and was discharged.
- n We report a case of fulminant amoebic colitis
Clin J Gastroenterol · PMID 37584867 · Read it on PubMed ↗
Elek et al. 2023
Radiologic and pathologic correlation of a renal venous hemangioma
Case report; doesn't explain the bleedingCase seriesVery low qualityRelated question
1 people2023
The kidney mass looked like kidney cancer on scans but was actually a benign blood vessel growth (venous hemangioma); the report does not explain or investigate the cause of her rectal bleeding
Who was studied
59-year-old woman with a long history of rectal bleeding who was found to have a kidney mass
Main outcome
what the kidney mass turned out to be
Quality
This is a single case report about an unrelated kidney finding, not a study of rectal bleeding, so it cannot say anything general about why bleeding happens.
Limitations
Single patient case report; the rectal bleeding is mentioned only as background history and is not investigated, explained, or linked to any diagnosis in this abstract.
Taken word for word from the abstract
- population a unique case of a 59-year-old African-American female with a renal venous hemangioma
- population The patient's presentation included a long history of rectal bleeding and an incidental discovery of a hypoattenuating mass in the left kidney
- primaryOutcome initially mimicked papillary-type renal cell carcinoma (RCC-pt) on imaging studies
- result Subsequent total nephrectomy confirmed the histopathological diagnosis of a venous hemangioma
- n a 59-year-old African-American female
Int Cancer Conf J · PMID 37577340 · Read it on PubMed ↗
Fernández Noël et al. 2023
Capsule endoscopy diagnosis of gastrointestinal melanoma
Capsule endoscopy found bowel melanoma spread.Case seriesVery low qualityRelated question
1 people2023
capsule endoscopy detected two lesions compatible with cutaneous melanoma metastasis to the small bowel, allowing more effective surgical planning
Who was studied
a 68-year-old patient with a history of cutaneous melanoma
What they received
capsule endoscopy
Compared with
conventional endoscopy and CT/PET CT
Main outcome
detection of small bowel melanoma metastases
Quality
this is a single case report, so it cannot establish how common any cause of symptoms is or support general conclusions.
Limitations
single case report with no comparison group and no information on rectal bleeding or hematochezia
Taken word for word from the abstract
- population a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma
- intervention Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected
- comparator conventional endoscopic study only detects 10-20% of lesions
- primaryOutcome two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected
- result allowing a much more effective surgical planning
- n a 68-year-old patient
Rev Esp Enferm Dig · PMID 37539537 · Read it on PubMed ↗
Khadka et al. 2023
Cap Polyposis: A Case Report
Rare polyp disease causing bleedingCase seriesVery low quality
1 people2023
diagnosed with cap polyposis, a rare condition with multiple inflammatory polyps in the rectum and sigmoid colon
Who was studied
18-year-old male patient with one year of painless rectal bleeding
Main outcome
cause of painless rectal bleeding found on colonoscopy
Quality
This is a single patient case report, so it cannot show how common this cause is or compare it to other explanations.
Limitations
Single case report; findings in one patient may not generalize to others with painless rectal bleeding.
Taken word for word from the abstract
- population a case of a 18-year-old male patient who underwent polypectomy for polyposis in multiple settings
- population He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum.
- primaryOutcome He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum.
- result Cap polyposis is a gastrointestinal disease with multiple inflammatory polyps between the distal colon and rectum.
- result He was managed with immediate and interval polypectomy.
- n a case of a 18-year-old male patient
JNMA J Nepal Med Assoc · PMID 37464856 · Read it on PubMed ↗
Tsuruta et al. 2023
Symptoms Contributing to the Diagnosis of Small Bowel Tumors
Blood in stool was one sign of small bowel tumorsRetrospectiveLow qualityRelated question
66 people2023
Hematochezia was the symptom that led to diagnosis in 12.1% of patients; abdominal pain was the most common presenting symptom (44.5%), and 28.8% were asymptomatic with tumors found incidentally; GISTs and benign tumors were more often asymptomatic than malignant tumors
Who was studied
patients diagnosed with small bowel tumors at one hospital
Main outcome
which symptoms led to detection of small bowel tumors
Quality
This is a small, single-center retrospective chart review of only 66 patients with small bowel tumors, not a study of painless rectal bleeding in the general population, so it cannot show how often painless bleeding signals a tumor.
Limitations
Small bowel tumors are rare and this abstract covers all presenting symptoms (mostly abdominal pain) rather than isolating painless bleeding; it does not separate hematochezia cases by whether pain was also present.
Taken word for word from the abstract
- population we examined 66 patients diagnosed with SBTs and determined their clinical characteristics
- n The study included 66 patients.
- primaryOutcome Symptoms that led to SBT detection were abdominal pain (44.5%), asymptomatic conditions (28.8%), hematochezia (12.1%), and anemia (10.6%).
- result Symptoms that led to SBT detection were abdominal pain (44.5%), asymptomatic conditions (28.8%), hematochezia (12.1%), and anemia (10.6%).
- result GISTs and benign tumors were more often asymptomatic than other malignant tumors.
Digestion · PMID 37437555 · Read it on PubMed ↗
Raut et al. 2023
Colonic pedunculated polypoid vascular ectasia mimicking ileocolic intussusception: a rare case report
Abnormal blood vessels caused the bleedingCase seriesVery low qualityRelated question
1 people2023
the bleeding was caused by a colonic vascular ectasia (abnormal blood vessel growth) that formed a polyp-like mass and mimicked a bowel intussusception on imaging
Who was studied
a 45-year-old woman with rectal bleeding and abdominal pain
Main outcome
cause of the rectal bleeding (hematochezia)
Quality
this is a single patient case report, so it cannot show how common this cause is or how it applies to other people
Limitations
single case report, and the patient had abdominal pain as well as bleeding, not painless bleeding alone
Taken word for word from the abstract
- n A 45-year-old woman presented with hematochezia and abdominal pain.
- population A 45-year-old woman presented with hematochezia and abdominal pain.
- result After histopathological evaluation, a final diagnosis of colonic polypoid vascular ectasia was made.
- result An intraluminal pedunculated polypoid growth extending up to the hepatic flexure of the colon was discovered.
- primaryOutcome A 45-year-old woman presented with hematochezia and abdominal pain.
Ann Med Surg (Lond) · PMID 37427223 · Read it on PubMed ↗
Qasim et al. 2023
Dieulafoy's Lesion of the Duodenum: A Rare and Fatal Cause of Gastrointestinal Bleed
Rare vessel defect caused bleeding.Case seriesVery low qualityRelated question
1 people2023
endoscopy found a Dieulafoy lesion (a fragile abnormal artery) in the duodenum as the source of bleeding
Who was studied
older woman with severe iron deficiency anemia needing repeated blood transfusions
Main outcome
cause of her unexplained bleeding/anemia
Quality
this is a single patient case report, so it cannot show how common this cause is or apply broadly.
Limitations
single case; describes upper gastrointestinal bleeding (duodenum), not painless rectal bleeding, and most patients with this lesion are described as asymptomatic or have upper GI symptoms like melena/hematemesis rather than isolated painless rectal bleeding.
Taken word for word from the abstract
- population a 71-year-old female who had a history of severe IDA requiring multiple blood transfusions and intravenous iron in the past
- intervention The treatment of duodenal DL includes thermal electrocoagulation, local epinephrine injection, sclerotherapy, banding, and hemoclipping.
- primaryOutcome was found to have duodenal DL
- result was found to have duodenal DL
- n a 71-year-old female
Cureus · PMID 37425531 · Read it on PubMed ↗
Hua et al. 2023
Selective IgA Deficiency with Multiple Autoimmune Comorbidities: A Case Report and Literature Review
Rare case: tumor and autoimmune disease caused bleeding with painCase seriesVery low qualityRelated question
1 people2023
The bleeding and abdominal discomfort occurred in a patient found to have a large genital wart-type tumor (condyloma) plus selective IgA deficiency with autoimmune hemolytic anemia, lupus, and thyroiditis; symptoms resolved after the tumor was removed and the autoimmune conditions were treated
Who was studied
a middle-aged man with abdominal discomfort, blood in the stool, and a large tumor in the genital/anal area, who also had an underlying antibody deficiency and several autoimmune conditions
Main outcome
what was causing the abdominal discomfort and rectal bleeding
Quality
This is a single patient's case report, and the patient had abdominal pain alongside the bleeding, so it doesn't describe bleeding without pain and can't show what usually causes that.
Limitations
Single case report; the patient had abdominal discomfort in addition to bleeding, not painless bleeding alone, so findings may not generalize to people with painless rectal bleeding.
Taken word for word from the abstract
- n A 48-year-old Han Chinese man presented with abdominal discomfort, hematochezia, and a large tumor in the anogenital region.
- population A 48-year-old Han Chinese man presented with abdominal discomfort, hematochezia, and a large tumor in the anogenital region.
- primaryOutcome The primary diagnosis of SIgAD was based on the patient's age, serum IgA concentration (0.067 g/L), and the evidence of chronic respiratory infection.
- result The clinical signs and laboratory results indicated autoimmune hemolytic anemia, systemic lupus erythematosus, and Hashimoto's thyroiditis. Abdominal discomfort and hematochezia subsided.
