When I wipe my bum I feel a lump — what is it?

This is most often a hemorrhoid, a swollen vein around the anus, which can bleed bright red when you wipe. A review of anorectal symptoms found that a lump plus bright red bleeding fits this pattern, but ongoing pain, a lump that changes, or weight loss are reasons to get it looked at rather than assume.

Is bright red blood on toilet paper always from hemorrhoids?

No. It's the most common cause described in the evidence, but studies also found that reporting rectal bleeding was linked to a higher chance of finding a pre-cancerous growth or early bowel cancer, particularly in adults under 50. The pattern of the blood and any other symptoms matter.

What should I do instead of just assuming it's hemorrhoids?

Mention it to a doctor, especially if it's new, keeps happening, or you're under 50 — studies found that bleeding in this group was linked to meaningfully higher odds of a serious growth, and that people often delay seeking help by a month or more. A doctor can examine you or arrange a simple stool test rather than you guessing.

Can rectal bleeding be a sign of bowel cancer in young people?

Yes, it can. Studies of adults under 50 found rectal bleeding was linked to more than double the odds of an advanced pre-cancerous growth, and to higher odds of early-onset bowel cancer diagnosis, even though the absolute number of people with cancer among those who bleed stayed low.

What tests can find out what's actually causing the bleeding?

A simple stool blood test (FIT) can help show who is at low risk and may not need further tests, while a direct examination such as anoscopy or colonoscopy can look inside and find the exact cause. A review proposed starting with a basic anal exam before moving to more invasive tests.

Why do I bleed bright red blood when I wipe my bum?

Name: Why do I bleed bright red blood when I wipe my bum?
Published: 2026-10-13
Keywords: why does my bum bleed when i wipe, bright red blood when i wipe my butt, red blood when i wipe my bum, why's my bum bleeding when i wipe, when i wipe my bum i feel a lump

In adults who notice bright red blood on toilet paper after wiping (with or without a palpable lump), what are the most common underlying anorectal causes and how often is each identified on evaluation?

How people search for this, in their own words

“why does my bum bleed when i wipe”
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Evidence review in plain language · compiled 2026-10-13 · checked 2026-10-13 · next 2026-11-13 · automated review, how it works

Bottom line

Bright red blood on the toilet paper is usually from hemorrhoids or a small tear near the anus (a fissure) — but it can sometimes be an early sign of a growing polyp or bowel cancer, so it is worth getting checked, especially if you are under 50 or it keeps happening.

A review of anorectal symptoms found that bright red blood just on the paper usually comes from hemorrhoids, while dark red blood, ongoing anal pain, or unexplained weight loss point more towards cancer [8]. Separately, large studies of people already having a colonoscopy for symptoms found that reporting rectal bleeding was linked to more than double the odds of finding an advanced pre-cancerous growth in adults under 50 [65], and to higher odds of being diagnosed with early-onset bowel cancer [88]. These studies describe people already being investigated for symptoms, not everyone who ever notices a spot of blood, so they cannot tell you the exact chance that your own bleeding is serious.

How certain

Moderate

A systematic review addresses this question, but the underlying trials are limited.

What it shows

Signal of harm

A well-conducted study in people reported harm.

studies found: 95studies found
randomised trials: 0randomised trials
people studied: 558,514people studied
reviews of trials: 4reviews of trials
years covered: 2025–2026years covered

Read this first

In adults under 50, having rectal bleeding as a symptom was linked to more than double the odds of an advanced pre-cancerous growth being found on colonoscopy.
Rectal bleeding was one of several symptoms linked to significantly higher odds of early-onset bowel cancer in adults aged 20 to 49.
People later diagnosed with bowel cancer often waited a month or more before seeking care, and bleeding in younger adults was sometimes initially dismissed as minor.

What the research shows

Bleeding caused by hemorrhoids
Hemorrhoids are repeatedly described as a common cause of bright red bleeding, but no study in this set gives a reliable percentage of how many people with this exact symptom turn out to have hemorrhoids.[1,2]
Insufficient evidence
Bleeding caused by an anal fissure (small tear)
No study here measured how often a fissure specifically explains bright red blood seen on wiping.
Not studied
Bleeding caused by other anorectal problems (polyps, fistulas, infections)
Single case reports describe rectal polyps, fistulas, and infections causing bleeding, but one case cannot tell you how often these explain the symptom generally.[1,2,3,4,5]
Not studied
Bleeding caused by a polyp or bowel cancer (colorectal neoplasia)
In people already referred for colonoscopy because of symptoms, having rectal bleeding was linked to more than double the odds of an advanced pre-cancerous growth in adults under 50, and to higher odds of early-onset bowel cancer — though the absolute number of people found to have cancer stayed low.[1,2,3]
Possible harm
Bleeding resolving after the cause is treated
Case reports show bleeding stopped after a specific cause (a polyp, a hemorrhoid, a fistula) was treated, but no study tracked how often bleeding resolves across an unselected group of people with this symptom.[1,2,3]
Insufficient evidence
Missing a serious cause at the first check
Studies of people later diagnosed with bowel cancer found many had a delay of a month or more before seeing a doctor, and symptoms in younger adults were sometimes initially dismissed.[1,2,3]
Possible harm

What it may help with

A systematic review identified features that help separate harmless bleeding from something more concerning: bright red blood just on the paper is usually from hemorrhoids, while dark red blood, ongoing anal pain, or unexplained weight loss point more towards cancer.[1]
A large national registry found that a simple stool blood test (FIT) can help show who has a very low chance of cancer even when they report rectal bleeding, which may reduce the need for invasive tests in lower-risk people.[1]

Important limitations

The main systematic review addressing this question included only 46 people in total, and the authors note there are few randomised trials and limited data from primary care settings.[1]
No randomised trial has tested how often each individual cause — hemorrhoids, fissure, polyp, or cancer — explains bright red bleeding in unselected people. Most of the supporting evidence here is single case reports of one rare patient, which cannot establish how common any cause is.[1,2,3,4,5]
The studies linking bleeding to cancer risk were done in people already referred for colonoscopy because of symptoms, not in the general population of people who simply notice blood on the paper, so the real-world risk for someone with no other symptoms may be lower than these figures suggest.[1,2]

What the studies found

Found a benefit38 · 40%
Found no clear effect2 · 2%
Mixed or unclear46 · 48%
Found possible harm9 · 9%

What kind of studies

Case series50 · 53%
Retrospective18 · 19%
Narrative review8 · 8%
Prospective cohort6 · 6%
Animal study5 · 5%
Systematic review2 · 2%
Meta-analysis2 · 2%
Laboratory study1 · 1%
Registry1 · 1%
Guideline1 · 1%
Case-control1 · 1%

The studies that decided it

Tu et al. 2026
Hemorrhoids and Rectal Cancer: A Systematic Review of Clinical Overlap, Diagnostic Misclassification, and Early Detection Strategies for Primary Care
Bright red usually hemorrhoids, dark red needs checking.Systematic reviewModerate quality
46 people2026
bright red bleeding on wiping is usually from hemorrhoids, but dark red blood, ongoing anorectal pain, or unexplained weight loss can signal rectal cancer and warrant checking
Who was studied
people with anorectal symptoms like rectal bleeding, where hemorrhoids and rectal cancer can look similar
What they received
reviewing symptoms and diagnostic methods to tell hemorrhoids apart from rectal cancer
Main outcome
how often hemorrhoids and rectal cancer symptoms overlap and cause misdiagnosis
Quality
this is a well-conducted review of existing studies, but it combines different types of research without new patient testing and notes a lack of strong trial evidence.
Limitations
few randomized controlled trials on diagnosis, limited data from primary care settings, and early-stage evidence for newer screening technologies
Taken word for word from the abstract
- population Hemorrhoidal disease (HD) and rectal cancer (RC) are common anorectal disorders with overlapping clinical symptoms, including rectal bleeding, altered bowel habits, and anorectal discomfort.
- intervention This systematic review aimed to summarize overlapping features, analyze causes of misdiagnosis, and review advances in early detection to provide practical guidance for primary care.
- primaryOutcome Rectal bleeding was the most frequent overlapping symptom, followed by altered bowel habits and anorectal discomfort.
- result Warning signs suggestive of RC included dark red blood per rectum, persistent anorectal pain, and unexplained weight loss.
- n Forty-six moderate- to high-quality studies were included in the analysis.
- limitations Limitations include scarcity of randomized controlled trials in diagnostic research, limited primary care data, and preliminary evidence for emerging technologies.
J Multidiscip Healthc · PMID 42699804 · Read it on PubMed ↗
Huynh et al. 2026
Influence of Patient Demographics, Symptoms, and Initial Provider Type on Timeliness of Rectal Cancer Diagnosis
Cancer diagnosis often delayed via primary care.RetrospectiveLow qualityRelated question
205 people2026
72% of patients had a delay in seeing a doctor after symptoms started; younger patients and those with bowel habit changes were more likely to be delayed, and patients who first saw a primary care doctor were more likely to have a delay in getting diagnosed than those who went to the emergency department
Who was studied
patients who had surgery for rectal cancer
What they received
type of first healthcare provider seen (emergency department vs primary care) and presenting symptoms
Compared with
emergency department visit versus primary care physician visit as the first point of contact
Main outcome
delay of more than 30 days between symptom onset and first medical evaluation
Quality
this is a retrospective chart review from one hospital looking at patterns in care, not a trial testing a treatment, so it can't tell you what causes bleeding or prove cause and effect
Limitations
single institution, retrospective design, relies on chart review and database data
Taken word for word from the abstract
- n Among 205 patients with available data
- population patients undergoing surgical resection for rectal cancer at a single institution
- intervention comparisons between emergency department versus primary care physician (PCP) for initial medical presentation
- comparator Patients presenting to a PCP were more likely to experience diagnosis delay compared to those presenting to the emergency department
- primaryOutcome The primary outcome was presentation delay, defined as >30 days from symptom onset to first medical evaluation.
- result Among 205 patients with available data, 147 (72%) experienced presentation delay.
- result Patients presenting to a PCP were more likely to experience diagnosis delay compared to those presenting to the emergency department (75% versus 55%, P = 0.012).
J Surg Res · PMID 42235251 · Read it on PubMed ↗
Alzaabi et al. 2026
Age-Specific Colonoscopic Yield and Symptom-Based Risk Stratification in Symptomatic Adults: A Bicenter Omani Analysis to Inform Early Detection and Screening Strategies for Colorectal Neoplasia
Bleeding linked to higher cancer riskRetrospectiveLow quality
2,041 people2026
in adults under 50, rectal bleeding was linked to more than double the odds of having advanced colorectal neoplasia
Who was studied
adults having colonoscopy for symptoms like bleeding or pain in Oman, split into under 50 and 50 and older
What they received
having rectal bleeding as a symptom before colonoscopy
Compared with
not having rectal bleeding as a symptom
Main outcome
finding advanced colorectal neoplasia (pre-cancer or cancer) on colonoscopy
Quality
this is a retrospective look-back at colonoscopy records from referral hospitals, not a trial, so it can show links but not prove how risky any one person's bleeding is
Limitations
cohort was mostly symptomatic patients referred to tertiary hospitals, so it cannot say what screening age is best, and authors state it cannot determine optimal screening thresholds
Taken word for word from the abstract
- n Of 2041 procedures, 742 (36.3%) were in patients <50 years
- population The cohort was predominantly symptomatic (71.9%), with 15.8% screening and 12.3% surveillance procedures.
- intervention Among younger adults, rectal bleeding (OR 2.17, 95% CI 1.15-4.08, p = 0.026) and abdominal pain (OR 2.14, 95% CI 1.15-3.98, p = 0.022) were significantly associated with ACRN.
- comparator Associations between presenting symptoms and ACRN were analyzed using univariable logistic regression
- primaryOutcome Outcomes included adenoma detection rate (ADR), advanced premalignant lesions (APL), colorectal cancer (CRC), and advanced colorectal neoplasia (ACRN; APL and/or CRC).
- result rectal bleeding (OR 2.17, 95% CI 1.15-4.08, p = 0.026) and abdominal pain (OR 2.14, 95% CI 1.15-3.98, p = 0.022) were significantly associated with ACRN
Medicina (Kaunas) · PMID 41752772 · Read it on PubMed ↗
Beaton et al. 2026
Real-World Performance of FIT Triage for Symptomatic Colonoscopy: Analysis of the UK National Endoscopy Database (NED)
Low stool-test result means low cancer risk.RegistryModerate qualityRelated question
447,109 people2026
a higher FIT stool-blood-test result was strongly linked to finding cancer, while people with iron-deficiency anaemia had higher cancer risk than those with just rectal bleeding; a low FIT result meant very low cancer risk even with bleeding symptoms
Who was studied
adults referred for colonoscopy because of bowel symptoms, including rectal bleeding and iron-deficiency anaemia
What they received
using a stool blood test (FIT) to decide who needs a colonoscopy
Compared with
deciding on colonoscopy based on symptoms alone (such as rectal bleeding)
Main outcome
how often colonoscopy found cancer or polyps
Quality
it is a very large real-world national database giving reliable patterns, but it looks at colonoscopy triage strategy rather than directly explaining the cause of a patient's bleeding
Limitations
observational registry data, FIT only recorded in 45% of cases, and it studies triage strategy rather than the specific causes of bright red rectal bleeding
Taken word for word from the abstract
- population Symptomatic procedures, including iron-deficiency anaemia (IDA), were identified and diagnostic yields calculated.
- intervention The UK has adopted faecal immunochemical testing (FIT) to triage symptomatic colonoscopy referrals.
- comparator demonstrates the superiority of FIT-based triage over symptom-based referral
- primaryOutcome Quantify diagnostic yield and independent effects of FIT, age, sex and symptoms on polyp and cancer detection in symptomatic colonoscopy.
- result FIT concentration showed a strong, graded association with cancer risk, weaker association with large polyps, and minimal association with small polyps. IDA was associated with higher cancer risk versus rectal bleeding (aOR 2.2, 95% CI, 2.0-2.3; p < 0.01).
- n Analysis of 447,109 symptomatic colonoscopies, with FIT recorded in 202,219 (45.2%).
Aliment Pharmacol Ther · PMID 41601400 · Read it on PubMed ↗
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
Bleeding linked to higher cancer odds.Case-controlModerate quality
2,052 people2026
rectal bleeding, along with other symptoms, was linked to significantly higher odds of early-onset colorectal cancer
Who was studied
adults aged 20 to 49 diagnosed with early-onset colorectal cancer, matched to similar patients without the cancer
What they received
having rectal bleeding as a symptom
Compared with
patients without early-onset colorectal cancer
Main outcome
odds of being diagnosed with early-onset colorectal cancer
Quality
It's a large, carefully matched study using medical records, but being retrospective and observational means it can show a link, not prove that bleeding causes or predicts cancer in any one person.
Limitations
Abstract does not explicitly discuss limitations; retrospective design based on medical record data from one multistate health system.
Taken word for word from the abstract
- n 684 EOCRC cases and 1,368 controls
- population 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
- intervention rectal bleeding
- comparator control patients without EOCRC
- 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 ↗
Roth et al. 2025
[Hematochezia : when should we worry ?]
Proposes exam order, no outcome dataNarrative reviewLow quality
size not given2025
The abstract proposes a diagnostic algorithm rather than reporting a tested result
Who was studied
people with hematochezia (bright red blood when wiping), including young people
What they received
a proposed diagnostic algorithm using anoscopy as the first examination
Compared with
current approach that does not distinguish between rectosigmoidoscopy and colonoscopy
Main outcome
how to properly diagnose the cause of hematochezia
Quality
This is a narrative discussion proposing a diagnostic approach, not a study that tested outcomes in patients.
Limitations
No patient numbers, no comparative data, and no outcomes are reported; it is an opinion/algorithm proposal rather than a controlled study.
Taken word for word from the abstract
- population It could be falsely reassuring when it happened in young people, for the proportion of malign causes is relatively low in this population.
- intervention We suggest an algorithm of diagnostic, which could use an anuscopy as first line examination, eventually completed by a colonoscopy depending on the results of the first examination as well as the evolution under treatment.
- comparator The gastroenterology societies do not differentiate rectosigmoidoscopy and colonoscopy, in the process of diagnostic of an hematochezia.
- primaryOutcome Hematochezia is a common symptom, which could reveal benign pathologies as well as malign.
- result We suggest an algorithm of diagnostic, which could use an anuscopy as first line examination, eventually completed by a colonoscopy depending on the results of the first examination as well as the evolution under treatment.
Rev Med Suisse · PMID 41262021 · Read it on PubMed ↗