Iran J Immunol · PMID 37158141 · Read it on PubMed ↗
Mauriz Barreiro et al. 2024
Mucosal Schwann cell hamartoma: a benign and little-known entity
Bleeding from hemorrhoids; incidental harmless growth foundCase seriesVery low quality
1 people2024
colonoscopy showed internal hemorrhoids and an incidental benign growth called a mucosal Schwann cell hamartoma; the bleeding was attributed to the hemorrhoids, and the hamartoma was judged harmless with no further tests needed
Who was studied
50-year-old woman with painless rectal bleeding for two weeks
Main outcome
cause of painless rectal bleeding found on colonoscopy and biopsy
Quality
this is a single patient case report, so it cannot show how common any cause of painless bleeding is or rule out other causes
Limitations
findings come from only one patient, so they cannot be generalized to explain most cases of painless rectal bleeding
Taken word for word from the abstract
- population 50 years-old female with personal history of mutation of the gene BRCA1 and previous prophylactic double anexectomy consulted for rectal bleeding without pain since two weeks
- primaryOutcome a colonoscopy was requested
- result The episodes of rectorrhagia were attributed to the presence of internal hemorrhoids.
- result Given that these lesions seem to not have malignant potential, the patient was discharged without control colonoscopies.
- n 50 years-old female
Rev Esp Enferm Dig · PMID 37114421 · Read it on PubMed ↗
Devi et al. 2023
Hemorrhoid Disease: A Review on Treatment, Clinical Research and Patent Data
Hemorrhoids can bleed without painNarrative reviewLow qualityRelated question
size not given2023
Hemorrhoids are described as being commonly painful but sometimes painless, and they cause rectal bleeding with or without prolapsing anal tissue
Who was studied
people with hemorrhoid disease (piles)
Main outcome
description of hemorrhoid disease symptoms, not a treatment outcome
Quality
This is a general narrative review about hemorrhoid treatments and patents, not a study designed to investigate causes of painless bleeding, so it only offers a passing descriptive statement rather than evidence.
Limitations
This is a treatment-focused review, not a study of symptom causes; it gives only a brief descriptive statement about hemorrhoid symptoms without supporting data or methodology for that claim.
Taken word for word from the abstract
- population Hemorrhoid disease (HD) is an anal-rectal ailment that is commonly painful or may be painless and causes rectal bleeding with or without prolapsing anal tissue.
- result Hemorrhoid disease (HD) is an anal-rectal ailment that is commonly painful or may be painless and causes rectal bleeding with or without prolapsing anal tissue.
- primaryOutcome It is generally associated with bleeding, prolapse, pruritus, and discomfort, which results in a diminished quality of life and well-being.
Infect Disord Drug Targets · PMID 37106517 · Read it on PubMed ↗
Díaz et al. 2023
Inpatient Hepatology Consultation: A Practical Approach for Clinicians
Discusses liver disease bleeding, not this symptomNarrative reviewLow qualityRelated question
size not given2023
The review discusses portal hypertensive gastrointestinal bleeding as one complication of worsening cirrhosis, among others like ascites, encephalopathy, and jaundice; it does not address painless rectal bleeding in people without liver disease.
Who was studied
adults with cirrhosis (chronic liver disease)
Main outcome
complications that occur when cirrhosis worsens (decompensation)
Quality
This is a general narrative review about hospital liver specialist consultations for cirrhosis complications, not a study focused on painless rectal bleeding or its causes.
Limitations
Covers bleeding only as a complication of cirrhosis and portal hypertension in hospitalized patients, not painless rectal bleeding in the general population being asked about here.
Taken word for word from the abstract
- population Cirrhosis is the end-stage of chronic liver disease
- primaryOutcome Complications could be related to portal hypertension and/or liver dysfunction, including ascites, portal hypertensive gastrointestinal bleeding, encephalopathy, and jaundice.
- result This review will discuss some of the most important precipitants of hepatic decompensation, including acute variceal bleeding, spontaneous bacterial peritonitis, and hepatic encephalopathy.
Med Clin North Am · PMID 37001953 · Read it on PubMed ↗
Caleça Emidio et al. 2023
Rectal Bezoar: A Rare Cause of Intestinal Obstruction
Rare bowel blockage from rectal bezoarCase seriesVery low qualityRelated question
1 people2023
the blockage and bleeding were caused by a hard bezoar stuck in the rectum, which could not be removed by endoscopy and had to be broken up and removed with instruments
Who was studied
an older woman with a rare rectal bezoar (blockage of hardened material) causing bowel obstruction
Main outcome
what was causing her intermittent bowel blockage and rectal bleeding
Quality
this is a single case report of one unusual patient, so it cannot show how common this cause is or whether it applies to people with painless bleeding generally
Limitations
single patient case report; the bleeding in this case occurred together with intermittent intestinal obstruction, not as a painless, isolated symptom, and anal stenosis was also present
Taken word for word from the abstract
- population We present a case of an 86-year-old woman, who had a bezoar located in an unusual location (rectum), most likely due to migration.
- primaryOutcome This condition led to symptoms of intermittent intestinal obstruction and rectal bleeding.
- result This condition led to symptoms of intermittent intestinal obstruction and rectal bleeding.
- n an 86-year-old woman
Cureus · PMID 36875249 · Read it on PubMed ↗
Gonzalez et al. 2023
Submucosal Necrotic Nodule of the Colon: An Enigmatic Entity Potentially Related to Anisakis Infection
Rare polyp, usually no bleeding.Case seriesLow qualityRelated question
25 people2023
Most patients (14 of 25) had no symptoms at all; only 4 of 25 (16%) had blood in stool. The nodules were usually small, benign-appearing, and did not recur.
Who was studied
Adults found to have a rare type of colon polyp (submucosal necrotic nodule), most without symptoms
Main outcome
Clinical and pathological features of these colon nodules, including symptoms like bleeding
Quality
It's a small, retrospective international case series without a comparison group, so it can't reliably show how often these lesions cause bleeding.
Limitations
Small sample, retrospective collection of cases, no control group, and the lesion is a specific rare finding rather than a general cause of painless rectal bleeding.
Taken word for word from the abstract
- n The final cohort included 25 patients
- population Symptoms were nonspecific, although 4 patients (16%) had blood in stool; 14 patients were asymptomatic.
- primaryOutcome To characterize the clinical and pathologic features of this lesion
- result Symptoms were nonspecific, although 4 patients (16%) had blood in stool; 14 patients were asymptomatic.
Arch Pathol Lab Med · PMID 36656170 · Read it on PubMed ↗
Singh et al. 2023
Primary amelanotic melanoma of anorectum - a rare case report with diagnostic challenge
Rare case: anorectal melanomaCase seriesVery low quality
1 people2023
the bleeding was caused by a rare anorectal amelanotic malignant melanoma, confirmed by biopsy and immunohistochemical staining
Who was studied
a 47-year-old woman with painless rectal bleeding
Main outcome
underlying cause of the painless rectal bleeding, identified through biopsy and immunohistochemistry
Quality
This is a single patient case report, so it cannot show how common this cause is, only that it can occur.
Limitations
Single case report; no comparison group; findings cannot be generalized to how often this cause occurs in people with painless rectal bleeding.
Taken word for word from the abstract
- population a 47-year-old woman who experienced painless rectal bleeding
- primaryOutcome Biopsies were obtained under endoscopic guidance for histomorphology and immunohistochemistry
- result A definitive diagnosis of amelanotic malignant melanoma was rendered.
- n a 47-year-old woman who experienced painless rectal bleeding
Pol J Pathol · PMID 38477093 · Read it on PubMed ↗
Vohra et al. 2022
Schwannoma of the Ascending Colon in a 22-Year-Old Male: A Case Report
Rare tumor found, but with pain tooCase seriesLow qualityRelated question
1 people2022
a rare benign tumor (schwannoma) was found as the cause of the bleeding and abdominal symptoms
Who was studied
22-year-old man with abdominal discomfort, bloating, and blood in stool
Main outcome
cause of symptoms found on colonoscopy and biopsy
Quality
This is a single patient case report, which cannot show how common this cause is or what usually explains painless bleeding.
Limitations
Single case; the patient had abdominal discomfort and bloating in addition to bleeding, so this does not describe painless bleeding alone; findings cannot be generalized.
Taken word for word from the abstract
- population a symptomatic 22-year-old male presenting with one month of discomfort in the right lower abdominal quadrant, abdominal bloating, and hematochezia
- primaryOutcome A sessile polyp measuring 0.5 cm was identified in the ascending colon on the colonoscopy
- result establishing the diagnosis of benign schwannoma
- n 22-Year-Old Male
Cureus · PMID 36582566 · Read it on PubMed ↗
Mahajna et al. 2023
Idiopathic Thrombocytopaenic Purpura associated with Inflammatory Bowel Disease: a multicentre ECCO CONFER case series
Low platelets caused some bleedingCase seriesLow qualityRelated question
32 people6.5 years
Among 32 patients with IBD and ITP, 8 had rectal bleeding, 13 had skin purpura, 3 had nosebleeds, 6 had mucosal petechiae, and 13 had no symptoms; most responded well to ITP treatment and none needed urgent colectomy for bleeding.
Who was studied
adults with inflammatory bowel disease (Crohn's disease or ulcerative colitis) who also developed idiopathic thrombocytopenic purpura (ITP)
Main outcome
clinical presentation and outcome of ITP (including bleeding symptoms) in people with IBD
Quality
This is a small, retrospective collection of rare cases with no comparison group, so it can only describe patterns seen in this specific rare combination of conditions, not prove a cause.
Limitations
retrospective case series from a rare-case reporting network, small sample size, no control group, and population restricted to people who already have inflammatory bowel disease plus a separate blood disorder (ITP) rather than the general population asking about painless rectal bleeding
Taken word for word from the abstract
- n This report includes 32 patients with concurrent ITP and IBD
- population patients with ITP and IBD
- primaryOutcome to evaluate the clinical presentation and outcome of ITP in patients with IBD
- result Eight patients had rectal bleeding, 13 had skin purpura, three had epistaxis, six had mucosal petechiae and 13 were asymptomatic.
J Crohns Colitis · PMID 36455965 · Read it on PubMed ↗
Reissnerova et al. 2022
Inflammatory cloacogenic polyp in an adolescent - case report and review of the literature
Rare benign polyp found as cause.Case seriesVery low qualityRelated question
1 people2022
A rare, usually benign polyp (inflammatory cloacogenic polyp) was found and removed as the cause of the boy's rectal bleeding
Who was studied
a 14-year-old boy with occasional rectal bleeding
Main outcome
finding the cause of rectal bleeding
Quality
This is a single patient case report with no comparison group, so it can only show one possible cause, not how common it is.
Limitations
Only one patient was described, and the abstract does not say whether his bleeding was painless.
Taken word for word from the abstract
- population a 14-year-old boy presenting with intermittent rectal bleeding
- primaryOutcome The most common clinical symptoms include rectal bleeding and altered bowel habits, although some patients may be asymptomatic.
- result the suspicious lesion was removed by transanal endoscopic microsurgery and the histological diagnosis of inflammatory cloacogenic polyp was established
- n a 14-year-old boy presenting with intermittent rectal bleeding
Rozhl Chir · PMID 36402562 · Read it on PubMed ↗
Tursi et al. 2022
When to Perform a Colonoscopy in Diverticular Disease and Why: A Personalized Approach
Diverticular disease can cause bleeding, review onlyNarrative reviewVery low qualityRelated question
size not given2022
The review states colonoscopy plays a crucial role in managing diverticular bleeding, and that diverticulosis is often an incidental finding in people with no symptoms undergoing screening colonoscopy
Who was studied
people with diverticular disease, including some with no symptoms and some with abdominal pain or rectal bleeding
Main outcome
when and why to perform colonoscopy in people with diverticular disease
Quality
This is a narrative review without a systematic search or original patient data, and it is not focused specifically on painless bleeding.
Limitations
It is a narrative review summarizing general colonoscopy timing in diverticular disease, not a study of people with painless bleeding specifically, and it reports no patient numbers or outcome data.
Taken word for word from the abstract
- population Diverticulosis can often be an unexpected diagnosis when colonoscopy is performed in asymptomatic subjects, generally for colorectal cancer screening, or it could reveal an endoscopic picture compatible with DD, including acute diverticulitis, in patients suffering from abdominal pain or rectal bleeding.
- primaryOutcome This article aims to summarize "when" to safely perform a colonoscopy in the different DD settings and "why".
- result colonoscopy plays a crucial role in managing diverticular bleeding
- result Diverticulosis can often be an unexpected diagnosis when colonoscopy is performed in asymptomatic subjects, generally for colorectal cancer screening
J Pers Med · PMID 36294852 · Read it on PubMed ↗
Di Serafino et al. 2022
The Role of CT-Angiography in the Acute Gastrointestinal Bleeding: A Pictorial Essay of Active and Obscure Findings
Describes CT scans for bleeding, not causes.Narrative reviewLow qualityRelated question
size not given2022
The abstract describes how CT angiography and related imaging techniques are used to identify sources of acute gastrointestinal bleeding, including obscure bleeding, but does not address causes of painless rectal bleeding specifically.
Who was studied
patients with acute gastrointestinal bleeding (not specified as painless)
Main outcome
use of CT angiography to find the source of gastrointestinal bleeding
Quality
This is a descriptive pictorial review about an imaging technique, not a study of causes or outcomes of painless rectal bleeding.
Limitations
It is a review focused on radiologic technique (CT angiography) for acute GI bleeding in general, not a study of painless hematochezia or its causes.
Taken word for word from the abstract
- population Gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalisation.
- primaryOutcome The learning objective of this review is to illustrate the computed tomography angiography technique, including the potential role of dual-energy computed tomography angiography, also highlighting the tips and tricks to identify the most common and uncommon features of acute gastrointestinal bleeding and its obscure form.
- result Radiologists should be aware of the appropriate uses of computed tomography angiography and other imaging modalities in patients with acute gastrointestinal bleeding, as well as the semiotics of bleeding and diagnostic pitfalls in order to appropriately diagnose and manage these patients.
Tomography · PMID 36287797 · Read it on PubMed ↗
Hui et al. 2022
Adjunctive endoscopic clip marking enhances non-operative management of massive lower gastrointestinal bleeding
Diverticular disease often causes painless bleeding.Case seriesLow qualityRelated question
36 people2022
The abstract notes in its background that diverticular disease is the leading cause of painless rectal bleeding, but the study itself reports that endoscopic clip marking plus embolization achieved non-operative control of bleeding in 83.3% of patients, with no deaths at 30 days.
Who was studied
adults with massive lower gastrointestinal bleeding caused by diverticular disease
What they received
endoscopic clip marking combined with transarterial embolization to control bleeding
Main outcome
success of stopping the bleeding without surgery (non-operative management)
Quality
This is a small retrospective case series of 36 patients without a comparison group, describing a treatment technique rather than directly studying why painless bleeding occurs.
Limitations
No control group, small sample, retrospective case series spanning many years, and the study's actual results concern treatment success rather than the cause of painless bleeding.
Taken word for word from the abstract
- population 36 patients with massive LGB from diverticular disease encompassing 44 separate bleeding episodes
- intervention The use of a novel technique of endoscopic pre-marking (EPM) with radiopaque metal clips to localize is described.
- primaryOutcome The overall success rate in non-operative management was 83.3% (30/36) patients.
- result Colonic diverticula disease (CD) is the leading cause of painless haematochezia and haemodynamic instability.
- result The overall success rate in non-operative management was 83.3% (30/36) patients.
- n 36 patients with massive LGB from diverticular disease encompassing 44 separate bleeding episodes
ANZ J Surg · PMID 36074650 · Read it on PubMed ↗
Zhong et al. 2022
Disseminated histoplasmosis and hemophagocytic lymphohistiocytosis in a patient receiving TNF-alpha inhibitor therapy
Rare infection caused bleeding, fever, diarrheaCase seriesVery low qualityRelated question
1 people2022
The patient was found to have disseminated histoplasmosis complicated by hemophagocytic lymphohistiocytosis, diagnosed from colon and bone marrow biopsies
Who was studied
An immunocompromised adult (ulcerative colitis on long-term TNF-alpha inhibitor therapy) who had diarrhea, fever, and rectal bleeding
Main outcome
Underlying cause of the patient's fever, diarrhea, and rectal bleeding
Quality
This is a single case report of one unusual, immunosuppressed patient, so it cannot show how often this cause explains bleeding or apply to people with isolated painless bleeding.
Limitations
Only one patient, who was immunosuppressed and had additional symptoms (six months of diarrhea, fever, pancolitis) rather than isolated painless bleeding, so this does not represent the general population asking about painless rectal bleeding.
Taken word for word from the abstract
- n we present a 26-year-old male
- population a 26-year-old male with history of ulcerative colitis receiving long-term TNF-alpha inhibitor therapy who presented with six months of diarrhea and recently fever and hematochezia
- primaryOutcome Disseminated histoplasmosis was ultimately diagnosed after examination of the colonic biopsy
- result Disseminated histoplasmosis was ultimately diagnosed after examination of the colonic biopsy. Bone marrow biopsy was also consistent with the diagnosis of histoplasmosis but also demonstrated hemophagocytic lymphohistiocytosis.
IDCases · PMID 36039152 · Read it on PubMed ↗
Devi et al. 2022
Meckel's Diverticulum - Clinical Presentation and Pitfalls in Diagnosis in the Pediatric Age Group in Singapore
Meckel's diverticulum can cause painless bleeding in kidsRetrospectiveLow qualityRelated question
99 people2022
Meckel's diverticulum was a cause of fresh painless rectal bleeding in children, and the diagnostic scan was most accurate specifically in those who presented with painless bleeding
Who was studied
Children who had surgery to remove a Meckel's diverticulum, studied over 13 years in Singapore
Main outcome
What caused painless rectal bleeding and how well a special scan (pertechnetate Meckel's scan) detected Meckel's diverticulum
Quality
This is a small retrospective review of children having surgery at one hospital, not a study designed to measure causes of bleeding in the general population.