What actually helps, on this site

More about the condition:

All 95 studiesEvery study that answered the question, with its design, size and result.

The other 89 studiesEverything else the search returned, including anything retracted.

Bahari et al. 2026
A Rare Mimicker of Malignancy: Inflammatory Cloacogenic Polyp Presenting as Obstruction in a Colon Cancer Survivor
Rare benign polyp mimicked cancer.Case seriesVery low qualityRelated question
1 people2026
the growth that looked like cancer recurrence turned out to be a benign inflammatory cloacogenic polyp, found through tissue biopsy
Who was studied
a colon cancer survivor presenting with symptoms suggesting cancer recurrence
What they received
not applicable (diagnostic case report)
Compared with
not applicable
Main outcome
correct diagnosis of the cause of symptoms (obstruction/suspected recurrence)
Quality
this is a single patient case report, so it cannot show how common this is or what causes bleeding in general
Limitations
single case, no control group, findings may not generalize to other patients with rectal bleeding
Taken word for word from the abstract
- n a challenging case where a patient with a history of cancer presented
- population a patient with a history of cancer presented with signs that strongly suggested a malignant recurrence
- result the final diagnosis was an inflammatory cloacogenic polyp
- primaryOutcome the final diagnosis was an inflammatory cloacogenic polyp
- intervention a detailed tissue examination is crucial for making the correct diagnosis
- comparator Inflammatory cloacogenic polyps are rare and often discovered either during routine colorectal cancer screenings or in symptomatic patients presenting with hematochezia.
Prague Med Rep · PMID 42831609 · Read it on PubMed ↗
Han et al. 2026
Mucinous adenocarcinoma presenting as adult colonic intussusception: A case report
Rare colon cancer found in one case.Case seriesVery low qualityRelated question
1 people2026
bright red blood was caused by a rare colon cancer (mucinous adenocarcinoma) causing bowel telescoping (intussusception)
Who was studied
a 75-year-old woman with multiple health problems and dementia
What they received
none (diagnostic workup and emergency surgery)
Compared with
none
Main outcome
cause of bleeding and bowel obstruction symptoms
Quality
this is a single patient case report, so it cannot tell you how likely this cause is for anyone else.
Limitations
single case report with no comparison group; findings may not generalize to other patients with rectal bleeding
Taken word for word from the abstract
- population a 75-year-old woman with multiple comorbidities who presented with hematochezia, abdominal distension, intermittent colicky pain, and progressive weight loss
- primaryOutcome Colonoscopy revealed a large intraluminal mass in the ascending colon, while contrast-enhanced computed tomography revealed ileocecal intussusception with ischemic features
- result Histopathology confirmed a moderately differentiated MAC without lymph node metastasis
- n a 75-year-old woman
- intervention Emergency right hemicolectomy was performed.
- comparator Here we describe a rare case of MAC causing colonic intussusception.
Medicine (Baltimore) · PMID 42798120 · Read it on PubMed ↗
Contento-Anaya et al. 2026
Diagnostic Indications and Endoscopic Correlates of Fecal Occult Blood Testing in Hospitalized Patients
No link between stool blood test and bleeding source.RetrospectiveLow qualityRelated question
160 people2026
after adjusting for the fact that positive tests were checked with endoscopy far more often than negative tests, there was no significant link between a positive FOBT and abnormal endoscopy findings
Who was studied
hospitalized adults who had a fecal occult blood test (FOBT) done, mostly for anemia or suspected GI bleeding
What they received
fecal occult blood test (FOBT) result (positive or negative)
Compared with
endoscopic findings (EGD or colonoscopy results)
Main outcome
whether a positive FOBT was linked to abnormal findings on endoscopy
Quality
it is a retrospective study with only 160 patients and acknowledged bias because positive and negative tests were not checked equally with endoscopy.
Limitations
retrospective design, differential (unequal) endoscopic verification between positive and negative test results, wide confidence intervals
Taken word for word from the abstract
- n We conducted a retrospective study of 160 hospitalized adults who underwent FOBT at a medium-complexity referral center.
- population FOBT is widely used for colorectal cancer screening in asymptomatic populations but is frequently applied in hospitalized patients with anemia or suspected gastrointestinal bleeding
- intervention fecal occult blood testing (FOBT)
- comparator its association with endoscopic findings while accounting for differential endoscopic verification
- primaryOutcome To evaluate the clinical utility of fecal occult blood testing (FOBT) in hospitalized patients, focusing on its indications and its association with endoscopic findings
- result no significant association between FOBT positivity and abnormal endoscopic findings persisted after multivariable adjustment or bias correction, for either EGD (OR 2.01, 95%CI 0.66-6.10) or colonoscopy (OR 4.58, 95%CI 0.39-54.3).
Diagnostics (Basel) · PMID 42793706 · Read it on PubMed ↗
Mitchell et al. 2026
Splenic Artery Pseudoaneurysm With Fistulization to the Transverse Colon: A Case Report
Rare cause, successfully treated with surgery.Case seriesVery low qualityRelated question
1 people2026
Bleeding stopped and symptoms resolved after treatment
Who was studied
Woman in her 80s with rectal bleeding
What they received
Endovascular embolization followed by splenectomy and colon resection
Compared with
None
Main outcome
Resolution of bleeding and symptoms
Quality
This is a single patient case report, which cannot show whether this treatment works in general.
Limitations
Single case report; cause of bleeding (splenic artery pseudoaneurysm with fistula to colon) is a rare condition, not representative of typical causes of bright red rectal bleeding.
Taken word for word from the abstract
- population a female in her 80s presenting with rectal bleeding, diagnosed with SAP with fistulization to the transverse colon
- intervention She was treated with endovascular embolization, which successfully resolved the bleeding, and subsequent splenectomy and splenic flexure colectomy.
- comparator She was treated with endovascular embolization, which successfully resolved the bleeding, and subsequent splenectomy and splenic flexure colectomy.
- primaryOutcome Once the complications resolved, the patient did well with symptom resolution.
- result endovascular embolization of the SAP with subsequent segmental resection of the involved colon proved to be a successful treatment
- n a female in her 80s
Cureus · PMID 42763603 · Read it on PubMed ↗
Sazal et al. 2026
Gastrointestinal Histoplasmosis Mimicking Intestinal Tuberculosis and Crohn's Disease: Ileocecal Involvement in an Immunocompetent Host
Found harmCase seriesVery low qualityRelated question
1 people2026
the patient developed severe lower gastrointestinal bleeding and died despite treatment
Who was studied
a 26-year-old immunocompetent man with abdominal pain, rectal bleeding, and weight loss
What they received
antifungal treatment (itraconazole then liposomal amphotericin B) for gastrointestinal histoplasmosis
Compared with
none
Main outcome
survival and resolution of gastrointestinal bleeding and disease
Quality
this is a single case report of a rare fungal infection, not a study of common causes of bleeding when wiping, so it cannot tell us much about the general question.
Limitations
single patient case report; rare opportunistic infection in a specific regional context, not representative of typical causes of bright red blood on wiping
Taken word for word from the abstract
- n A 26-year-old immunocompetent male presented
- population A 26-year-old immunocompetent male presented with a 3-month history of diffuse abdominal pain, hematochezia, and 16 kg weight loss.
- intervention Itraconazole was initiated, followed by liposomal amphotericin B.
- comparator Initial biopsies were inconclusive.
- primaryOutcome On day 15, the patient developed catastrophic lower gastrointestinal hemorrhage, resulting in refractory hemodynamic collapse and death.
- result On day 15, the patient developed catastrophic lower gastrointestinal hemorrhage, resulting in refractory hemodynamic collapse and death.
Clin Case Rep · PMID 42761181 · Read it on PubMed ↗
Polo et al. 2026
Conserved Epithelial Remodeling Programs Underlie Pediatric Juvenile Colorectal Polyps Associated with Allergic Sensitization
Allergy-driven inflammation found in polyp tissue.Laboratory studyVery low qualityRelated question
8 people2026
Thousands of genes were turned up or down in polyp tissue, showing strong allergy-type inflammation and changes to the gut lining, with some overlap with genes seen in colon cancer
Who was studied
children with colon polyps causing rectal bleeding and allergy-related (IgE) sensitization
What they received
Analyzing gene activity in cells from the polyp tissue
Compared with
gene activity in nearby normal-looking tissue from the same children
Main outcome
differences in gene activity between polyp tissue and nearby tissue
Quality
This is a small lab study looking at gene activity in tissue samples, not a treatment trial, so it can't tell us how to stop or explain bleeding in general.
Limitations
Very small number of children studied (8 polyp samples, 7 matched nearby-tissue samples), specific to allergy-associated juvenile polyps rather than bleeding causes in general, and no clinical outcome or treatment was tested.
Taken word for word from the abstract
- n epithelial cells isolated from pediatric JP (n = 8) and paired tissue circumjacent to polyp (TCP) (n = 7)
- population obtained from children with a history of rectal bleeding and IgE sensitization to food allergens
- intervention Whole-transcriptome RNA sequencing (RNA-seq) was performed on epithelial cells isolated from pediatric JP
- comparator paired tissue circumjacent to polyp (TCP) (n = 7)
- primaryOutcome Differential expression, functional enrichment (GO, KEGG, GSEA), and cross-dataset comparison with TCGA colorectal adenocarcinoma (CRC) was conducted.
- result Differential expression analysis identified 3273 differentially expressed genes (2342 upregulated, 931 downregulated in JP vs. TCP)
- result JP epithelium displayed a coherent type 2 inflammatory signature, encompassing upregulation of the alarmin IL33, eosinophil-attracting chemokines (CCL11, CCL24), IgE receptor subunits (FCER1A, FCER1G), and a coordinately activated leukotriene and prostaglandin biosynthetic program
Int J Mol Sci · PMID 42737845 · Read it on PubMed ↗
Guo et al. 2026
Utility of the Inflammatory Bowel Disease Serology, Genetics, and Inflammation (IBD-SGI) Panel in the Evaluation of Atypical Ulcerative Colitis With Active Nonsteroidal Anti-Inflammatory Drug Use: A Case Report
Blood test aided colitis diagnosis.Case seriesVery low qualityRelated question
1 peoplethree-month follow-up
the blood panel supported a diagnosis of ulcerative colitis when combined with other test results, and the patient improved after starting targeted treatment
Who was studied
a 39-year-old man with rectal bleeding, diarrhea, and long-term high-dose NSAID use
What they received
a blood test panel (IBD-SGI) used alongside colonoscopy and biopsy to help diagnose the cause of bleeding
Compared with
colonoscopy and biopsy findings alone, without the blood panel
Main outcome
whether the blood panel helped clarify the diagnosis when biopsy results were unclear between NSAID damage and inflammatory bowel disease
Quality
this is a single patient case report, so it cannot show whether this approach works in general.
Limitations
single case report with no comparison group, so findings cannot be generalized
Taken word for word from the abstract
- population A 39-year-old man with hematochezia, diarrhea, and chronic high-dose NSAID use developed anemia, elevated fecal calprotectin, and endoscopic evidence of inflammation.
- intervention an IBD-SGI blood panel was used
- comparator Biopsies by colonoscopy showed focal colitis with features suggestive of both NSAID injury and IBD.
- primaryOutcome To provide additional diagnostic support in this challenging case, an IBD-SGI blood panel was used.
- result the panel results supported a diagnosis of UC
- n A 39-year-old man with hematochezia, diarrhea, and chronic high-dose NSAID use
- followUp At the three-month follow-up, the patient had resumed his daily activities and returned to work.
Cureus · PMID 42699967 · Read it on PubMed ↗
Liu et al. 2026
Salmonella Typhimurium infection complicating very early-onset inflammatory bowel disease presenting with Pseudo-intussusception: a case report
Bleeding resolved with antibiotics and anti-inflammatories.Case seriesVery low qualityRelated question
1 people2026
symptoms resolved within 10 days of combined treatment
Who was studied
a 5-year-old boy with fever, abdominal pain, and bloody diarrhea
What they received
IV antibiotic (cefotaxime) combined with dexamethasone enemas and mesalazine suppositories
Main outcome
resolution of symptoms
Quality
This is a single patient case report, so it cannot show whether the treatment would work for others.
Limitations
Single case report in a young child with a rare combination of infection and very early-onset inflammatory bowel disease, not a general study of rectal bleeding.
Taken word for word from the abstract
- n a 5-year-old boy who presented with fever, paroxysmal abdominal pain, and high-volume watery hematochezia
- population a 5-year-old boy who presented with fever, paroxysmal abdominal pain, and high-volume watery hematochezia
- intervention The patient received a combined regimen of systemic intravenous cefotaxime sodium and localized therapy comprising dexamethasone retention enemas and mesalazine suppositories
- primaryOutcome with symptom resolution within 10 days
- result with symptom resolution within 10 days
Front Pediatr · PMID 42682644 · Read it on PubMed ↗
Jin et al. 2026
Primary Care Management of Ileal Pouch Disorders: Diagnosis, Treatment, and Referral
Not relevant to this question.Narrative reviewVery low qualityRelated question
size not given2026
This is a general review describing symptoms and management of pouch disorders, not a study testing an intervention; it does not address bright red bleeding when wiping in the general population
Who was studied
people living with an ileal pouch after surgery for ulcerative colitis or familial polyposis
What they received
not applicable (review of diagnosis and management approaches)
Compared with
not applicable
Quality
This is a narrative review describing management guidance rather than a study testing a treatment or reporting outcome data relevant to the question asked.
Limitations
This abstract concerns a specific surgical population (ileal pouch patients) and does not address bright red bleeding in the general population; no original data or outcomes are reported.
Taken word for word from the abstract
- population patients with IPAA
- result Patients with pouch disorders present with nonspecific gastrointestinal symptoms that may include increased stool frequency, urgency, abdominal or pelvic discomfort, tenesmus, rectal bleeding, and difficulty in evacuating the pouch.
- intervention patients with mild suspected pouchitis and no alarm features may be treated with empirical antibiotic therapy with close follow-up
- comparator Topical mesalamine may be used for suspected cuffitis.
Mayo Clin Proc · PMID 42680252 · Read it on PubMed ↗
Zhang et al. 2026
A case series study of fever-diarrhea-hematochezia triad as the first presentation in plasma EBV DNA-positive diseases
Describes rare, severe EBV illness, not common causes.Case seriesVery low qualityRelated question
size not given2026
most patients were seriously ill with an EBV-related disease, often misdiagnosed at first, and most died, though aggressive treatment helped a few survive long-term
Who was studied
adults with fever, diarrhea and bright red blood in stool who also tested positive for EBV virus in their blood
What they received
various treatments tried (corticosteroids, chemotherapy, surgery, stem cell transplant)
Main outcome
diagnosis found and whether patients survived
Quality
This is a small, uncontrolled case series of patients with a rare, severe illness, so it cannot reliably show what helps and does not apply to common causes of this symptom.
Limitations
Retrospective case series with no control group, exact number of patients not stated, and population is a rare severe EBV-related illness rather than typical causes of bright red blood on wiping.
Taken word for word from the abstract
- population patients aged ≥14 years presenting with the triad of fever (>38 °C), diarrhea (≥3 loose stools/day), and hematochezia, accompanied by plasma EBV DNA positivity (≥500 copies/mL)
- intervention Treatments varied (corticosteroids, chemotherapy, surgery)
- primaryOutcome To characterize the clinical spectrum and outcomes of fever-diarrhea-hematochezia triad as the first presentation in plasma EBV DNA-positive diseases
- result Despite high overall mortality (64.3%), five patients achieved long-term survival, including one who received intensive therapies such as hematopoietic stem cell transplantation and combination chemotherapy, suggesting a potential benefit of aggressive intervention in selected cases.
- result Misdiagnosis occurred in 57.1% of cases.
Front Cell Infect Microbiol · PMID 42656448 · Read it on PubMed ↗
Ishikami et al. 2026
Hemorrhage from a Jejunal Lymphangioma
Rare small bowel tumor removed, bleeding stoppedCase seriesVery low qualityRelated question
size not given2026
a rare benign tumor in the small intestine was found to be causing the bleeding and was successfully removed
Who was studied
a patient with severe anemia from active gastrointestinal bleeding
What they received
double-balloon endoscopy for diagnosis and laparoscopic-assisted surgical removal
Compared with
none
Main outcome
finding the source of bleeding and stopping it
Quality
this is a single patient case report, so it cannot show how common this cause is or how well treatment works in general
Limitations
only one patient described, and the bleeding source was in the small intestine rather than from the rectum/anus as in typical bright red blood on wiping
Taken word for word from the abstract
- n we report a case of jejunal lymphangioma
- population presenting with severe anemia due to active bleeding
- intervention detected by double-balloon endoscopy and successfully managed by laparoscopic-assisted resection
- comparator successfully managed by laparoscopic-assisted resection
- primaryOutcome severe anemia due to active bleeding, which was detected by double-balloon endoscopy
- result successfully managed by laparoscopic-assisted resection
Acta Med Okayama · PMID 42633996 · Read it on PubMed ↗
Grześkiewicz-Szostak et al. 2026
Early-Onset Colorectal Cancer: From Epidemiologic Shift to Life-Course Carcinogenesis and Age-Attuned Care
Bleeding can signal bowel cancer in young adults.Narrative reviewLow qualityRelated question
size not given2026
Rectal bleeding and other red-flag symptoms are often dismissed or underestimated in younger adults, causing delayed cancer diagnosis
Who was studied
Adults under age 50 diagnosed with colorectal (bowel) cancer
What they received
Earlier screening and faster investigation of warning symptoms like rectal bleeding
Compared with
Older-onset (conventional) colorectal cancer and standard screening age thresholds
Main outcome
Whether bleeding and other symptoms lead to timely diagnosis of bowel cancer in young adults
Quality
This is a narrative review summarizing other studies' findings rather than a new study that directly tested why bleeding occurs, so it carries limited weight for a specific causal answer.
Limitations
It is a review article synthesizing existing literature, not a controlled study, and does not quantify bleeding causes in a defined bleeding population.
Taken word for word from the abstract
- population Early-onset colorectal cancer (EOCRC), conventionally defined as colorectal cancer diagnosed before the age of 50 years
- intervention Lowering the average-risk screening age to 45 years is necessary but insufficient
- comparator reframing EOCRC as an age-attuned clinical and biological challenge rather than a simple early presentation of conventional colorectal cancer
- primaryOutcome diagnosis is commonly delayed because alarm features such as rectal bleeding, abdominal pain, altered bowel habits, and anaemia are often underestimated in younger adults
- result diagnosis is commonly delayed because alarm features such as rectal bleeding, abdominal pain, altered bowel habits, and anaemia are often underestimated in younger adults
Curr Oncol Rep · PMID 42618835 · Read it on PubMed ↗
Lee et al. 2026
The Effect of Nexpowder in Reducing Post-ESD Coagulation Syndrome in Proximal Colon Lesions: A Retrospective Multicenter Study
Fewer complications after colon tumor removal.RetrospectiveLow qualityRelated question
75 people2026
Coagulation syndrome occurred in 2.9% of patients given the powder versus 20.0% of control patients
Who was studied
patients who had colon polyp/tumor removal surgery (ESD) for high-risk proximal colon lesions
What they received
applying Nexpowder (a hemostatic powder) to the wound after colon tumor removal
Compared with
no powder applied (standard care)
Main outcome
rate of post-procedure coagulation syndrome (pain, fever, inflammation needing antibiotics)
Quality
This was a retrospective, non-randomized study with a small number of patients and events, so it cannot rule out bias or chance.
Limitations
Retrospective design, small sample size, non-randomized allocation between groups, from a different condition (colon tumor removal, not hemorrhoidal bleeding).
Taken word for word from the abstract
- population patients who underwent colorectal ESD between April 2023 and October 2024 for PECS high-risk lesions
- intervention Nexpowder was applied prophylactically in 35 patients (46.7%)
- comparator 40 patients (53.3%) served as controls
- primaryOutcome PECS was defined as postprocedural abdominal pain, fever, and elevated inflammatory markers requiring antibiotics.
- result The incidence was significantly lower in the Nexpowder group (2.9% [CI 0.3-12.6]) than in the control group (20.0% [CI 9.9-34.2]; p = 0.032).
- n Nexpowder was applied prophylactically in 35 patients (46.7%), while 40 patients (53.3%) served as controls.
J Gastroenterol Hepatol · PMID 42522103 · Read it on PubMed ↗
Ünal et al. 2026
Upadacitinib as a rescue therapy for steroid- and infliximab-refractory acute severe ulcerative colitis: short- and long-term effectiveness and safety in a multicenter cohort study
Bleeding eased with rescue drug.RetrospectiveLow qualityRelated question
50 people48 weeks
stool frequency, rectal bleeding, and inflammation markers improved rapidly by week 1 and remained improved to week 48; 22% of patients still needed colectomy
Who was studied
hospitalized patients with severe ulcerative colitis who did not respond to steroids and infliximab
What they received
upadacitinib (a newer oral medication) as a third-line rescue treatment
Compared with
no comparison group; all patients received upadacitinib after prior treatments failed
Main outcome
clinical remission, symptom response, and need for colon removal surgery over 48 weeks
Quality
This was a retrospective study without a comparison group, so it cannot prove upadacitinib caused the improvement rather than natural recovery or other factors.
Limitations
Retrospective design, no control group, and this is a specific hospitalized population with severe treatment-resistant ulcerative colitis, not a general population with rectal bleeding.
Taken word for word from the abstract
- n Fifty patients with ASUC from 11 centers
- population hospitalized patients with ASUC (Truelove and Witts criteria) who received UPA following the failure of intravenous corticosteroids (IV-CS) and IFX
- intervention third-line UPA was associated with a low colectomy rate and sustained response up to 1 year
- comparator In this retrospective multicenter cohort (11 centers), 50 patients with severe ulcerative colitis refractory to intravenous corticosteroids and infliximab received upadacitinib.
- primaryOutcome Outcomes included UPA persistence, clinical remission (CR), partial Mayo score (pMAYO) ≤ 2, clinical response (≥3-point reduction in pMAYO), and colectomy rates over 48 weeks of follow-up.
- result Stool frequency, rectal bleeding, pMayo score, and C-reactive protein (CRP) improved rapidly by week 1 and were thereafter maintained to week 48.
Inflamm Bowel Dis · PMID 42485228 · Read it on PubMed ↗
Bai et al. 2026
Comparison of PEG-Based and Non-PEG Bowel Preparation for Emergency Colonoscopy in Acute Lower Gastrointestinal Bleeding: A Real-World Cohort Study with IPTW Analysis
Prep method didn't change bleeding-source detectionRetrospectiveLow qualityRelated question
157 people2026
After adjusting for differences between groups, diagnosis rates, finding signs of recent bleeding, and stopping bleeding were similar between PEG and non-PEG groups, though PEG gave better bowel cleanliness and more complete exams
Who was studied
patients with acute lower gastrointestinal bleeding having emergency colonoscopy
What they received
bowel cleansing with PEG (polyethylene glycol) solution before colonoscopy
Compared with
bowel cleansing without PEG (non-PEG laxative approach)
Main outcome
rate of finding the bleeding source on colonoscopy and rate of stopping the bleeding
Quality
This is a retrospective, non-randomized study of methods for colonoscopy prep in people already diagnosed with bleeding, so it carries little weight and doesn't address causes of bleeding.
Limitations
Retrospective design, use of statistical adjustment (IPTW) rather than randomization, and findings were etiology-dependent, meaning results varied depending on the type of bleeding source.
Taken word for word from the abstract
- n 157 patients undergoing emergency colonoscopy for ALGIB, stratified into PEG (n = 67) and non-PEG (n = 90) groups
- population patients undergoing emergency colonoscopy for ALGIB
- intervention stratified into PEG (n = 67) and non-PEG (n = 90) groups
- comparator stratified into PEG (n = 67) and non-PEG (n = 90) groups
- primaryOutcome Primary outcomes were endoscopic diagnosis (including definitive and presumptive) and hemostasis rates
- result overall core outcomes including endoscopic diagnosis (86.5% vs. 80.3%), stigmata of recent hemorrhage (SRH) detection (42.7% vs. 43.9%) and hemostasis (12.5% vs. 16.9%) were comparable between groups (all adjusted P > 0.05)
Dig Dis Sci · PMID 42455494 · 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)
Rare cause found: Meckel's diverticulum.Case seriesVery low qualityRelated question
1 people2026
the Meckel's scan found a Meckel's diverticulum that other tests had missed, and it was surgically removed
Who was studied
an 18-year-old man with sudden rectal bleeding
What they received
99mTc-pertechnetate scintigraphy (Meckel's scan) to find the bleeding source
Compared with
other tests tried first (CT scan, sigmoidoscopy, colonoscopy, endoscopy, capsule endoscopy)
Main outcome
finding the cause of the bleeding
Quality
this is a single patient's case report, so it cannot show how common this cause is or how reliable the test is in general.
Limitations
only one patient; a case report cannot establish how often this explains bright red bleeding on wiping, which is usually from much more common causes like hemorrhoids or fissures.
Taken word for word from the abstract
- population an 18-year-old male patient who presented to the emergency department with a 24-hour history of 4 episodes of fresh rectal bleeding
- intervention A Meckel's scan eventually confirmed the presence of a Meckel's diverticulum
- comparator computed tomography scan, sigmoidoscopy, colonoscopy, esophagogastroduodenoscopy, and capsule endoscopy, none of which revealed any abnormalities
- primaryOutcome diagnosed by 99mTc-pertechnetate scintigraphy (Meckel's scan)
- result 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.
- n An 18-Year-Old Man
Am J Case Rep · PMID 42430297 · Read it on PubMed ↗
Morrow et al. 2026
Lead Time and Tailored Messaging Promote Early-Onset Colorectal Cancer Prevention and Screening
Rectal bleeding warrants colonoscopy evaluation.Narrative reviewVery low qualityRelated question
size not given2026
not reported as a study result; the abstract states that rectal bleeding, along with other symptoms, should prompt diagnostic colonoscopy regardless of age
Who was studied
people of screening age for colorectal cancer, including those under 50 with symptoms
What they received
tailored messaging and lead-time education to promote colorectal cancer screening and prevention
Quality
This is a narrative discussion of screening guidelines and messaging strategies, not an original research study with data on causes of bleeding.
Limitations
The abstract offers general commentary and guideline recommendations rather than original data on causes of rectal bleeding.
Taken word for word from the abstract
- population Early-onset colorectal cancer is defined as a diagnosis before the age of 50 years.
- intervention implement lead-time messaging with tailored messages to promote on-time screening and primary prevention through diet and lifestyle
- result These patients should be referred, regardless of age, for a diagnostic colonoscopy.
- result A high index of suspicion is helpful when any patient presents with complaints of unexplained weight loss, abdominal pain, bloating, change in bowel habits, or rectal bleeding.
Gastroenterol Nurs · PMID 42397354 · Read it on PubMed ↗
Shi et al. 2026
Coexistence of rectal adenocarcinoma and rectal and lymph node tuberculosis: a case report with a limited narrative review
Rare case: cancer plus hidden tuberculosis.Case seriesVery low qualityRelated question
1 peopleone year
surgery and anti-tuberculosis therapy were successful, with no tumor recurrence or new tuberculosis at one year
Who was studied
a 72-year-old man with a history of pulmonary tuberculosis presented with three months of intermittent hematochezia and tenesmus
What they received
not a treatment study; describes diagnosis and treatment of coexisting rectal cancer and tuberculosis
Main outcome
correct diagnosis and outcome after treatment of rectal adenocarcinoma with concurrent rectal/lymph node tuberculosis
Quality
this is a single patient case report, so it cannot tell us how common or likely any cause of bleeding is in general.
Limitations
single case, no control group, cannot establish how often rectal bleeding is due to cancer versus tuberculosis versus other causes.