Limitations
Retrospective, pediatric-only population, and focused on surgical patients rather than all people with painless rectal bleeding, so results may not apply to adults.
Taken word for word from the abstract
- population The clinical presentation of a retrospective cohort of patients who underwent MD from January 2007 to December 2019 was studied.
- n Ninety-nine patients underwent MD.
- primaryOutcome The modes of presentation, treatment, and the diagnostic utility of pertechnetate Meckel's scans were evaluated.
- result The sensitivity/specificity of Meckel's scan was higher in patients presenting with painless rectal bleeding.
- result Meckel's scan has a high sensitivity in the children presenting with fresh painless rectal bleeding but is of limited use in the diagnosis of Meckel's diverticulum in other forms of presentations.
J Indian Assoc Pediatr Surg · PMID 35733589 · Read it on PubMed ↗
Belabbes et al. 2022
Endoscopic Resection of a Large Colonic Lipoma Simulating a Tumor Revealed by Hemorrhage: A Case Report and Literature Review
Benign lipoma caused bleeding, mimicked cancerCase seriesVery low qualityRelated question
1 people2022
a 5 cm colon lipoma (benign fatty tumor) was found and removed by endoscopy; it had been causing the bleeding and mimicked a tumor
Who was studied
a 34-year-old woman with abdominal pain and rectal bleeding
Main outcome
finding the cause of a large colon growth that caused bleeding
Quality
This is a single patient case report with no comparison group, so it can't tell us how often this cause explains bleeding in general.
Limitations
Single case, patient also had abdominal pain so this doesn't match painless bleeding; findings can't be generalized.
Taken word for word from the abstract
- population a 34-year-old woman who presented with paroxysmal abdominal pain in the left iliac fossa withmoderate hematochezia that had been evolving for six months
- n a 34-year-old woman
- primaryOutcome An accurate preoperative diagnosis of lipomas is necessary
- result Colonoscopy revealed a large polyp of over 5 cm located 40 cm from the anal margin. She underwent endoscopic resection without complications. The histological examination confirmed the lipomatous nature.
Cureus · PMID 35719757 · Read it on PubMed ↗
Sharma et al. 2022
Massive Lower Gastrointestinal Hemorrhage as a Complication of Severe Campylobacter Enteritis
Severe gut infection caused major bleedingCase seriesVery low qualityRelated question
1 people2022
Severe Campylobacter gastroenteritis caused massive lower GI bleeding requiring multiple blood transfusions and ICU admission
Who was studied
A 48-year-old man with severe Campylobacter gut infection
Main outcome
Cause of severe lower gastrointestinal bleeding
Quality
This is a single patient case report, so it cannot show how common or typical this cause is for people with painless bleeding.
Limitations
Single case, no information on whether the bleeding was painless, and the abstract notes typical Campylobacter illness usually includes abdominal pain rather than painless bleeding
Taken word for word from the abstract
- population a 48-year-old male who presented with massive lower GI bleeding requiring multiple transfusions and admission to the medical intensive unit; the patient was ultimately diagnosed with severe Campylobacter gastroenteritis
- primaryOutcome acute massive lower gastrointestinal (GI) bleeding is a rare complication of Campylobacter gastroenteritis
- result We describe a unique case of a 48-year-old male who presented with massive lower GI bleeding requiring multiple transfusions and admission to the medical intensive unit; the patient was ultimately diagnosed with severe Campylobacter gastroenteritis.
- n a 48-year-old male
Cureus · PMID 35602845 · Read it on PubMed ↗
LeCompte et al. 2022
Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review
Rare cause, usually with painSystematic reviewLow qualityRelated question
934 people2022
Most patients with heterotopic pancreas had abdominal pain, and only a small fraction had gastrointestinal bleeding, usually along with other symptoms rather than painless bleeding alone
Who was studied
Patients with symptomatic heterotopic pancreas of the stomach and duodenum
Main outcome
Clinical symptoms caused by heterotopic pancreas
Quality
This is a mix of a small single-center retrospective case series and a systematic review of mostly small case reports, with no control group and high risk of selection bias.
Limitations
Combines retrospective chart review with pooled case reports of varying quality; focuses on a rare upper-GI malformation, not on painless rectal bleeding, and bleeding was almost always accompanied by abdominal pain rather than painless.
Taken word for word from the abstract
- population Twenty-nine patient were identified with HP at a single center, with six of these identified has having clinical symptoms.
- n Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients.
- primaryOutcome Clinical manifestations included, gastrointestinal bleeding, gastric ulceration with/without perforation, pancreatitis, and gastric outlet obstruction.
- result The majority of patients presented with abdominal pain (67%) combined with one of the following clinical categories: (1) Dyspepsia, (n = 445, 48%); (2) Pancreatitis (n = 260, 28%); (3) Gastrointestinal bleeding (n = 80, 9%); and (4) Gastric outlet obstruction (n = 80, 9%).
World J Gastroenterol · PMID 35582670 · Read it on PubMed ↗
Facanali et al. 2022
SMALL BOWEL IS LARGELY AFFECTED IN BEHÇET'S DISEASE: A LONG-TERM FOLLOW-UP OF GASTROINTESTINAL SYMPTOMS
Bowel damage often found without bleedingRetrospectiveVery low qualityRelated question
19 people15 years
Small bowel ulcers were found in most patients (78.9%), including many who had no gastrointestinal symptoms at all; only 3 of the 19 patients had reported bleeding at baseline
Who was studied
Adults with Behçet's disease who had a small-bowel endoscopy (double-balloon enteroscopy)
Main outcome
Whether small bowel ulcers/damage seen on endoscopy matched up with gastrointestinal symptoms like bleeding, pain or diarrhea
Quality
Very small single-center study of only 19 people with a specific rare disease, not representative of general painless rectal bleeding.
Limitations
Tiny sample (19 patients), specific to Behçet's disease rather than the general population with painless rectal bleeding, retrospective record review for symptom history, long recall period (15-year follow-up).
Taken word for word from the abstract
- population This study included 19 Behçet's disease patients who underwent DBE.
- primaryOutcome to verify if these findings were associated to the presence of gastrointestinal symptoms and disease activity after long-term follow-up
- result Small bowel ulcers were diagnosed in 78.9%, with 63.1% of jejunal involvement.
- result Bleeding was reported by three patients at baseline and persisted in only one patient.
- result Small bowel involvement in Behçet's disease was frequently demonstrated by DBE even in asymptomatic patients.
- n This study included 19 Behçet's disease patients who underwent DBE.
- followUp After a mean follow-up of 15 years the endoscopic findings were associated to the presence of gastrointestinal symptoms
Arq Gastroenterol · PMID 35442321 · Read it on PubMed ↗
Li et al. 2022
Successful treatment of an enormous rectal mucosa-associated lymphoid tissue lymphoma by endoscopic full-thickness resection: A case report
Rare lymphoma found as bleeding causeCase seriesVery low qualityRelated question
1 people2022
Colonoscopy revealed a large rectal mass that was diagnosed as a rare type of lymphoma (MALToma), which was removed by endoscopic surgery with no recurrence seen on follow-up imaging.
Who was studied
A 71-year-old woman with rectal bleeding who also had abdominal pain
Main outcome
Cause of the rectal bleeding found on colonoscopy and biopsy
Quality
This is a single case report of one patient who also had abdominal pain, so it cannot show how often bleeding without pain is caused by something like this.
Limitations
Single case report; the patient had accompanying abdominal pain, not painless bleeding alone, and no comparison group exists.
Taken word for word from the abstract
- n A 71-year-old woman
- population A 71-year-old woman suffered intermittent hematochezia for 1 mo, accompanied with abdominal pains but without weight loss, fever, chills or fatigue.
- primaryOutcome Postoperative pathological analysis indicated colorectal MALToma.
- result Colonoscopy showed a massive hemispheric mass with rough and hyperemic mucosa in the lower rectum.
- result The patient underwent endoscopic full-thickness resection.
- result follow-up positron emission tomography-CT and colonoscopy showed no residual lesion, remnants or lymph node metastasis.
World J Gastroenterol · PMID 35431493 · Read it on PubMed ↗
Liu et al. 2022
Gastrointestinal amyloidosis in a patient with smoldering multiple myeloma: A case report
Amyloidosis caused gut bleeding and ulcersCase seriesVery low qualityRelated question
1 peoplenearly five years
Biopsies of the stomach and colon showed amyloid deposits (AL amyloidosis) causing ulcers, bruising, and bleeding in the gut, linked to an underlying plasma cell disorder (smoldering multiple myeloma)
Who was studied
a 63-year-old woman with smoldering multiple myeloma who had leg swelling, abdominal swelling, abdominal pain, and bloody stools
Main outcome
cause of the gastrointestinal bleeding and ulcers found on endoscopy
Quality
This is a single patient case report, so it cannot show how common this cause is or apply broadly to people with painless bleeding.
Limitations
Single case; the patient had abdominal pain and distension along with bleeding, not painless bleeding alone, so this does not match the specific symptom pattern being asked about.
Taken word for word from the abstract
- population A 63-year-old woman presented with lower limb edema, abdominal distension, abdominal pain, and hematochezia.