Taken word for word from the abstract
- population A 72-year-old man with a history of pulmonary tuberculosis presented with three months of intermittent hematochezia and tenesmus.
- n A 72-year-old man with a history of pulmonary tuberculosis presented with three months of intermittent hematochezia and tenesmus.
- intervention A Hartmann procedure was performed after stable disease was confirmed.
- result At one year, there was no tumor recurrence or new tuberculosis.
- primaryOutcome Postoperative pathology showed rectal adenocarcinoma with no lymph node metastasis (0/24) but unexpectedly revealed granulomatous inflammation in lymph nodes and rectal tissue.
Front Oncol · PMID 42370147 · Read it on PubMed ↗
Souto et al. 2026
Colonic Leishmaniasis Mimicking a Malignant Stricture: Initial Presentation of Human Immunodeficiency Virus Infection - A Case Report
Rare parasite infection caused severe bleedingCase seriesVery low qualityRelated question
1 people2026
Bleeding was caused by a colonic lesion from visceral leishmaniasis infection, requiring emergency bowel surgery
Who was studied
39-year-old man newly diagnosed with HIV and severe immune suppression
What they received
none (diagnostic colonoscopy and surgery)
Compared with
none
Main outcome
cause of severe rectal bleeding (hematochezia)
Quality
This is a single unusual case report in a severely immunosuppressed HIV patient, so it says little about typical causes of bleeding when wiping.
Limitations
Single case report in a patient with advanced HIV and a rare parasitic infection; not representative of typical causes of bright red bleeding on wiping.
Taken word for word from the abstract
- population a 39-year-old man who presented with anorexia, weight loss, and diarrhea
- n We report a case of a 39-year-old man
- intervention Colonoscopy revealed a pseudotumoral, ulcerated, and stricturing lesion in the ascending colon; histology confirmed colonic leishmaniasis.
- comparator The patient progressed to hemorrhagic shock, requiring urgent right hemicolectomy.
- primaryOutcome During hospitalization, he developed severe hematochezia.
- result histology confirmed colonic leishmaniasis. The patient progressed to hemorrhagic shock, requiring urgent right hemicolectomy.
GE Port J Gastroenterol · PMID 42367594 · Read it on PubMed ↗
Galea et al. 2026
Investigating Iron Deficiency Anaemia in the Elderly
Not about bright red bleeding.Prospective cohortLow qualityRelated question
92 peopleone year
many elderly patients were too frail for full investigation, only a minority had cancer found, and higher comorbidity and living in a care home predicted higher one-year death risk
Who was studied
elderly patients aged 75 and older referred to a gastroenterology clinic because of iron deficiency anaemia
What they received
different diagnostic investigations for iron deficiency anaemia such as endoscopy, OGD, and CT colonography
Compared with
no control group; comparison was between different investigation strategies and patient comorbidity levels
Main outcome
diagnosis of underlying cause of iron deficiency anaemia and one-year mortality
Quality
this is a small single-group observational study without a comparison group, so it can't show what actually causes bright red rectal bleeding.
Limitations
small sample size, no control group, frailty prevented investigation in 13% of patients, and the study focuses on anaemia work-up rather than the cause of visible rectal bleeding.
Taken word for word from the abstract
- n 92 patients were recruited
- population Patients ≥75 years referred to gastroenterology for investigation of IDA were recruited.
- intervention 26% underwent upper and lower GI assessment (14% had bidirectional endoscopy and 12% had oesophagogastroduodenoscopy (OGD) + computed tomography (CT) colonography).
- comparator Alternative strategies including trans-nasal endoscopy and CT colonography, should be considered as first-line tests to balance diagnostic yield, prognosis and procedural safety.
- primaryOutcome This study aimed to evaluate the outcomes of elderly patients with IDA, identify underlying causes, and assess one-year mortality.
- result Overall, one-year mortality rate was 28% (CCI mean score: 6.7).
Ulster Med J · PMID 42327595 · Read it on PubMed ↗
Cespedes Useche et al. 2026
Paraneoplastic Myeloperoxidase (MPO)-Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis Revealing Colon Adenocarcinoma in a Patient With Controlled HIV Infection: A Case Report
Unclear resultCase seriesVery low qualityRelated question
1 people2026
the bleeding (hematochezia) was found to be caused by a colon mass that was confirmed as stage IIIA colorectal adenocarcinoma
Who was studied
a 61-year-old man with well-controlled HIV infection
What they received
no intervention for rectal bleeding; this is a case report about vasculitis and colon cancer diagnosis
Compared with
none
Main outcome
diagnosis of the underlying cause of symptoms including hematochezia
Quality
this is a single patient case report, so it cannot show how common or likely this cause is for other people with bright red bleeding.
Limitations
This is a single case report; findings in one unusual patient (with HIV and an associated autoimmune vasculitis) may not apply to the general population with rectal bleeding.
Taken word for word from the abstract
- n A 61-year-old man with well-controlled HIV infection
- population A 61-year-old man with well-controlled HIV infection presented with nephritic syndrome and palpable purpura.
- intervention Treatment included glucocorticoids, plasmapheresis, and azathioprine, followed by right hemicolectomy and adjuvant CAPEOX chemotherapy.
- comparator Treatment included glucocorticoids, plasmapheresis, and azathioprine, followed by right hemicolectomy and adjuvant CAPEOX chemotherapy.
- primaryOutcome During hospitalization, the patient developed hematochezia, for which a colonoscopy was performed, and a mass was identified in the ascending colon.
- result Histopathological analysis confirmed stage IIIA colorectal adenocarcinoma.
Cureus · PMID 42326116 · Read it on PubMed ↗
Xie et al. 2026
Lichang decoction suppresses AOM+DSS-induced colitis-associated cancer via regulating intestinal flora and suppressing the Wnt/β-catenin signaling pathway
Herbal mix reduced cancer-related bleeding in mice.Animal studyLow qualityRelated question
size not given2026
Reduced tumor burden, inflammation, and bleeding (hematochezia) in mice via gut microbiota and Wnt/β-catenin pathway changes
Who was studied
Mice with chemically induced colitis-associated colon cancer (not human patients)
What they received
Lichang Decoction (a traditional Chinese herbal formula)
Compared with
Untreated mice or 5-fluorouracil-treated mice
Main outcome
Tumor number/size, inflammation, and gut microbiota changes
Quality
This is an animal study using mice with a specific induced cancer model, not a human study of rectal bleeding from common causes like hemorrhoids or fissures.
Limitations
Animal model only, specific to colitis-associated cancer rather than common causes of bright red rectal bleeding in humans such as hemorrhoids or anal fissures; not tested in humans.
Taken word for word from the abstract
- population An azoxymethane/dextran sulfate sodium (AOM+DSS)-induced CAC mouse model was established
- intervention treated with low- or high-dose LCD, or 5-fluorouracil (5-Fu)
- comparator treated with low- or high-dose LCD, or 5-fluorouracil (5-Fu)
- primaryOutcome Clinical symptoms, tumor burden, histopathological changes and inflammatory responses were evaluated.
- result LCD treatment significantly alleviated weight loss, diarrhea and hematochezia, reduced disease activity index scores, and markedly suppressed tumor number and size in CAC mice.
Phytomedicine · PMID 42322762 · Read it on PubMed ↗
Memon 2026
Fever of Unknown Origin as an Isolated Manifestation of Ulcerative Colitis Despite Clinical and Radiographic Remission: A Case Report
Not about rectal bleeding at all.Case seriesVery low qualityRelated question
1 people2026
fever was caused by ulcerative colitis itself even though bowel symptoms and scans looked improved, after infections and other causes were ruled out
Who was studied
68-year-old woman with HIV and ulcerative colitis
What they received
fever evaluation during ulcerative colitis treatment (vedolizumab, mesalamine, prednisone)
Compared with
none
Main outcome
cause of persistent fever
Quality
this is a single patient case report, so it cannot show what causes bleeding or how common this is in general
Limitations
single case report; fever without bowel symptoms is described as very rare, so findings may not apply to typical patients
Taken word for word from the abstract
- population a 68-year-old woman with a history of well-controlled HIV infection and recently diagnosed UC
- intervention was initiated on vedolizumab, mesalamine, and a prednisone taper
- comparator An extensive infectious workup, including blood cultures, viral studies, fungal biomarkers, Lyme disease testing, tick-borne testing, and autoimmune serologies, was negative.
- primaryOutcome persistent daily fevers and initial concern for an infectious etiology of pyrexia
- result The patient's fevers were ultimately attributed to an atypical systemic inflammatory manifestation of UC.
- n We present a 68-year-old woman
Cureus · PMID 42306028 · Read it on PubMed ↗
Adeniran et al. 2026
An Unusual Case of Pancreatic Ductal Adenocarcinoma With Synchronous Rectal Metastasis in a Younger Female
Rare cancer cause, not typicalCase seriesVery low qualityRelated question
1 people14 months
bleeding was caused by pancreatic cancer that had spread to the rectum, initially misdiagnosed as gastritis
Who was studied
a 49-year-old woman with stage IV pancreatic cancer that had spread to the rectum
Main outcome
identifying the cause of rectal bleeding and abdominal pain
Quality
this is a single unusual case report and cannot tell you what is likely causing bleeding in most people.
Limitations
single case report of an extremely rare condition (sixth case reported worldwide); not generalizable to typical causes of rectal bleeding.
Taken word for word from the abstract
- population We describe a case of a 49-year-old woman with Stage IV PDAC with synchronous rectal metastases.
- n We describe a case of a 49-year-old woman
- result The hallmark of her symptoms was hematochezia and epigastric pain, initially misdiagnosed as gastritis. However, the patient returned with new laboratory and imaging findings of the synchronous pancreatic tail and rectal masses confirmed by histology.
- primaryOutcome Immunohistochemistry was crucial in distinguishing a primary PC from a rectal primary.
- followUp The patient continues to undergo chemotherapy 14 months after presentation.
Case Rep Gastrointest Med · PMID 42305908 · Read it on PubMed ↗
Sassun et al. 2026
Anorectal Melanoma Management Evolution: A Narrative Review
Rare melanoma can also cause bleeding.Narrative reviewVery low qualityRelated question
size not given2026
survival gains have been modest and largely confined to specific subgroups, with some improvement using combined immunotherapy and surgery
Who was studied
patients with anorectal melanoma, a very rare cancer
What they received
review of surgical and immunotherapy treatments for anorectal melanoma
Compared with
older treatments like radical surgery and chemotherapy versus newer sphincter-preserving surgery and immunotherapy
Main outcome
survival and quality of life outcomes with different treatment approaches
Quality
this is a narrative review of a very rare cancer, not a study measuring causes of bleeding, so it offers no reliable evidence for a typical person's symptom.
Limitations
narrative review without systematic methodology; focuses on a rare cancer rather than common causes of bleeding when wiping; no staging system agreed; high recurrence rates
Taken word for word from the abstract
- population Anorectal melanoma (ARM) is one of the rarest and most aggressive subtypes of melanoma, representing less than 1% of all melanomas
- intervention Immune checkpoint inhibitors have become the cornerstone of treatment, while KIT-mutated tumors may benefit from tyrosine kinase inhibitors.
- comparator Historically dominated by radical abdominoperineal resection, surgical treatment has shifted toward sphincter-preserving wide local excision when negative margins can be achieved
- primaryOutcome comparable survival outcomes and superior functional results regarding bowel, urogenital, and psychological quality of life
- result Survival gains have been modest and largely confined to specific subgroups.
- result selected matched cohorts reporting 3-year overall survival rates up to 71-75% when combined with abdominoperineal resection
- population Patients typically present with nonspecific symptoms such as rectal bleeding, often resulting in advanced disease at diagnosis
Ann Ital Chir · PMID 42304159 · Read it on PubMed ↗
Suleman et al. 2026
Schistosomal Colitis as an Uncommon Cause of Hematochezia in a School-Aged Boy: A Case Report
Rare parasite infection caused bleeding, treatableCase seriesVery low qualityRelated question
1 people2026
the boy responded well to praziquantel treatment after being diagnosed with schistosomal colitis
Who was studied
a 9-year-old boy living in a schistosomiasis-endemic region with painless rectal bleeding
What they received
oral praziquantel treatment
Compared with
none
Main outcome
resolution of symptoms after treatment
Quality
this is a single case report so it cannot show how common this cause is or how well treatment works in general
Limitations
only one patient described, in a tropical disease-endemic area, which may not apply to most people with this symptom
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
- intervention treatment with oral Praziquantel (40 mg/kg)
- comparator The patient responded well to treatment with oral Praziquantel
- primaryOutcome The patient responded well to treatment with oral Praziquantel (40 mg/kg)
- result The patient responded well to treatment with oral Praziquantel (40 mg/kg).
Clin Med Insights Pediatr · PMID 42290952 · Read it on PubMed ↗
Samaddar et al. 2026
Characterizing symptom patterns in early-onset colorectal cancer: insights from a national inpatient analysis
Bleeding rarely meant cancer in this study.RetrospectiveLow qualityRelated question
18,017 people2026
Constipation was much more strongly linked to early-onset cancer than to late-onset cancer, especially in women under 40, while rectal bleeding and anemia also differed but less dramatically; even so, actual cancer rates among people with these symptoms stayed low
Who was studied
adults hospitalized with colorectal cancer, comparing those diagnosed before age 50 (early-onset) to those diagnosed later (late-onset), matched with non-cancer controls
What they received
early-onset colorectal cancer (diagnosed before age 50)
Compared with
late-onset colorectal cancer (diagnosed after age 50) and age-matched non-cancer controls
Main outcome
how strongly different symptoms (including constipation, anemia, and rectal bleeding) were linked to a colorectal cancer diagnosis
Quality
this is a large but retrospective hospital-database study using billing codes, so it can show patterns but cannot prove that any one symptom like bleeding actually causes or reliably predicts cancer.
Limitations
The abstract notes findings come from hospitalized patients, which may over-represent more advanced or complicated disease rather than early detection, and absolute cancer prevalence was low despite strong relative associations.