- primaryOutcome Gastric and colonic tissue biopsy confirmed the diagnosis of AL by positive Congo red staining.
- result Colonoscopy showed hyperemic and edematous mucosa of the distal ascending colon and sigmoid colon with the presence of multiple round and irregular ulcers, submucosal ecchymosis, and hematoma.
- result Gastric and colonic tissue biopsy confirmed the diagnosis of AL by positive Congo red staining.
- n A 63-year-old woman presented with lower limb edema, abdominal distension, abdominal pain, and hematochezia.
- followUp She is doing well at nearly five years of follow up.
World J Clin Cases · PMID 35321167 · Read it on PubMed ↗
Kang et al. 2021
Surgical perspectives of symptomatic omphalomesenteric duct remnants: Differences between infancy and beyond
Gut remnant causes painless bleeding in kids.RetrospectiveLow qualityRelated question
35 people2021
Meckel's diverticulum, a leftover piece of embryonic gut tissue, was the most common cause found, and a special nuclear scan was the most useful test for finding it in children with painless rectal bleeding
Who was studied
children diagnosed with a congenital intestinal remnant called an omphalomesenteric duct remnant (including Meckel's diverticulum)
Main outcome
what causes and how to diagnose symptoms (including painless rectal bleeding) from this congenital gut remnant
Quality
This is a small retrospective review of only 35 pediatric surgical patients, not adults, so it can only weakly support ideas about painless bleeding causes in adults.
Limitations
Retrospective chart review, small sample size, and the population is children, not adults, so findings may not generalize to adult painless rectal bleeding.
Taken word for word from the abstract
- population The medical records of pediatric patients diagnosed with OMDR were reviewed retrospectively.
- n A total of 35 patients (7 infants, 28 children beyond infancy) were finally included.
- primaryOutcome To find surgical perspectives for the pediatric age-related variants of OMDR and make recommendations for optimal management.
- result Several diagnostic tools were used, but Meckel's scan was most useful in diagnosing OMDR in patients with painless rectal bleeding.
- result In both groups, Meckel's diverticulum (MD) was the most common type of OMDR
World J Clin Cases · PMID 35071553 · Read it on PubMed ↗
Kurita et al. 2022
Transcatheter arterial embolization followed by surgical laparotomy for hemorrhagic shock due to intestinal bleeding: a case report
Rare small-bowel cause of severe bleedingCase seriesVery low qualityRelated question
1 people2022
Bleeding came from small jejunal diverticula with amyloidosis deep in the small intestine; treated with artery embolization plus surgery
Who was studied
An 80-year-old woman with sudden massive intestinal bleeding and shock
Main outcome
What caused the bleeding and how it was treated
Quality
A single case report cannot show how common any cause is or apply to typical painless bleeding.
Limitations
Single patient; presented with hemorrhagic shock (an emergency, not painless bleeding); small bowel source rather than typical rectal bleeding causes.
Taken word for word from the abstract
- n An 80-year-old female presenting with hematochezia and hemorrhagic shock was transferred to our institution.
- population An 80-year-old female presenting with hematochezia and hemorrhagic shock was transferred to our institution.
- result Multiple jejunal diverticula were detected near Treitz' ligament, and an induration of NBCA was palpable in the nearby mesentery.
- result The intraoperative diagnosis was massive bleeding from acquired jejunal diverticula for which jejunectomy including the nearby diverticulum was performed to prevent future bleeding.
- result Histological examination of the specimen revealed several false diverticula with intestinal amyloidosis.
- primaryOutcome Combined treatment of TAE and surgical laparotomy appears to be effective, because the bleeding point can be identified by palpation of the embolic material.
Surg Case Rep · PMID 35038053 · Read it on PubMed ↗
Baumgartner et al. 2021
Liver Disease: Cirrhosis
Cirrhosis can cause bleeding, not specifically rectal.Narrative reviewLow qualityRelated question
size not given2021
The review notes that cirrhosis can be asymptomatic (compensated) until it decompensates, at which point it can cause variceal bleeding, ascites, or encephalopathy; it does not address painless rectal bleeding specifically.
Who was studied
adults with cirrhosis (liver scarring)
Main outcome
cirrhosis-related complications including variceal bleeding
Quality
This is a general narrative review summarizing cirrhosis management, not a study generating new data on rectal bleeding.
Limitations
This is a broad review of cirrhosis diagnosis and management; it discusses variceal bleeding as a complication of liver disease but does not focus on or specifically evaluate painless rectal bleeding as a symptom.
Taken word for word from the abstract
- population Cirrhosis is pathologic scarring of liver tissue that leads to impaired liver function.
- primaryOutcome Clinicians should evaluate for and manage cirrhosis-related complications, including hepatocellular carcinoma, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, esophageal varices, and other complications.
- result compensated (ie, asymptomatic) cirrhosis may decompensate, causing ascites, hepatic encephalopathy, or variceal bleeding.
FP Essent · PMID 34855340 · Read it on PubMed ↗
Hermosa et al. 2021
Diffuse cavernous hemangioma of the rectum
Rare vascular growth causing painless bleeding.Case seriesVery low quality
1 people2021
The bleeding was caused by a diffuse cavernous hemangioma (a rare benign vascular lesion) of the rectum and anus, requiring surgical removal
Who was studied
A 34-year-old man with chronic painless rectal bleeding
Main outcome
Underlying cause of chronic painless rectal bleeding
Quality
This is a single case report, so it cannot show how common this cause is or apply broadly to people with painless bleeding.
Limitations
Only one patient is described, and diffuse cavernous hemangioma is described as rare, so this cannot indicate typical cause of painless bleeding.
Taken word for word from the abstract
- population We present a 34-year-old male with a DCH of the rectum and anus
- primaryOutcome The most frequent symptom is chronic rectal bleeding which is painless
- result We present a 34-year-old male with a DCH of the rectum and anus who required an APR because of affection of dentate line.
- n We present a 34-year-old male
Cir Cir · PMID 34851591 · Read it on PubMed ↗
Barella et al. 2021
Unusual Mesenchymal Tumors of the Lower Gastrointestinal Tract: When You Hear Hoofbeats in the Night, Do Not Forget the Zebras
Various rare tumors found incidentally on colonoscopy.Case seriesLow qualityRelated question
99 people2021
A total of 99 cases were identified: 45 GISTs, 42 lipomas, 4 leiomyomas, 3 Kaposi sarcomas, 1 schwannoma, 1 ganglioneuroma, 1 hemangioma, 1 inflammatory fibroid polyp, and 1 challenging case of spindle cell melanoma
Who was studied
patients found to have mesenchymal tumors of the lower GI tract on colonoscopy done for various reasons (bleeding, pain, constipation, diarrhea, or bowel obstruction), not specifically painless bleeding
Main outcome
types and frequency of mesenchymal tumors of the lower GI tract
Quality
This is a small retrospective single-center pathology case series that does not separately analyze people with painless bleeding, so it cannot show whether bleeding predicts these tumors.
Limitations
Retrospective single-institution case series; polyps were found during colonoscopy done for a mix of symptoms (bleeding, pain, constipation, diarrhea, obstruction), with no breakdown of outcomes specifically for painless bleeding.
Taken word for word from the abstract
- n A total of 99 cases were identified
- population small solitary asymptomatic polyps are accidently found during a screening colonoscopy performed for hematochezia, abdominal pain, constipation, diarrhea, and bowel obstruction
- primaryOutcome we illustrate our experience with mesenchymal tumors of the lower GI tract
- result A total of 99 cases were identified: 45 GISTs, 42 lipomas, 4 leiomyomas, 3 Kaposi sarcomas, 1 schwannoma, 1 ganglioneuroma, 1 hemangioma, 1 inflammatory fibroid polyp, and 1 challenging case of spindle cell melanoma
Pathobiology · PMID 34814148 · Read it on PubMed ↗
El Hajra Martínez et al. 2021
Inverted Meckel's diverticulum diagnosed using capsule endoscopy: A case report
Hidden bowel pouch found, not bleedingCase seriesVery low qualityRelated question
1 people2021
capsule endoscopy led to detection of an inverted Meckel's diverticulum, diagnosed by CT and confirmed by surgery, in a patient who had anemia but no bleeding
Who was studied
a 33-year-old man with iron deficiency anemia, no gastrointestinal bleeding symptoms
Main outcome
finding the cause of iron deficiency anemia via capsule endoscopy and imaging
Quality
This is a single case report of one patient, so it cannot show how common or predictive any finding is.
Limitations
Only one patient was studied, and the patient did not have the painless rectal bleeding symptom this question asks about; he had iron deficiency anemia without gastrointestinal bleeding.
Taken word for word from the abstract
- population a 33-year-old man with iron deficiency anemia without manifestation of gastrointestinal bleeding
- n a 33-year-old man with iron deficiency anemia
- primaryOutcome a capsule endoscopy was performed and offered us a clue to subsequently confirm the diagnosis of inverted Meckel's diverticulum via computed tomography scan
- result The final pathology report described a Meckel's diverticulum.
- result an upper gastrointestinal endoscopy and total colonoscopy were performed, but no abnormalities were found within the observed area
World J Gastroenterol · PMID 34629826 · Read it on PubMed ↗
Fuller et al. 2022
Clinicopathologic Features of Gynecologic Malignancies Presenting Clinically as Colonic Malignancies
Rare gynecologic cancers can mimic colon cancerRetrospectiveLow qualityRelated question
16 people2022
Advanced gynecologic cancers (mostly a type called serous carcinoma) can rarely show up as colon lesions, causing symptoms like bloody stools, abdominal pain, weight loss, or blockage; one case had no symptoms and was found on a screening colonoscopy
Who was studied
Adults found to have gynecologic (ovarian/uterine) cancers that showed up as colon masses or GI symptoms, including some with bloody stools
Main outcome
What GI symptoms or findings led to discovery of these gynecologic cancers
Quality
This is a small retrospective review of archived pathology records from only two hospitals, so it cannot show how common this cause of bleeding is, only that it can happen.
Limitations
Retrospective chart review from two institutions, only 16 cases, most patients had other symptoms besides bleeding (like abdominal pain), so it does not isolate painless bleeding specifically.
Taken word for word from the abstract
- population gynecologic malignancies (adnexal or uterine) causing gastrointestinal (GI) signs (eg, mass on colonoscopy) or symptoms (eg, bloody stools) clinically mimicking a GI primary malignancy
- n We identified 16 cases: 13 biopsies and 3 resections.
- primaryOutcome Gastrointestinal-type complaints included abdominal pain, weight loss, hematochezia, and obstruction; 1 case was asymptomatic and found during screening colonoscopy.
- result Advanced gynecologic malignancies, most commonly serous carcinoma, can rarely manifest as GI lesions.
Am J Clin Pathol · PMID 34302332 · Read it on PubMed ↗
Alyahyawi 2021
Rare cause of painless lower gastrointestinal bleeding: A case report
Endometriosis caused painless rectal bleeding.Case seriesVery low quality
1 people2021
the painless bleeding was found to be caused by intestinal endometriosis, confirmed after surgical removal of the affected bowel segment
Who was studied
a 44-year-old female patient with intermittent painless rectal bleeding and no other symptoms
Main outcome
identifying the underlying cause of painless rectal bleeding
Quality
this is a single patient case report, so it cannot show how common this cause is or rule out other explanations.
Limitations
only one patient described, no comparison group, and diagnosis required surgery rather than a simple test.
Taken word for word from the abstract
- population A 44-year-old female patient suffering from intermittent hematochezia for the past three months was presented with no medical history or any other symptoms correlating with current complaints.
- primaryOutcome Intermittent hematochezia of the patient got worse in the following months without any other concurrent symptom.
- result Laparoscopically assisted ileocecal resection with a sutured side-to-side ileoascendostomy was then performed.
- n A 44-year-old female patient
Int J Surg Case Rep · PMID 34252643 · Read it on PubMed ↗
Koirala et al. 2021
Symptomatic familial adenomatous polyposis in an adolescent: A case report
Bleeding traced to inherited polyp disease.Case seriesVery low qualityRelated question
1 people2021
The bleeding was caused by familial adenomatous polyposis (FAP), an inherited condition with numerous colon polyps and a near-certain lifetime risk of colorectal cancer
Who was studied
13-year-old girl with rectal bleeding and family history of similar bleeding and early death from a genetic colon disease
Main outcome
identifying the cause of the rectal bleeding
Quality
This is a single case report with no comparison group, so it cannot show how common this cause is, only that it can occur.
Limitations
Single case in an adolescent with a strong family history of an inherited syndrome; does not establish how often painless bleeding in typical adults is due to this cause, and the bleeding here is not clearly described as painless.
Taken word for word from the abstract
- population a 13-year-old girl diagnosed with FAP who presented in our center with symptoms of hematochezia along with a positive history of the untimely demise of her father and elder sister with similar symptoms
- n a case of a 13-year-old girl diagnosed with FAP
- primaryOutcome Diagnosis is made by finding hundreds to thousands of adenomatous polyps in the colon and rectum, and molecular analysis of the APC gene which forms the definitive diagnosis.
- result Familial adenomatous polyposis (FAP) is an inherited colorectal cancer syndrome characterized by several adenomatous polyps of the gastrointestinal mucosa with a universal risk of colorectal cancer in a lifetime.
Int J Surg Case Rep · PMID 34186461 · Read it on PubMed ↗
Urrutia Soto et al. 2021
Symptomatic Meckel's Diverticulum in pediatrics
Rare childhood cause of GI bleedingCase seriesVery low qualityRelated question
3 people2021
One of three children had gastrointestinal bleeding (melena) with severe anemia requiring blood transfusion, caused by a Meckel's diverticulum found at surgery; the other two cases presented with bowel obstruction and a congenital duct abnormality, not bleeding
Who was studied
Children with Meckel's diverticulum (ages 6 months to newborn)
Main outcome
Symptoms and diagnosis of Meckel's diverticulum
Quality
This is a report of only 3 pediatric cases, not a study designed to answer how often bleeding occurs or what causes it in adults.
Limitations
Tiny case series (n=3) in children, not adults; the bleeding case involved melena and severe anemia requiring transfusion, not painless rectal bleeding; findings cannot be generalized to adult painless hematochezia.
Taken word for word from the abstract
- population Case 1: A six-month-old patient with obstructive bowel syndrome.
- n To describe 3 sympto matic presentations of MD
- primaryOutcome To describe 3 sympto matic presentations of MD and to discuss its symptoms, signs, and possible diagnostic-therapeutic tools.
- result Case 2: A three-year-old patient presenting with digestive hemorrhage and severe anemia requiring blood transfusion.
- result Due to persis tent melena, the patient required a new blood transfusion.
Andes Pediatr · PMID 34106190 · Read it on PubMed ↗
Tilahun et al. 2020
Leech in the Rectum Causing Lower GI Bleeding in a Four Years Old Child: A Case Report
Leech caused the bleeding.Case seriesVery low qualityRelated question
1 people24 hours
a leech was found attached in the rectum and removed, which was the cause of the bleeding
Who was studied
a four years old child with painless rectal bleeding
Main outcome
cause of painless lower gastrointestinal bleeding
Quality
This is a single child case report, so it cannot show how common this cause is or apply to adults.
Limitations
Single pediatric case report; findings in a 4-year-old child may not generalize to adults with painless rectal bleeding.
Taken word for word from the abstract
- population This is a four years old male child who presented with painless, bright red rectal bleeding for two weeks.
- intervention Leech was removed from the rectum by letting the child sit on a bucket of water.
- primaryOutcome CASE DETAILS: This is a four years old male child who presented with painless, bright red rectal bleeding for two weeks.
- result Leech was removed from the rectum by letting the child sit on a bucket of water.
- n This is a four years old male child
Ethiop J Health Sci · PMID 33883854 · Read it on PubMed ↗
Tomasević et al. 2022
Anemia as a Problem: GEH Approach
Anemia can hide GI bleeding, even cancerNarrative reviewLow qualityRelated question
size not given2022
GI malignancies are the most common cause of chronic bleeding causing anemia, and bidirectional endoscopy is recommended even in patients with anemia but no GI symptoms
Who was studied
Adults with anemia referred to gastroenterologists, including some with no GI symptoms at all
Main outcome
Finding the GI cause of anemia through endoscopic examination
Quality
This is a narrative review summarizing general clinical practice and recommendations, not a study with original patient data or a defined cohort.
Limitations
No original data, no defined patient population with painless rectal bleeding specifically, and no quantitative results reported.
Taken word for word from the abstract
- population patients with anemia are often referred to a gastroenterologist
- population In anemic, GI asymptomatic patients, there are recommendations for bidirectional endoscopy.
- primaryOutcome Esophagogastroduodenoscopy, colonoscopy, and the small intestine examinations in specific situations play a crucial role in diagnosing anemia.
- result Although GI malignancies are the most common cause of chronic bleeding, all conditions leading to blood loss, malabsorption, and chronic inflammation should be considered.
Dig Dis · PMID 33866318 · Read it on PubMed ↗
Nessel et al. 2020
Myocardial Ischemia, a Rare Presentation of Meckel's Diverticulum
Rare cause: bowel pouch bleedCase seriesLow qualityRelated question
1 people2020
Exploratory laparotomy revealed an infarcted Meckel's diverticulum as the source of the bleeding
Who was studied
an elderly male in his early 80's who presented to the emergency department with a 2-day history of emesis and hematochezia, in addition to sudden onset syncope and angina-like symptoms
Main outcome
identifying the cause of the gastrointestinal bleed
Quality
This is a single case report, so it cannot show how common or typical this cause is for people with painless bleeding.
Limitations
Single patient case report; the bleeding here occurred together with vomiting, syncope, and angina-like chest symptoms, not as painless bleeding alone.
Taken word for word from the abstract
- population an elderly male in his early 80's who presented to the emergency department with a 2-day history of emesis and hematochezia, in addition to sudden onset syncope and angina-like symptoms
- primaryOutcome Imaging, including CT-scan and Technetium-99 RBC scan, visualized a gastrointestinal bleed.
- result Exploratory laparotomy revealed an infarcted Meckel's diverticulum.