Taken word for word from the abstract
- n Among 18,017 EOCRC hospitalizations
- population We analyzed 2020-2022 National Inpatient Sample data, performing 1:1 age-matched comparisons between CRC patients and controls without CRC.
- intervention early-onset CRC (EOCRC, diagnosed before age 50)
- comparator We hypothesized that EOCRC presents with distinct symptom profiles compared to late-onset CRC (LOCRC).
- primaryOutcome several symptoms demonstrated differential associations compared to LOCRC, including constipation, iron-deficiency anemia, and hematochezia
- result Constipation showed the strongest divergence between EOCRC and LOCRC (aOR 2.50 vs. 1.12), particularly among women under 40 (aOR 5.72; p < 0.001).
- result the absolute prevalence of colorectal cancer among constipation-related hospitalizations remained low, underscoring the need for cautious interpretation and further prospective validation
Cancer Treat Res Commun · PMID 42287778 · Read it on PubMed ↗
Sasse et al. 2026
Not Just a Cyst: A Draining Gluteal Lesion Revealing a Rectocutaneous Fistula in Ulcerative Colitis
Rare fistula from colitis found.Case seriesVery low qualityRelated question
1 people2026
found a rectocutaneous fistula from the rectum into the buttock tissue, caused by severe ulcerative colitis of the rectum and sigmoid colon
Who was studied
a 48-year-old man with poorly controlled ulcerative colitis
What they received
pelvic MRI and colonoscopy to investigate rectal pain and a draining buttock lesion
Compared with
none
Main outcome
diagnosis of the cause of rectal bleeding and gluteal lesion
Quality
this is a single patient case report, so it cannot show how common this cause of bleeding is or how well any treatment works.
Limitations
single case report with no comparison group or outcome data on treatment effectiveness.
Taken word for word from the abstract
- population a 48-year-old man with poorly controlled ulcerative colitis (UC) who presented with severe rectal pain, hematochezia, and a chronically draining lesion on the left buttock
- n a 48-year-old man with poorly controlled ulcerative colitis
- intervention pelvic magnetic resonance imaging unexpectedly revealed a rectocutaneous fistula extending from the distal rectum into the left gluteal soft tissues
- comparator Initial cross-sectional imaging revealed active colitis, and targeted ultrasound of the left buttock suggested a benign epidermal inclusion cyst
- primaryOutcome Before discharge, pelvic magnetic resonance imaging unexpectedly revealed a rectocutaneous fistula extending from the distal rectum into the left gluteal soft tissues
- result pelvic magnetic resonance imaging unexpectedly revealed a rectocutaneous fistula extending from the distal rectum into the left gluteal soft tissues
ACG Case Rep J · PMID 42282467 · Read it on PubMed ↗
Aksim et al. 2026
Lower Gastrointestinal Bleeding Revealing an Early-Stage Primary Anorectal Melanoma: A Case Report
Rare melanoma found as cause.Case seriesVery low qualityRelated question
1 people2026
the bleeding was caused by a rare anorectal melanoma, which was treated successfully with surgery and immunotherapy
Who was studied
a 62-year-old woman with mild rectal bleeding
What they received
surgery combined with adjuvant immunotherapy
Main outcome
diagnosis and successful treatment of the cause of rectal bleeding
Quality
this is a single patient case report, which cannot show how common this cause is or how well treatment works in general.
Limitations
only one patient is described, so it cannot tell you how likely this rare cause is to explain your bleeding.
Taken word for word from the abstract
- n a 62-year-old women
- population We report the case of a 62-year-old women who presented for an etiological evaluation of mild rectal bleeding without other associated signs.
- intervention The patient was successfully treated with surgery and adjuvant immunotherapy.
- primaryOutcome several biopsies were performed, confirming the diagnosis of rectal melanoma
- result several biopsies were performed, confirming the diagnosis of rectal melanoma. The patient was successfully treated with surgery and adjuvant immunotherapy.
Gulf J Oncolog · PMID 42274068 · Read it on PubMed ↗
Pinto et al. 2026
Cytomegalovirus (CMV) Colitis Complicated by a Stricture in an Immunocompetent Adult
Rare colitis mimicked cancer, no bleeding noted.Case seriesVery low qualityRelated question
1 people2026
the stricture was caused by CMV colitis rather than cancer, diagnosed only after tissue biopsy
Who was studied
an immunocompetent woman
What they received
diagnosis and tissue biopsy for suspected colon cancer
Main outcome
cause of a colonic stricture
Quality
This is a single patient case report, so it cannot show how common or typical this cause is.
Limitations
Single case report with no control group or outcome data beyond diagnosis.
Taken word for word from the abstract
- population CMV colitis in an immunocompetent woman
- intervention requires tissue diagnosis because noninvasive testing may not reliably exclude disease
- primaryOutcome presenting with a colonic stricture initially presumed to be malignant
- 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
Cureus · PMID 42255849 · Read it on PubMed ↗
Shi et al. 2026
Angiodysplasia as a rare cause of acute hematochezia in a 33-year-old with vascular risk factors: a case report
Rare vessel abnormality, successfully clipped.Case seriesVery low qualityRelated question
1 people6 months
bleeding was stopped with clips and did not return over 6 months
Who was studied
a 33-year-old man with chronic alcohol use and poorly controlled high blood pressure
What they received
endoscopic titanium clips to stop bleeding from rectal vascular lesions
Compared with
no comparator (single case)
Main outcome
whether bleeding stopped and did not come back
Quality
this is a single patient case report, so it cannot show what causes bleeding in general or how common this is.
Limitations
only one patient was described, there was no comparison group, and the cause (angiodysplasia) is described as an exceedingly rare cause of this kind of bleeding, especially in young people.
Taken word for word from the abstract
- n A 33-year-old male with a history of chronic alcohol use and poorly controlled hypertension presented with acute, massive hematochezia and symptomatic anemia.
- population A 33-year-old male with a history of chronic alcohol use and poorly controlled hypertension
- intervention hemostasis was achieved using mechanical endoscopic titanium clips
- comparator mechanical clipping is a highly effective, targeted alternative to thermal ablation for localized rectal vascular lesions
- primaryOutcome No recurrent bleeding occurred during 6 months of follow-up.
- result No recurrent bleeding occurred during 6 months of follow-up.
Front Med (Lausanne) · PMID 42239962 · Read it on PubMed ↗
Alashqar et al. 2026
An unusual superior mesenteric arteriovenous malformation causing obscure gastrointestinal bleeding: a case report
Rare vascular cause found and treated.Case seriesVery low qualityRelated question
1 people2026
bleeding stopped and hemoglobin stabilized after embolization
Who was studied
a 71-year-old man with decompensated alcoholic liver cirrhosis and recurrent gastrointestinal bleeding
What they received
endovascular embolization of a mesenteric arteriovenous malformation
Compared with
none
Main outcome
stopping gastrointestinal bleeding and stabilizing blood counts
Quality
This is a single patient case report, so it cannot show how common this cause is or how well treatment works in general.
Limitations
Single case report in a patient with advanced liver cirrhosis and multiple other bleeding sources, so findings may not generalize to other causes of bright red rectal bleeding.
Taken word for word from the abstract
- population A 71-year-old man with decompensated alcoholic liver cirrhosis and a history of recurrent gastrointestinal bleeding presented with two days of hematochezia and worsening anemia.
- intervention The patient was successfully managed with endovascular embolization
- comparator Despite prior endoscopic treatment of esophageal varices, gastric antral vascular ectasia, and colonic AVMs, no active bleeding source was identified on repeat endoscopy.
- primaryOutcome resulting in stabilization of hemoglobin levels and cessation of overt gastrointestinal bleeding
- result resulting in stabilization of hemoglobin levels and cessation of overt gastrointestinal bleeding
- n A 71-year-old man with decompensated alcoholic liver cirrhosis
BMC Gastroenterol · PMID 42231181 · Read it on PubMed ↗
Khiari et al. 2026
[Lower gastrointestinal bleeding]
Several possible bowel-bleeding causes listed.Narrative reviewVery low qualityRelated question
size not given2026
The review lists causes (including anorectal disorders, diverticulosis, angiodysplasia, ischemic colitis, tumors) and describes diagnostic/treatment steps (colonoscopy, CT angiography, embolization, surgery), but reports no outcome data comparing treatments.
Who was studied
people with bleeding from the lower bowel (colon/rectum), often older adults
What they received
not an intervention study — this is a review describing diagnosis and treatment approaches for lower bowel bleeding
Compared with
not reported
Main outcome
overview of causes and management of lower gastrointestinal bleeding
Quality
This is a general narrative review summarizing known causes and management steps rather than original research with measured outcomes.
Limitations
No original data, patient numbers, or outcome results are given; it is a broad overview rather than a study of this specific symptom.
Taken word for word from the abstract
- population It predominantly affects elderly patients in whom it is associated with increased morbidity and mortality.
- intervention Colonoscopy is the reference diagnostic and therapeutic procedure, ideally performed within 24 hours with CT angiography reserved for cases of hemodynamic instability.
- result The main causes include diverticulosis, anorectal disorders, angiodysplasias, ischemic colitis, post-endoscopic resection complications, and tumor-related bleeding.
- primaryOutcome Lower gastrointestinal bleeding (LGIB) is a common emergency, defined nowadays as bleeding of colorectal origin.
- comparator In case of failure, therapeutic escalation includes repeat endoscopy, arterial embolization, and, as a last resort, surgery.
Rev Prat · PMID 42227634 · Read it on PubMed ↗
Gadour et al. 2026
Techniques and outcomes review of the endoscopic management of gastrointestinal bleeding
Review of bleeding treatments, not causes.Narrative reviewVery low qualityRelated question
size not given2026
The abstract summarizes techniques and strategies but does not report a specific quantitative result or outcome comparison
Who was studied
People with gastrointestinal bleeding (general review, not specific to bright red blood on wiping)
What they received
Endoscopic treatments for GI bleeding (e.g. clips, band ligation, argon plasma coagulation, powders)
Compared with
Different endoscopic techniques compared with each other / standard care
Main outcome
Effectiveness of endoscopic techniques in managing GI bleeding
Quality
This is a general narrative review of treatment techniques, not a study answering why someone bleeds bright red blood when wiping.
Limitations
No original data, no participant numbers, no specific findings relevant to the cause of bright red rectal bleeding on wiping; it is an expert overview of endoscopic treatment techniques for GI bleeding in general.
Taken word for word from the abstract
- population Gastrointestinal (GI) bleeding is a frequent and potentially life-threatening emergency
- intervention combination therapies for peptic ulcer bleeding, band ligation for esophageal and selected gastric varices, argon plasma coagulation (APC) for vascular malformations and tumor bleeding, and emerging approaches such as over-the-scope clips (OTSC), hemostatic powders, radiofrequency ablation (RFA), and self-expandable metal stents (SEMS)
- comparator This review synthesizes current evidence and guideline-based strategies for endoscopic management of GI bleeding
- primaryOutcome We also review risk stratification scores, transfusion strategies, and timing of endoscopy, all of which are crucial to optimizing outcomes.
- result Successful management of GI bleeding demands a personalized approach integrating patient-specific factors, bleeding etiology, and local expertise.
Expert Rev Gastroenterol Hepatol · PMID 42217226 · Read it on PubMed ↗
Fogleman et al. 2026
Overlapping Cytomegalovirus Infection and Inflammatory Pouchitis After Liver Transplantation: When Antivirals Alone Are Insufficient
CMV infection caused pouch bleeding hereCase seriesVery low qualityRelated question
size not given2026
Bleeding and viremia improved with antivirals, but inflammation persisted and needed additional treatment with guselkumab
Who was studied
A liver transplant patient with chronic pouchitis, ulcerative colitis, and primary sclerosing cholangitis who had rectal bleeding
What they received
Antiviral therapy for CMV infection, followed by guselkumab for ongoing inflammation
Compared with
No comparator (single case)
Main outcome
Improvement in bleeding and viral levels, and control of pouch inflammation
Quality
This is a single patient case report, so it cannot show how common this cause of bleeding is or how well treatments generally work.
Limitations
Only one patient described, with a specific and unusual combination of conditions (prior pouch surgery, transplant, CMV infection) not typical of most people with rectal bleeding.
Taken word for word from the abstract
- population a patient with chronic antibiotic-dependent pouchitis, ulcerative pancolitis, primary sclerosing cholangitis, and orthotopic liver transplant who presented with hematochezia
- intervention The patient was treated with antiviral therapy with improvement in bleeding and viremia.
- comparator We present the case of a patient
- primaryOutcome with improvement in bleeding and viremia
- result The patient was treated with antiviral therapy with improvement in bleeding and viremia. However, persistent refractory pouch inflammation ultimately required guselkumab.
Gastro Hep Adv · PMID 42164831 · Read it on PubMed ↗
Ravella et al. 2026
Primary Rectal Squamous Cell Carcinoma: A Rare Gastrointestinal Malignancy Presenting As Hematochezia
Rare cancer found as one causeCase seriesVery low qualityRelated question
1 people2026
a rare rectal squamous cell cancer was found and treated with chemoradiation instead of surgery
Who was studied
a 67-year-old man with abdominal cramping, lightheadedness, fatigue, and new rectal bleeding
What they received
chemoradiation with 5-fluorouracil, mitomycin C, and radiation therapy
Compared with
traditional surgical approaches
Main outcome
diagnosis and treatment approach for the rectal mass causing bleeding
Quality
this is a single patient case report, so it cannot tell you how likely any particular cause of bleeding is for other people
Limitations
single case report of an extremely rare cancer, no comparison group, and findings cannot be generalized to typical causes of bright red rectal bleeding
Taken word for word from the abstract
- n a 67-year-old male
- population a 67-year-old male with a history of paroxysmal atrial fibrillation who presented with abdominal cramping, lightheadedness, fatigue, and new-onset hematochezia