- n an elderly male in his early 80's
Spartan Med Res J · PMID 33655180 · Read it on PubMed ↗
Zhu et al. 2021
Gastrointestinal hemorrhage caused by duodenal metastasis from a primary lung adenocarcinoma: A case report
Rare metastatic tumor caused bleeding.Case seriesVery low qualityRelated question
1 people2021
The bleeding was caused by a tumor in the duodenum that had spread there from his original lung cancer; he also had abdominal (epigastric) pain as part of his presentation
Who was studied
a 62-year-old man with a history of lung cancer surgery, who developed severe blood in the stool
Main outcome
cause of severe gastrointestinal bleeding (hematochezia)
Quality
This is a single, highly unusual case of cancer that spread from the lungs to the intestine, so it cannot tell us what usually causes painless bleeding in other people.
Limitations
Single case report of an extremely rare condition (lung cancer metastasis to the duodenum); the patient had abdominal pain as an initial symptom, not painless bleeding, and findings from one patient cannot be generalized.
Taken word for word from the abstract
- n A 62-year-old male, who underwent radical lung cancer surgery two years ago
- population A 62-year-old male, who underwent radical lung cancer surgery two years ago, was readmitted to Guangzhou Red Cross Hospital complaining of epigastric pain.
- primaryOutcome the patient reported severe hematochezia
- result Histopathological and immunohistochemical staining results confirmed that the lung adenocarcinoma had metastasized to the duodenum.
- result Prior to the second cycle of targeted treatment with anlotinib, the patient reported severe hematochezia.
Mol Clin Oncol · PMID 33604052 · Read it on PubMed ↗
Malik et al. 2021
Severe Acute Colonic Diverticular Bleeding: The Efficacy of Rapid Bowel Preparation With 1 L Polyethylene Glycol Ascorbate Solution and Direct Endoscopic Hemoclipping for Successful Hemostasis
Diverticula can cause painless bleedingCase seriesVery low qualityRelated question
size not given2021
the case report describes using a fast 1-L bowel prep and direct clipping to successfully stop diverticular bleeding, and notes diverticular disease is a well-known cause of painless lower GI bleeding
Who was studied
adults with severe acute bleeding from colon diverticula (pouches), which causes painless rectal bleeding
What they received
rapid 1-liter bowel-cleansing solution before urgent colonoscopy, plus endoscopic clipping to stop the bleeding
Compared with
traditional larger-volume bowel-prep solutions
Main outcome
stopping the bleeding (hemostasis) during urgent colonoscopy
Quality
This is a case report describing a technique in one or a few patients, with no control group or reported patient numbers, so it mainly illustrates a procedure rather than proving how common or how severe diverticular bleeding is.
Limitations
Case report format with no specific number of patients given, no comparison group, and the focus is on a bowel-prep/clipping technique rather than on explaining why bleeding is painless.
Taken word for word from the abstract
- population Colonic diverticular bleeding is an established cause of painless acute lower gastrointestinal hemorrhage.
- intervention rapid bowel preparation with a very-low-volume novel 1 L polyethylene glycol ascorbate solution in the setting of acute severe colonic diverticular bleeding
- comparator The 1-L regimen may demonstrate similar efficacy to that of traditional higher volume preparations
- primaryOutcome to achieve hemostasis with direct hemoclipping
- result the endoscopic technique using epinephrine followed by direct hemoclipping may be added to the armamentarium for acute colonic diverticular hemorrhage as the first treatment
J Investig Med High Impact Case Rep · PMID 33596710 · Read it on PubMed ↗
Gualtieri et al. 2021
Perianal streptococcal disease in childhood: systematic literature review
Strep infection can cause perianal bleedingSystematic reviewLow qualityRelated question
size not given3½ months (for recurrence)
Children with perianal strep infection usually have defecation problems, perianal pain, itching, rectal bleeding or fissure, and a sharply bordered red patch around the anus; diagnosis is often delayed 3 weeks or more, and about 1 in 5 cases come back within a few months
Who was studied
children, mostly boys 7 years or younger, with perianal symptoms
Main outcome
what perianal streptococcal infection looks like and how it is diagnosed
Quality
It pools small case reports and case series on a childhood condition, not adult patients with painless bleeding, so it only loosely informs this question.
Limitations
Describes a pediatric infection whose classic picture includes perianal pain and fissure, not painless rectal bleeding in adults; it does not address adult hematochezia causes.
Taken word for word from the abstract
- population More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness.
- primaryOutcome The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection.
- result The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases.
Eur J Pediatr · PMID 33532889 · Read it on PubMed ↗
Vaabengaard et al. 2020
Complicated Meckel's Diverticulum in Children: Clinical Presentation, Diagnostic Work-Out, Surgical Approach and Postoperative Complications
Bowel pouch can cause unexplained bleeding in kidsRetrospectiveLow qualityRelated question
58 people2020
Of 18 children who presented with rectal bleeding or melaena, the diverticulum was identified before surgery in only one case despite an average of 3.2 preoperative tests; most patients needed surgery to find the cause, and two had postoperative complications
Who was studied
children under 15 having surgery for complications of Meckel's diverticulum, some with rectal bleeding or melaena and some with acute abdominal pain
Main outcome
how often Meckel's diverticulum was correctly diagnosed before surgery, and surgical approach/complications
Quality
small retrospective surgical series in children with mixed symptoms, not a study of painless bleeding specifically
Limitations
retrospective design, pediatric population, groups mix rectal bleeding with melaena and with a separate acute-abdomen group, and bleeding is not specified as painless
Taken word for word from the abstract
- population a two-center, retrospective analysis of all children below the age of 15 years, operated for complications to MD
- primaryOutcome The primary aim of the present study was to evaluate the diagnostic process and surgical approach in relation to clinical presentation.
- result In the 18 patients presenting with rectal bleeding or melaena an average of 3.2 preoperative investigations were performed and in only one case the MD was recognized preoperatively.
- n A total of 58 patients were included.
Cureus · PMID 33520549 · Read it on PubMed ↗
Sharma et al. 2021
Recurrent haematochezia in an 85-year-old man with hepatocellular carcinoma
Radiation therapy for liver cancer caused bowel bleedingCase seriesVery low quality
1 people2021
radiation treatment for his liver cancer had damaged his bowel, causing painless bleeding
Who was studied
an 85-year-old man with liver cirrhosis and liver cancer, treated with radiation therapy
Main outcome
cause of painless rectal bleeding
Quality
This is a single patient's case, so it cannot tell us how common this cause is for people in general.
Limitations
Single case report; findings cannot be generalised to other patients with painless rectal bleeding.
Taken word for word from the abstract
- population An 85-year-old man with Child-Pugh A cirrhosis secondary to non-alcoholic steatohepatitis presented to casualty with four days of painless haematochezia with dark blood without haemodynamic compromise.
- primaryOutcome the importance of considering radiation induced colitis as a cause for painless lower gastrointestinal bleeding
- result He was found to have haemorrhagic radiation colitis which was treated with argon plasma coagulation (APC).
- n An 85-year-old man
BMJ Case Rep · PMID 33408109 · Read it on PubMed ↗
Ferdaus et al. 2021
Giant Villous Adenoma: A Rare Case of Colorectal Adenoma that Mimic Colorectal Cancer
Benign polyp caused bleeding, not cancer.Case seriesVery low quality
1 people2021
A large benign colorectal adenoma (villous adenoma with low-grade dysplasia) was found to be the cause, not cancer, though it initially looked suspicious for cancer
Who was studied
A 65-year-old woman with years of intermittent painless, scanty rectal bleeding and mucus discharge
Main outcome
What was causing the painless rectal bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or how it compares with other causes of painless bleeding.
Limitations
Only one patient was described, with no comparison group, so findings cannot be generalized to people with painless rectal bleeding in general.
Taken word for word from the abstract
- population We came across a 65 years female with intermittent per rectal mucus discharge for last 10 years and intermittent fresh, painless, scanty per rectal bleeding along with weakness and fatigue for last 5 years.
- n We came across a 65 years female with intermittent per rectal mucus discharge for last 10 years and intermittent fresh, painless, scanty per rectal bleeding along with weakness and fatigue for last 5 years.
- primaryOutcome histopathological report of colonoscopic biopsy was contradictory
- result Resected specimen was sent for histopathological study and it reveals- villous adenoma with low grade dysplasia.
Mymensingh Med J · PMID 33397878 · Read it on PubMed ↗
Alkhamis et al. 2020
Good Outcome of Early-Stage Rectal Cancer Diagnosed During Pregnancy
Painless bleeding caused by early rectal cancer.Case seriesVery low qualityRelated question
1 people2020
Sigmoidoscopy showed a small fungating, intramural mass that was diagnosed as early rectal cancer (tubulovillous adenoma with focal intramucosal carcinoma), which was removed completely during the procedure.
Who was studied
A 30-year-old patient, gravida 3, presented at 9-week gestation with a history of sudden painless, fresh, rectal bleeding with no aggravating factors such as constipation or hemorrhoids.
Main outcome
identifying the cause of painless rectal bleeding
Quality
This is a single patient's case report with no comparison group, so it cannot show how common this cause of bleeding is in general.
Limitations
Single case report in a pregnant patient; findings cannot be generalized to the broader population of adults with painless rectal bleeding.
Taken word for word from the abstract
- population A 30-year-old patient, gravida 3, presented at 9-week gestation with a history of sudden painless, fresh, rectal bleeding with no aggravating factors such as constipation or hemorrhoids.
- primaryOutcome Sigmoidoscopy showed a small fungating, intramural mass, 40 cm from the anal verge, which easily bled upon touch.
- result the histopathological diagnosis was a tubulovillous adenoma with focal intramucosal carcinoma
- n A 30-year-old patient, gravida 3, presented at 9-week gestation
Am J Case Rep · PMID 32866137 · Read it on PubMed ↗
Anyfantakis et al. 2020
Rectal Lipoma in an Elderly Male: A Case Report
Lipoma found causing a mass, not bleeding.Case seriesVery low qualityRelated question
1 people2020
The mass was diagnosed as a rectal lipoma after trans-anal excision and histopathology; this specific patient presented with a protruding mass, not with rectal bleeding, and had an uneventful recovery.
Who was studied
an elderly male with a protruding rectal mass noticed during defecation
Main outcome
diagnosis and removal of the rectal mass
Quality
It is a single case report, so it cannot show how common or predictive any particular symptom is for the general population.
Limitations
Only one patient is described, and the abstract's general statement about lipomas causing bleeding is not shown to apply to this specific case, which did not involve bleeding.
Taken word for word from the abstract
- population We present a case of an elderly male admitted to the Department of Surgery of a general hospital in Crete, complaining of a protruding rectal mass during defecation.
- n We present a case of an elderly male
- primaryOutcome Histopathology of the resected specimen confirmed the diagnosis.
- result The mass was removed by trans-anal excision.
- result The patient had an uneventful postoperative course and was discharged home at the second postoperative day.
Cureus · PMID 32617237 · Read it on PubMed ↗
Gómez-Jurado et al. 2020
Lower gastrointestinal bleeding due to colonic fistula caused by a gossypiboma: Case report and literature review
Rare: forgotten surgical sponge caused bleedingCase seriesVery low qualityRelated question
1 people2020
a forgotten surgical sponge from a prior operation had formed a mass that eroded into the colon, causing a fistula and bleeding; the patient died
Who was studied
an elderly man with sudden rectal bleeding and unstable blood pressure, who had had abdominal surgery many years earlier
Main outcome
finding the cause of his lower gastrointestinal bleeding
Quality
this is a single patient's case report, so it cannot show how common or typical this cause of bleeding is
Limitations
only one patient, no mention of whether the bleeding was painless, and a very rare cause (retained surgical sponge) unlikely to explain most cases of painless rectal bleeding
Taken word for word from the abstract
- n An 85-year-old male, previous left nephrectomy 12 years before, came to the emergency room with hematochezia and hemodynamic instability.
- population An 85-year-old male, previous left nephrectomy 12 years before, came to the emergency room with hematochezia and hemodynamic instability.
- primaryOutcome An emergent angio-CT revealed a 12 cm mass due to a gossypiboma near the descending colon; the presence of air suggested an infection and/or fistulization to the bowel.
- result It was decided not to perform invasive procedures, resulting in the patient's death.
Int J Surg Case Rep · PMID 32506032 · Read it on PubMed ↗
Zagaceta Torres et al. 2020
[Cystic lymphangioma of the rectum-sigmoid in a public hospital in Lima-Peru: case report]
Rare benign growth caused bleeding.Case seriesVery low qualityRelated question
1 people2020
a rare benign lymphatic malformation (cystic lymphangioma) of the rectum and sigmoid was found as the cause of the bleeding and pain, confirmed by tissue biopsy
Who was studied
a patient with rectal bleeding, pain, and changes in bowel habits
Main outcome
finding the cause of the rectal symptoms through colonoscopy and biopsy
Quality
This is a single case report, so it cannot show how common this cause is or whether it applies to people with painless bleeding.
Limitations
Only one patient was studied, and that patient had pain and altered bowel habits, not painless bleeding as asked about here.
Taken word for word from the abstract
- n We present a case of cystic rectal-sigmoid lymphangioma that we had in our hospital
- population the patient presented with proctalgia, alternating evacuation and intermittent rectal bleeding
- primaryOutcome The diagnosis is made by endoscopy, auxiliary images and is confirmed by histology.
- result The definitive diagnosis was made by histopathology, which describes dilated lymphatic ducts, surrounded by endothelial cells, findings consistent with cystic rectal-sigmoid lymphangioma.
Rev Gastroenterol Peru · PMID 32369468 · Read it on PubMed ↗

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.

Searched: PubMed · ClinicalTrials.gov · Crossref on 2026-10-26
The exact search — paste this into PubMed to repeat it: ("Gastrointestinal Hemorrhage"[Mesh] OR hematochezia[tiab] OR "blood in stool"[tiab] OR "rectal bleeding"[tiab] OR "bloody stool"[tiab]) AND ("Colorectal Neoplasms"[Mesh] OR "Hemorrhoids"[Mesh] OR "Fissure in Ano"[Mesh] OR "Diverticulosis, Colonic"[Mesh] OR etiology[tiab] OR cause[tiab] OR causes[tiab] OR diagnosis[tiab]) AND (painless[tiab] OR "no pain"[tiab] OR asymptomatic[tiab]); PubMed expanded that to: ("Gastrointestinal Hemorrhage"[MeSH Terms] OR "hematochezia"[Title/Abstract] OR "blood in stool"[Title/Abstract] OR "rectal bleeding"[Title/Abstract] OR "bloody stool"[Title/Abstract]) AND ("Colorectal Neoplasms"[MeSH Terms] OR "Hemorrhoids"[MeSH Terms] OR "Fissure in Ano"[MeSH Terms] OR "diverticulosis, colonic"[MeSH Terms] OR "etiology"[Title/Abstract] OR "cause"[Title/Abstract] OR "causes"[Title/Abstract] OR "diagnosis"[Title/Abstract]) AND ("painless"[Title/Abstract] OR "no pain"[Title/Abstract] OR "asymptomatic"[Title/Abstract])
What came back: 729 records found · 196 read · 135 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Studies mainly about painful anal fissure bleeding
Studies mainly about bleeding with abdominal pain (e.g. diverticulitis, ischemic colitis)
Studies mainly about upper GI bleeding (melena)
Studies mainly about bleeding during pregnancy (obstetric causes)
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
Limits: Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

729records came back from the search
196were read
135actually answered the question

Risks and safetyReported side effects and who should be careful.

Painless bleeding can be the first sign of colorectal cancer, or rarer cancers like anorectal melanoma, which are more treatable when found early.
Bleeding that isn't noticed or is ignored over time can lead to iron-deficiency anemia without any other warning sign.

Why people askWhat brings people to this question.

Seeing blood in the toilet bowl or on toilet paper is frightening, even without pain, because blood is strongly associated with cancer in people's minds.
Because nothing hurts, it's tempting to assume it's minor and put off seeing a doctor.
Hemorrhoids are common and often assumed to be the automatic explanation, so people may self-treat instead of getting checked.

Common questionsShort answers, drawn from the same studies.

What does it mean if my poop is lined with blood little?: A thin streak or small amount of blood on the stool's surface is often linked to a problem right at the anus or lower rectum, such as hemorrhoids or a small blood vessel issue, rather than bleeding higher up. It still deserves a doctor's look to make sure a polyp or something else isn't also there.
Is bright red blood in stool bad?: Bright red blood usually means the bleeding is coming from the rectum, anus, or lower colon, and in large hospital studies it was most often caused by hemorrhoids, small ulcers, or abnormal blood vessels rather than cancer. Still, cancer and polyps were also found in people with this symptom in some studies, so it's a reason to get checked, not something to assume is safe to ignore.
What causes bright red blood when you poop?: Studies point to hemorrhoids, small rectal ulcers, abnormal or fragile blood vessels, diverticulosis (small pouches in the colon), and polyps as common painless causes. Less often, case reports describe rarer causes such as vascular growths, benign tumors, or, rarely, a cancer.
Does blood in stool mean cancer?: Not usually — most people in these studies who had blood in their stool were found to have a benign cause, like hemorrhoids or blood vessel changes. But cancer and precancerous polyps were also found in some people with this symptom, and even in people with none, so blood in the stool should prompt a colonoscopy to rule cancer out, rather than rule it in.
What happens if there is blood in your poop?: It depends entirely on the cause, which only a doctor's exam or colonoscopy can find — outcomes in these studies range from a hemorrhoid needing no treatment, to a polyp removed during colonoscopy, to, less often, a cancer needing further care. Because the possible causes range from harmless to serious, the next step is getting it looked at, not waiting to see if it stops.

What has changedEvery re-check, and whether it changed the answer.

2026-10-26
Clear the 'Under re-review' backlog: rebuild every remaining first-method (ev-1) page under the current method. 108 new studies · 77 no longer retrieved · evidence strength very low → low · conclusion signal of harm → not applicable.
How certain we are changed. The conclusion changed.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

Contact the office

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.