- intervention treated with chemoradiation using 5-fluorouracil, mitomycin C, and radiation therapy
- comparator improved outcomes compared to traditional surgical approaches
- primaryOutcome Biopsies confirmed moderately differentiated invasive SCC
- result its management has shifted toward definitive chemoradiation with improved outcomes compared to traditional surgical approaches
Cureus · PMID 42164016 · Read it on PubMed ↗
Ninomiya et al. 2026
Peranal Endoscopic Myectomy for Lower Rectal Lesions with Severe Fibrosis: A Retrospective Study
Bleeding common after this rectal surgery.RetrospectiveLow qualityRelated question
25 people2026
after the procedure, 56% of patients had bleeding (hematochezia), which was usually self-limited, and intentional PAEM had a higher rate of fully clear removal margins than unintentional PAEM
Who was studied
patients who had a procedure to remove lower rectal lesions with severe scarring (fibrosis)
What they received
peranal endoscopic myectomy (PAEM), a technique to cut out rectal lesions through the muscle layer
Compared with
unintentional PAEM (done by accident during a different procedure) versus intentional PAEM
Main outcome
whether the procedure worked well and was safe, including clear removal margins and bleeding afterward
Quality
this is a small, retrospective study from one hospital looking at a surgical technique, not a study of why ordinary people bleed when wiping.
Limitations
retrospective design, small number of patients (25), single center, and it studies bleeding as a complication of a specific rectal surgery rather than general causes of bleeding when wiping
Taken word for word from the abstract
- n PAEM was performed in 25 patients (unintentional PAEM, 13; intentional PAEM, 12)
- population patients who underwent PAEM for lower rectal lesions between January 2017 and December 2024
- intervention Peranal endoscopic myectomy (PAEM), also known as endoscopic intermuscular dissection, enables resection of lower rectal lesions with severe submucosal fibrosis by dissecting the inner circular muscle.
- comparator PAEM was performed intentionally after October 2023, whereas unintentional PAEM occurred during endoscopic submucosal dissection (ESD) prior to October 2023.
- primaryOutcome We aimed to evaluate the efficacy and safety of PAEM.
- result After PAEM, hematochezia occurred in 14 patients (56%), but most cases were self-limited and one patient had hematochezia requiring prolonged hospitalization.
- result The negative vertical margin rate was higher in the intentional PAEM group than in the unintentional PAEM group, with similar findings observed in an additional analysis excluding salvage cases (88% vs. 33%, P = 0.007).
Dig Dis Sci · PMID 42154125 · Read it on PubMed ↗
Babino et al. 2026
A Rare Case of Sterile Retrostyloid Abscess in a Patient With Crohn's Disease: Diagnostic and Therapeutic Insights
Not relevant to your bleeding question.Case seriesVery low qualityRelated question
1 people2026
abscess resolved after surgical drainage plus antibiotics and corticosteroids
Who was studied
44-year-old woman with Crohn's disease on corticosteroids
What they received
surgical drainage combined with antibiotics and corticosteroids
Compared with
none
Main outcome
resolution of neck abscess and symptoms
Quality
this is a single patient case report, so it cannot show whether the treatment generally works or explain common causes of rectal bleeding
Limitations
single case report; abscess was a rare extraintestinal complication, not a direct study of rectal bleeding causes
Taken word for word from the abstract
- n A 44-year-old woman with Crohn's disease receiving corticosteroid therapy is presented
- population A 44-year-old woman with Crohn's disease receiving corticosteroid therapy
- intervention Surgical drainage, combined with antibiotics and corticosteroids, led to clinical resolution.
- comparator Surgical drainage, combined with antibiotics and corticosteroids, led to clinical resolution.
- primaryOutcome led to clinical resolution
- result Surgical drainage, combined with antibiotics and corticosteroids, led to clinical resolution.
Case Rep Med · PMID 42146941 · Read it on PubMed ↗
Das et al. 2026
Schistosoma-Associated Colorectal Carcinoma in a Young Male
Rare case: cancer from parasite infection.Case seriesVery low qualityRelated question
1 people2026
Rectal bleeding was caused by a rare case of colorectal cancer linked to a parasitic infection (schistosomiasis)
Who was studied
19-year-old male with childhood freshwater exposure
What they received
none (diagnostic case report)
Main outcome
diagnosis and treatment of rectal bleeding cause
Quality
This is a single patient case report, so it cannot tell you how likely this cause is for anyone else.
Limitations
Single case report; findings may not generalise to other patients with rectal bleeding.
Taken word for word from the abstract
- population We describe a 19-year-old male with rectal carcinoma, likely linked to childhood freshwater exposure.
- n We describe a 19-year-old male with rectal carcinoma
- primaryOutcome He presented with rectal bleeding and prolapsing mass, underwent surgery, and histopathology confirmed poorly differentiated adenocarcinoma.
- result Schistosoma parasite eggs were seen on histology and along with the environmental history supported the presumptive diagnosis of SA-CRC.
- intervention He was treated with neoadjuvant chemoradiotherapy, surgery for the colorectal carcinoma and praziquantel for eradication of Schistosomiasis.
QJM · PMID 42143719 · Read it on PubMed ↗
Vaghiri et al. 2026
Bridging the gap: a systematic literature review and meta-analysis on the management of rectal wall defect after transanal excision
Stitching surgical opening cuts bleedingMeta-analysisLow qualityRelated question
size not given2026
closing the opening was linked to less rectal bleeding and fewer re-admissions, but took longer to perform, with no difference in other outcomes
Who was studied
people who had a rectal tumor removed through the anus with a full-thickness surgical opening left in the rectal wall
What they received
stitching the rectal wall opening closed after the tumor removal
Compared with
leaving the rectal wall opening open to heal on its own
Main outcome
rates of rectal bleeding and hospital re-admission after surgery
Quality
it pools only six non-randomized comparative studies with some heterogeneity, so the evidence is not very strong.
Limitations
based on six comparative (not randomized) studies with inconsistent protocols; authors say randomized trials with longer-term data are still needed
Taken word for word from the abstract
- population full-thickness (FT) excision
- intervention rectal defect closure
- comparator leaving the defect open following full-thickness (FT) excision
- primaryOutcome significantly reduced rectal bleeding (OR = 0.57, 95% CI: 0.35-0.94, p = 0.03; I2 = 26%) and re-admission rates
- result Closing the rectal defect was associated with significantly reduced rectal bleeding (OR = 0.57, 95% CI: 0.35-0.94, p = 0.03; I2 = 26%) and re-admission rates (OR = 0.34, 95% CI: 0.16-0.76, p = 0.008; I2 = 0%) compared with the open group, while other outcomes were not significantly different.
- limitations randomized studies with homogeneous protocols and consistent long-term outcome data are still needed to provide definitive answers
Tech Coloproctol · PMID 42141324 · Read it on PubMed ↗
Zhong et al. 2026
Ischemic colitis in a child: a case report and narrative review
Rare cause, fully resolved with careCase seriesVery low qualityRelated question
1 people2026
complete symptom resolution without recurrence
Who was studied
a 6-year-old boy with rectal bleeding
What they received
conservative treatment (bowel rest, IV fluids, mucosal protective medicines)
Compared with
none reported
Main outcome
resolution of bleeding and symptoms
Quality
This is a single child's case report, not a study comparing treatments, so it can't tell us what usually causes bleeding or what works best.
Limitations
Single pediatric case of a rare condition (ischemic colitis), not generalizable to typical causes of bright red blood when wiping.
Taken word for word from the abstract
- population A 6-year-old boy presented with recurrent hematochezia for 6 days and mild abdominal pain.
- intervention Conservative management with bowel rest, intravenous fluids, and mucosal protective agents achieved complete symptom resolution without recurrence.
- comparator Conservative management with bowel rest, intravenous fluids, and mucosal protective agents achieved complete symptom resolution without recurrence.
- primaryOutcome achieved complete symptom resolution without recurrence
- result achieved complete symptom resolution without recurrence
- n A 6-year-old boy presented with recurrent hematochezia for 6 days and mild abdominal pain.
Front Pediatr · PMID 42137563 · Read it on PubMed ↗
Long et al. 2026
Effect of preoperative anemia on postoperative outcomes in mixed hemorrhoids: a retrospective observational study
More post-surgery pain if anemicRetrospectiveLow qualityRelated question
127 people12 months
patients with anemia had more pain and worse sleep after surgery, but no difference in bleeding, infection, wound healing or 12-month recurrence
Who was studied
patients with mixed hemorrhoids who had hemorrhoid surgery
What they received
having anemia before surgery
Compared with
not having anemia before surgery
Main outcome
complications after hemorrhoid surgery, including pain, bleeding, infection, wound healing and recurrence
Quality
it is a retrospective study of two uneven groups without adjustment for other factors, and the authors themselves say the findings need confirmation in larger studies
Limitations
observational design, exploratory analysis, no multivariable adjustment, moderate sample size
Taken word for word from the abstract
- n A total of 127 patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy
- population patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy
- intervention 48 patients in the preoperative anemia group
- comparator 79 patients in the preoperative non-anemia group
- primaryOutcome Postoperative complications such as postoperative pain, delayed bleeding, wound infection, wound edema, urinary retention, insomnia severity index (ISI) within 7 days, wound healing time, and recurrence rates (prolapse or bleeding) within 12 months
- result preoperative anemia was associated with higher postoperative pain scores and poorer sleep quality within 7 days after Milligan-Morgan hemorrhoidectomy. However, no significant associations were observed between preoperative anemia and other postoperative complications, wound healing time, or 12-month recurrence rates.
- followUp recurrence rates (prolapse or bleeding) within 12 months
BMC Gastroenterol · PMID 42129663 · Read it on PubMed ↗
Zhai et al. 2026
Rectal metastasis from primary small-cell lung cancer: A case report and literature review
Rare lung cancer spread caused bleeding; chemo helped.Case seriesVery low qualityRelated question
1 people2026
bleeding stopped and tumor shrank partially after chemotherapy
Who was studied
73-year-old woman with small-cell lung cancer that had spread to the rectum
What they received
chemotherapy (4 courses)
Compared with
none
Main outcome
rectal bleeding and tumor response
Quality
This is a single patient case report, so it cannot show what usually causes rectal bleeding or what treatment works in general.
Limitations
Single case report; this is an extremely rare cause of rectal bleeding (metastatic lung cancer), not representative of typical causes.
Taken word for word from the abstract
- n a 73-year-old female patient
- population a 73-year-old female patient who was diagnosed with neuroendocrine SCLC based on a lung biopsy obtained by needle
- intervention The patient underwent 4 courses of chemotherapy.
- comparator The patient underwent 4 courses of chemotherapy.
- primaryOutcome The hematochezia then subsided, and radiological evaluation of the rectal metastases and primary lung tumors suggested a partial response.
- result The hematochezia then subsided, and radiological evaluation of the rectal metastases and primary lung tumors suggested a partial response.
Medicine (Baltimore) · PMID 42116387 · Read it on PubMed ↗
Kurland et al. 2026
Variations in symptoms, endoscopy use and emergency diagnosis of colorectal cancer by body mass index: a retrospective cohort study using linked electronic health records in England
Higher BMI linked to more urgent cancer referral.RetrospectiveLow qualityRelated question
5,571 people2026
Patients with obesity or overweight were more likely to be referred urgently and less likely to be diagnosed as a cancer emergency than normal-weight patients
Who was studied
patients with symptomatic colorectal cancer diagnosed in England between 2011 and 2015
What they received
having a higher body mass index (overweight or obesity)
Compared with
having a normal body mass index
Main outcome
how patients were diagnosed with colorectal cancer (emergency vs urgent referral) and symptoms/endoscopy use before diagnosis
Quality
It is a retrospective study using health records, which can show patterns but cannot prove that weight itself causes differences in how bleeding or cancer gets diagnosed.
Limitations
Retrospective cohort design using linked administrative records, which cannot establish causation and may have incomplete symptom recording.
Taken word for word from the abstract
- n 5571 patients with symptomatic CRC diagnosed in England between 2011 and 2015
- population 5571 patients with symptomatic CRC diagnosed in England between 2011 and 2015
- intervention Body mass index (BMI) confers a higher risk of colorectal cancer (CRC) and may influence cancer diagnostic pathways
- comparator patients with obesity versus normal weight
- primaryOutcome Route to CRC diagnosis (emergency presentation and fast-track referrals among patients with new-onset red flag symptoms), presenting symptoms and pre-diagnostic endoscopy use.
- result Patients with CRC with higher BMI are more likely to be referred urgently and less likely to experience emergency cancer diagnosis than normal weight patients.
BMJ Open · PMID 42097658 · Read it on PubMed ↗
Rao et al. 2026
Idiopathic mesenteric phlebosclerosis: A case report
Rare bowel vein disease; bleeding improved with treatment.Case seriesVery low qualityRelated question
1 people2026
Abdominal pain and bleeding improved, with imaging and colonoscopy showing improvement
Who was studied
A 59-year-old man with abdominal pain and blood in stool
What they received
Conservative (non-surgical) medical treatment
Compared with
None
Main outcome
Abdominal pain and rectal bleeding improvement, plus imaging/colonoscopy findings
Quality
This is a single patient case report, which cannot show whether the treatment caused the improvement or reliably applies to others.
Limitations
Single case report, no comparison group, rare and unusual condition (idiopathic mesenteric phlebosclerosis) rather than typical causes of rectal bleeding.
Taken word for word from the abstract
- population A 59-year-old middle-aged man was admitted to the gastroenterology department due to recurrent upper abdominal pain for 1 month.
- intervention The patient received conservative treatment during hospitalization.
- comparator The patient received conservative treatment during hospitalization.
- primaryOutcome After conservative treatment, the patient's abdominal pain and hematochezia improved, and the findings of computed tomography and colonoscopy also showed improvement in the condition.
- result After conservative treatment, the patient's abdominal pain and hematochezia improved, and the findings of computed tomography and colonoscopy also showed improvement in the condition.
- n A 59-year-old middle-aged man was admitted to the gastroenterology department
Medicine (Baltimore) · PMID 42071876 · Read it on PubMed ↗
Swain et al. 2026
Advanced adenomas among young endurance runners: A prospective hypothesis-generating prevalence study
Higher polyp risk in runners.Prospective cohortLow qualityRelated question
94 people2026
Advanced adenomas were found in 15.0% of runners, compared with a historical rate of 1.2% in average-risk screening populations
Who was studied
Runners aged 35 to 50 who had completed multiple marathons or ultramarathons, with no colonoscopy in the last 10 years
What they received
Colonoscopy screening in endurance runners
Compared with
Historical rate of advanced adenomas in average-risk adults aged 40-49 undergoing routine screening colonoscopy
Main outcome
Prevalence of advanced colorectal adenomas (precancerous polyps)
Quality
This is a small, single-arm study with no direct control group, compared only to a historical benchmark, and the authors themselves call it hypothesis-generating.
Limitations
No concurrent control group; compared to historical screening rates; small sample; authors state findings are hypothesis-generating and limited by differences in symptom profile and risk factors between groups
Taken word for word from the abstract
- n 94 participants (54.3% female; median age, 42 years) underwent colonoscopy
- population participants had completed at least 2 ultramarathons (50 km or longer) or at least 5 marathons and had no colonoscopy within 10 years
- intervention Participants completed a questionnaire and underwent colonoscopy.
- 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 advanced adenomas in 14 (15.0%; 95% binomial CI, 8.4-23.7%); no cancers were detected
Cancer Epidemiol · PMID 42066739 · Read it on PubMed ↗
Ramai et al. 2026
Prophylactic Clip Closure to Prevent Bleeding After Colorectal Endoscopic Submucosal Dissection: A Cost-Effectiveness Study
Clip cost-effective after bowel procedure.Systematic reviewLow qualityRelated question
size not given2026
clipping cost about $88,843 per extra quality-adjusted life year, below the $100,000 cutoff
Who was studied
patients who had a colon polyp removed using endoscopic submucosal dissection
What they received
placing a clip to close the wound after the procedure
Compared with
not placing a clip after the procedure
Main outcome
cost per quality-adjusted life year gained
Quality
this is a computer model based on assumed probabilities and costs, not real patient outcomes being measured directly.
Limitations
findings are based on model assumptions and may not reflect real-world practice.
Taken word for word from the abstract
- population colorectal ESD
- intervention prophylactic clip closure of post-ESD mucosal defects
- comparator ESD without closure
- primaryOutcome The primary outcome was the incremental cost-effectiveness ratio, evaluated against a willingness-to-pay threshold of $100,000 per quality-adjusted life-year (QALY).
- result prophylactic clipping was more effective and more costly than no clipping, yielding an incremental cost-effectiveness ratio of $88,843/QALY
- limitations these findings are based on model assumptions and should be interpreted in the context of these parameters.
Clin Transl Gastroenterol · PMID 42059448 · Read it on PubMed ↗
Kirchberg et al. 2026
The Development and Evaluation of a Clinical Reasoning Case for Second-Year Medical Students
Not about why you bleed.Prospective cohortVery low qualityRelated question
92 people2026
Confidence and attitudes improved significantly, and knowledge scores increased with one item reaching significance
Who was studied
second-year medical students
What they received
a clinical reasoning teaching case about hematochezia (rectal bleeding) as part of a course
Compared with
students' own responses before the teaching session
Main outcome
students' confidence, attitudes, and knowledge about clinical reasoning and hematochezia
Quality
This is a medical education study about teaching students, not a clinical study of patients with bleeding, so it cannot tell you why bleeding happens.
Limitations
Only 92 of 123 students completed both surveys, and this is a self-reported confidence/knowledge survey, not a clinical outcome study.
Taken word for word from the abstract
- population second-year preclinical medical students
- n Of the 123 medical students who attended the case, 92 completed both surveys (74.8% response rate).
- intervention a clinical reasoning case focused on hematochezia as part of a year-long longitudinal clinical reasoning course for second-year preclinical medical students
- comparator A pre- and postintervention survey measured changes in students' confidence and attitudes
- primaryOutcome changes in students' confidence and attitudes about clinical reasoning skills and concepts and knowledge of hematochezia
- result Confidence improved significantly in all domains (P < .01 for problem representation; P < .0001 for others). Students' attitudes toward case-based learning also improved (P < .0001). Knowledge scores increased for all items, with 1 reaching statistical significance (P < .05).
MedEdPORTAL · PMID 42058479 · Read it on PubMed ↗
Hu et al. 2026
Detection and surgical intervention in anorectal malignant melanoma: a case report
Rare melanoma found after bleeding; surgery removed it.Case seriesVery low qualityRelated question
1 peoplesix months
no tumor recurrence or complications six months after surgery
Who was studied
a 54-year-old woman with rectal bleeding and changed bowel habits
What they received
surgical removal of the rectum and anus (abdominoperineal resection) for anorectal malignant melanoma
Compared with
none
Main outcome
tumor recurrence and complications after surgery
Quality
This is a single patient case report, which cannot show what usually causes rectal bleeding or how well treatments work in general.
Limitations
Single case report with only six months of follow-up; findings cannot be generalized.
Taken word for word from the abstract
- population a 54-year-old Chinese female patient who was referred to our hospital with a two-month history of rectal bleeding secondary to altered bowel habits
- intervention The patient underwent abdominoperineal resection, which proceeded without complications.
- comparator CASE PRESENTATION
- primaryOutcome During the six months follow-up period, there was no evidence of tumor recurrence or long-term postoperative complications in the patient.
- result there was no evidence of tumor recurrence or long-term postoperative complications in the patient
- n a 54-year-old Chinese female patient
J Med Case Rep · PMID 42050610 · Read it on PubMed ↗
Arabi et al. 2026
Multiple Myeloma Presenting as Lower Gastrointestinal Bleeding: A Case Report
Rare blood cancer causing bleedingCase seriesVery low qualityRelated question
size not given2026
endoscopy did not find a cause, but hematologic and imaging tests confirmed multiple myeloma, and the patient was successfully treated
Who was studied
a 46-year-old man with gastrointestinal bleeding and severe anemia
What they received
bortezomib-based chemotherapy and supportive care after diagnosis of multiple myeloma
Main outcome
finding the cause of unexplained GI bleeding and anemia
Quality
This is a single patient case report, so it cannot show how common this cause is or how reliable the treatment is for others.
Limitations
Single case report with no comparison group; cannot determine how often myeloma causes this type of bleeding or whether treatment works reliably for others.
Taken word for word from the abstract
- population a case of MM in a 46-year-old man who presented with gastrointestinal bleeding and severe anemia
- intervention The patient was successfully treated with bortezomib-based chemotherapy and supportive care
- primaryOutcome Routine endoscopic evaluation was inconclusive, but further hematologic and imaging investigations confirmed multiple myeloma
- result Routine endoscopic evaluation was inconclusive, but further hematologic and imaging investigations confirmed multiple myeloma
- result The patient was successfully treated with bortezomib-based chemotherapy and supportive care
Clin Case Rep · PMID 42040372 · Read it on PubMed ↗
Thiagarajan et al. 2026
Pedunculated Polypoidal Anal Canal Lymphangioma in an Adult Male: A Report of a Rare Case and Review of the Literature
Rare benign tumor, not bleeding-related.Case seriesVery low qualityRelated question
1 people2026
complete excision was performed and confirmed as a lymphangioma, with excellent outcomes
Who was studied
an adult male in his early twenties with a polyp in the anal canal
What they received
complete excision of the polypoid lesion
Compared with
none reported
Main outcome
diagnosis and outcome after removal of the anal canal lesion
Quality
This is a single patient case report, so it cannot show how common this cause of bleeding is or compare treatments.
Limitations
Single case report with no control group or comparison, and the patient did not present with the symptom of bright red bleeding that prompted this question.
Taken word for word from the abstract
- population An adult male in his early twenties presented with complaints of a bloating sensation in his abdomen.
- intervention Complete excision of the lesion was performed and sent for histopathological examination (HPE)
- comparator Complete excision remains curative with excellent outcomes.
- primaryOutcome The diagnosis of anal lymphangioma was established and confirmed by IHC with D2-40 and CD31.
- result Complete excision remains curative with excellent outcomes.
- n An adult male in his early twenties presented with complaints of a bloating sensation in his abdomen.
Cureus · PMID 42037797 · Read it on PubMed ↗
Li et al. 2026
[Untargeted metabolomics reveals therapeutic mechanism of Fuzi Lizhong Pills on oxazolone-induced ulcerative colitis in mice]
Found a benefitAnimal studyVery low qualityRelated question
size not given7 consecutive days
the herbal treatment reduced bleeding, diarrhea, weight loss and colon inflammation in mice compared to untreated diseased mice
Who was studied
mice with chemically induced colon inflammation (ulcerative colitis model)
What they received
Fuzi Lizhong Pills (a Chinese herbal medicine)
Compared with
untreated model mice
Main outcome
disease severity including weight loss, diarrhea, bleeding, colon damage and inflammation markers
Quality
this is a mouse experiment using a chemically induced disease model, not a study of humans with this symptom, so it tells us little about a person's bleeding when wiping.
Limitations
animal model of a specific artificially induced disease, not human rectal bleeding from ordinary causes; no information on sample size reported
Taken word for word from the abstract
- population The mouse model of acute ulcerative colitis(UC) was established by skin sensitization via oxazolone(OXZ) combined with rectal enema
- intervention Successfully modeled mice were treated with Fuzi Lizhong Pills(FLP) for 7 consecutive days
- comparator Compared with the model group
- primaryOutcome The therapeutic effects were comprehensively evaluated
- result FLP significantly ameliorated the weight loss, diarrhea, and hematochezia in the mouse model of UC
- followUp treated with Fuzi Lizhong Pills(FLP) for 7 consecutive days
Zhongguo Zhong Yao Za Zhi · PMID 42011576 · Read it on PubMed ↗
Wang et al. 2026
Sanghuangporus vaninii extract exerts dual anti-tumor effects in colitis-associated colorectal cancer by direct cytotoxicity and macrophage reprogramming via the PPARγ/NF-κB axis
Mushroom extract reduced tumors in mice.Animal studyVery low qualityRelated question
size not given2026
SH extract reduced tumor number and inflammation and improved survival in mice
Who was studied
mice with colitis-associated colorectal cancer (induced by AOM/DSS)
What they received
Sanghuangporus vaninii (SH) mushroom extract
Compared with
untreated AOM/DSS mice
Main outcome
tumor development and inflammation in the colon
Quality
This is an animal and lab study, not a human study, so it cannot tell you why you personally are bleeding.
Limitations
Animal model only, no human data, does not address the symptom of bright red blood when wiping.
Taken word for word from the abstract
- population AOM/DSS-induced CAC mouse model
- intervention Sanghuangporus vaninii (SH)
- comparator SH treatment dose-dependently suppressed colitis-associated carcinogenesis in AOM/DSS mice
- primaryOutcome evaluate the antitumor effect of SH on colitis-associated colorectal cancer (CAC)
- result SH treatment dose-dependently suppressed colitis-associated carcinogenesis in AOM/DSS mice, improving body weight, colon length, and survival, while reducing tumor number and disease activity index.
J Ethnopharmacol · PMID 41974235 · Read it on PubMed ↗
Townsend et al. 2026
Knowledge, Symptom Awareness, and Referral Practices of Primary Care Providers in Early-Onset Colorectal Cancer
Doesn't explain causes of bleeding.RetrospectiveLow qualityRelated question
1,490 people2026
About 45% of providers would refer patients with rectal bleeding to colonoscopy or offer a stool test, and most would first do a workup and check family history rather than refer immediately
Who was studied
primary care providers in the United States
What they received
assessing primary care providers' awareness of colorectal cancer symptoms and their referral practices for patients under 50
Compared with
no comparator group; descriptive survey only
Main outcome
providers' symptom awareness and referral/diagnostic practices for early-onset colorectal cancer
Quality
This is a self-reported survey of doctors' practices, not a study of patients or of what actually causes bleeding, so it can't tell you why someone bleeds.
Limitations
Relies on self-reported survey data from providers rather than actual patient outcomes or diagnoses; does not study the bleeding itself or its causes.
Taken word for word from the abstract
- n This survey included 1490 PCPs practicing in the United States.
- population primary care providers' (PCPs') awareness of CRC-related symptoms and their diagnostic approaches for patients under age 50
- intervention examine primary care providers' (PCPs') awareness of CRC-related symptoms and their diagnostic approaches for patients under age 50 using the 2023 DocStyles panel survey
- comparator A descriptive analysis was conducted to examine symptom awareness and referral practices.
- primaryOutcome Symptom awareness of early-onset CRC was highest for changes in bowel habits (79%) and lowest for abdominal pain (43%).
- result Around 45% of PCPs would refer patients with rectal bleeding/bloody stools to diagnostic colonoscopy or offer a stool-based screening test.
Popul Health Manag · PMID 41943394 · Read it on PubMed ↗
Masina et al. 2026
Evaluating clinicopathological pattern and management of colorectal cancer for adult patients presenting at Queen Elizabeth Central Hospital: a 10-year retrospective review
Bleeding occurred in some cancer patients.RetrospectiveLow qualityRelated question
192 people2026
rectal bleeding was one of the main symptoms, seen in 78 of 192 patients, most of whom were diagnosed at an advanced stage
Who was studied
adult patients diagnosed with colorectal cancer at a hospital in Malawi
What they received
various treatments including surgery and chemotherapy for colorectal cancer
Compared with
no comparison group described
Main outcome
patterns of symptoms, diagnosis, and treatment of colorectal cancer
Quality
this is a retrospective review of cancer patients, not a study designed to find out how often bright red bleeding is caused by cancer versus other things, and many cases lacked confirmed histology.
Limitations
retrospective design, single hospital, 42.71% of cases had no histology report confirming the cancer diagnosis
Taken word for word from the abstract
- n There were 192 patients identified with CRC.
- population adult patients presenting at Queen Elizabeth Central Hospital (QECH), Malawi
- intervention Surgery was the main treatment for 155 (80.73%) patients while chemotherapy was offered to 81 (42.19%) patients.
- comparator This retrospective cross-sectional study evaluated clinicopathological pattern and management of CRC
- primaryOutcome evaluated clinicopathological pattern and management of CRC for adult patients
- result Abdominal pain and rectal bleeding were the predominant symptoms occuring in 100 (52.08%) and 78 (40.63%) respectively.
BMC Gastroenterol · PMID 41942892 · Read it on PubMed ↗
Acharya et al. 2026
Colocolic intussusception caused by a descending colon lipoma in an adult: a rare case report
Rare bowel tumor caused bleeding.Case seriesVery low qualityRelated question
1 people2026
the bleeding and symptoms were caused by a rare benign fatty tumor making part of the bowel fold into itself, fixed by surgery
Who was studied
a 47-year-old man with abdominal pain, loose stools, and fresh rectal bleeding
What they received
surgical removal of a colon lipoma causing intussusception (left hemicolectomy)
Main outcome
diagnosis and treatment outcome of the bowel blockage causing bleeding
Quality
This is a single patient case report, so it cannot show how common this cause is or how well treatment generally works.
Limitations
Single case report; no control group; findings cannot be generalized to typical causes of rectal bleeding.
Taken word for word from the abstract
- population A 47-year-old male presented with a 10-day history of intermittent periumbilical abdominal pain, loose stools, and fresh rectal bleeding.
- intervention Left hemicolectomy with side-to-side colocolic anastomosis was performed.
- primaryOutcome Imaging revealed a colocolic intussusception with a 5 × 4 cm fat-density lesion in the descending colon, suggestive of a submucosal lipoma.
- result Exploratory laparotomy confirmed transverse-to-descending colonic intussusception with a lipoma serving as the lead point.
- n A 47-year-old male presented
Int J Surg Case Rep · PMID 41938454 · Read it on PubMed ↗
Saleh et al. 2026
Rectal predominance and annular wall thickening: Abdominal computed tomography and clinical characteristics of colorectal cancer in a resource-limited setting
Rectal bleeding linked to colorectal cancer riskCase seriesLow qualityRelated question
60 people2026
CT scan correctly identified cancer with 88.9% sensitivity and 91.7% specificity, and bleeding from the back passage (hematochezia) was significantly linked to confirmed cancer cases
Who was studied
patients suspected of having colorectal cancer referred for abdominal CT at a hospital
What they received
abdominal CT scan to detect and stage suspected colorectal cancer
Compared with
histology results (biopsy diagnosis)
Main outcome
how well CT scan findings matched actual colorectal cancer diagnosis, and which symptoms were linked to cancer
Quality
This was a small, single-centre study of only 60 patients with exploratory statistical associations, so its findings are not strong enough to draw firm conclusions.
Limitations
Small sample size, cross-sectional design, single hospital setting, and the authors state associations should be considered exploratory due to small sample size and multiple comparisons.
Taken word for word from the abstract
- n This was a cross-sectional, hospital-based study of 60 patients with suspected CRC
- population patients suspected of having CRC at Muhimbili National Hospital between August 2019 and February 2020
- intervention abdominal CT scans are commonly used to detect and stage CRC before treatment
- comparator Clinical characteristics, abdominal CT findings, and histology results were recorded in a structured questionnaire
- primaryOutcome Abdominal CT showed good performance (sensitivity 88.9%, specificity 91.7%, accuracy 90.0%)
- result Significant associations were found with lower education (p = 0.04), alcohol use (p = 0.02), and hematochezia (p = 0.03).
Surg Oncol · PMID 41903361 · Read it on PubMed ↗
Albéniz et al. 2026
External validation and optimization of the Limoges score to improve the delayed bleeding risk prediction after colorectal endoscopic submucosal dissection: the Delayed Bleeding ESD (DEBE) score
Not relevant to bleeding on wipingProspective cohortLow qualityRelated question
4,767 people2026
the new DEBE score predicted delayed bleeding better than the older score, with acceptable but not excellent accuracy
Who was studied
adults who had a colorectal endoscopic submucosal dissection (a procedure to remove colon growths)
What they received
a new risk-scoring tool called DEBE score using patient and procedure factors before the procedure
Compared with
the existing Limoges bleeding risk score
Main outcome
clinically significant delayed bleeding after the colon procedure
Quality
this is a large study of a specific endoscopic procedure, not of general rectal bleeding, so it doesn't tell you why an ordinary person sees blood on wiping.
Limitations
abstract does not describe limitations such as missing data, follow-up completeness, or population restriction beyond the ESD setting
Taken word for word from the abstract
- population 4767 ESDs were included
- intervention A new score called DEBE (Delayed Bleeding ESD) was developed: age ≥ 75 years (2 points), lesion size ≥ 50 mm (5 points), ASA classification III-IV (4 points), location in the rectum (2 points) or proximal colon (1 point), anticoagulants (7 points) and antiplatelets (3 points).
- comparator The Limoges score was externally validated.
- primaryOutcome The Limoges Bleeding Score estimates an individual's risk of clinically significant delayed bleeding (CSDB) after colorectal endoscopic submucosal dissection (ESD).
- result The score showed acceptable discrimination (area under the curve 0.712), adequate calibration, and consistent performance after internal validation.
- n 4767 ESDs were included
Endoscopy · PMID 41871608 · Read it on PubMed ↗
Zhang et al. 2026
Analysis of 6-week mortality and influencing factors in patients with liver cirrhosis and portal vein thrombosis complicated by acute gastrointestinal bleeding
Unrelated: death risk in liver disease.RetrospectiveLow qualityRelated question
232 people6 weeks
higher ALP levels and failure of initial treatment within 5 days were linked to greater risk of dying within 6 weeks
Who was studied
patients with liver cirrhosis and portal vein thrombosis who had acute gastrointestinal bleeding
What they received
not applicable (observational risk factor analysis)
Compared with
patients who survived vs those who died within 6 weeks
Main outcome
death within 6 weeks of gastrointestinal bleeding
Quality
this is a retrospective study of a specific, more severe condition (cirrhosis with vein clots and major bleeding), so it mainly shows risk factors for death rather than answering why someone sees bright red blood when wiping.
Limitations
retrospective design; studies a specific high-risk population (cirrhosis with portal vein thrombosis) rather than general rectal bleeding
Taken word for word from the abstract
- n 232 patients with liver cirrhosis and portal vein thrombosis complicated by acute gastrointestinal bleeding
- population patients with liver cirrhosis and portal vein thrombosis complicated by acute gastrointestinal bleeding
- primaryOutcome 6-week mortality of acute gastrointestinal bleeding in patients with liver cirrhosis and portal vein thrombosis
- result elevated ALP levels showed a positive association with 6-week mortality [OR=1.01, 95% CI (1.01, 1.01), p < 0.01] and 5-day treatment failure showed a positive association with 6-week mortality [OR=11.27, 95% CI (3.45, 36.81),p < 0.01]
- comparator the patients were divided into a mortality group (n = 34) and a non-mortality group (n = 198)
- intervention This was a retrospective study.
PLoS One · PMID 41860832 · Read it on PubMed ↗
Tanrıkulu et al. 2026
Waiting in the Shadows: Diagnostic Delays and Illness Perceptions in Colorectal Cancer Patients
Many patients delayed seeking careRetrospectiveLow qualityRelated question
114 people2026
patients waited an average of 7.3 months before seeking help, with 60.6% delaying more than a month, mainly because they did not know the signs of colorectal cancer
Who was studied
patients diagnosed with colorectal cancer attending an oncology outpatient clinic
What they received
no treatment tested; patients were surveyed about their symptoms and time to seeking medical care
Compared with
no comparison group
Main outcome
time between first noticing symptoms and seeking medical help, and factors linked to delay
Quality
this is a small, single-clinic cross-sectional survey relying on patient recall, so it can show patterns but not prove cause or test a treatment
Limitations
cross-sectional design, single clinic, reliance on patient self-report of symptom timing, no control group
Taken word for word from the abstract
- n included 114 patients with colorectal cancer
- population patients with colorectal cancer
- intervention A structured questionnaire and the Brief Illness Perception Scale
- primaryOutcome the time between the onset of initial symptoms and the decision to seek medical help
- result The mean time from symptom onset to seeking medical help was 7.3 ± 11.0 months (range: 1-62.5). A delay of more than one month was observed in 60.6% of patients
- result Most participants (76.3%) reported being unaware of the signs and symptoms of colorectal cancer
- comparator The most common reported complaints included changes in bowel habits (22.0%), rectal bleeding (15.3%), fatigue (13.1%), and abdominal pain (11.2%).
Semin Oncol Nurs · PMID 41832104 · Read it on PubMed ↗
Babaei et al. 2026
Recurrent ileocolic variceal hemorrhage treated with superselective Onyx embolization: A case report
Rare vein bleeding stopped by embolization.Case seriesVery low qualityRelated question
1 people2026
Complete cessation of bleeding after embolization
Who was studied
35-year-old woman with ulcerative colitis, primary sclerosing cholangitis, and cirrhosis with recurrent rectal bleeding and severe anemia
What they received
Superselective embolization using Onyx followed by glue embolization
Compared with
none
Main outcome
Stopping the bleeding from ileocolic and appendicular varices
Quality
This is a single patient case report, so it cannot show how often this treatment works or whether it applies to other people.
Limitations
Only one patient described, no comparison group, and this cause of bleeding (ectopic varices from liver disease) is rare and different from common causes of bright red blood when wiping.
Taken word for word from the abstract
- n a 35-year-old woman with ulcerative colitis, primary sclerosing cholangitis, and cirrhosis
- population a 35-year-old woman with ulcerative colitis, primary sclerosing cholangitis, and cirrhosis who presented with recurrent hematochezia and severe anemia
- intervention Superselective embolization using Onyx followed by glue embolization
- comparator Superselective embolization using Onyx followed by glue embolization resulted in complete cessation of bleeding.
- primaryOutcome resulted in complete cessation of bleeding
- result Superselective embolization using Onyx followed by glue embolization resulted in complete cessation of bleeding.
Radiol Case Rep · PMID 41798667 · Read it on PubMed ↗
Pereira et al. 2026
CHANGING PATTERNS IN THE EPIDEMIOLOGY OF ACUTEGASTROINTESTINAL BLEEDING IN BRAZIL OVER THE LAST 12 YEARS
Hemorrhoids are one common cause.RetrospectiveLow qualityRelated question
2,145 people2026
hemorrhoids were one of the common causes of lower gastrointestinal bleeding, and overall death rates from bleeding fell over time
Who was studied
patients admitted to a hospital in Brazil with gastrointestinal bleeding over a 12-year period
What they received
none - this is a descriptive study of bleeding causes and outcomes, not a treatment
Compared with
comparison between two time periods (2012-2017 vs 2018-2023), not a treatment comparator
Main outcome
causes of bleeding and death rates, and how these changed over time
Quality
this is a single-center retrospective review of hospitalized bleeding patients, not a study designed to explain why someone sees blood when wiping.
Limitations
abstract does not address outpatient or non-hospitalized bleeding, and does not isolate hemorrhoids as a specific research question - it is a broad descriptive review of hospitalized GI bleeding causes
Taken word for word from the abstract
- n 2.145 patients (1.214 males, mean age 70+16 years) were admitted
- population All patients admitted to the Gastrointestinal (GI) Unit of the Portuguese Hospital of Salvador, Bahia, Brazil with the diagnosis of GIB between January 2012 and December 2023 were retrospectively investigated.
- intervention retrospectively investigated
- comparator between 2012-2017 (period 1) and 2018-2023 (period 2)
- primaryOutcome Demographics, type and etiology of GIB and in-hospital mortality were evaluated in two different periods
- result colonic diverticular disease (CDD), actinic proctocolitis (APC) and hemorrhoids (HE)
- result a significant decrease in mortality in recent years (14,2% vs 10.1% of deaths in period 2, P=0.005)
Arq Gastroenterol · PMID 41779539 · Read it on PubMed ↗
Yang et al. 2026
Alleviating Effects of Zophobas morio and Tenebrio molitor Larvae Protein Powder on Dextran Sodium Sulfate-Induced Inflammatory Bowel Disease in Mice
May reduce bowel inflammation and bleeding, in mice.Animal studyVery low qualityRelated question
size not given2026
insect protein powders reduced disease severity, bleeding, diarrhea, and inflammation, and improved gut bacteria balance compared to untreated colitis mice
Who was studied
mice with chemically induced colitis (DSS-induced), not human patients
What they received
protein powder from Zophobas morio and Tenebrio molitor larvae (edible insect protein)
Compared with
mice with colitis given no insect protein powder (DSS group)
Main outcome
disease severity measures including bleeding, diarrhea, weight loss, colon damage and inflammation
Quality
this is an animal study in mice with a chemically induced disease model, so it may not apply to humans with ordinary rectal bleeding.
Limitations
Animal model of induced colitis, not a study of humans or of the common causes of bright red rectal bleeding like hemorrhoids or fissures.
Taken word for word from the abstract
- population A 3% dextran sodium sulfate (DSS)-induced mouse colitis model was established
- intervention ZML protein powder (ZMLpp) and TML protein powder (TMLpp)
- comparator compared with the DSS group
- primaryOutcome Disease Activity Index (DAI), colon length, spleen weight, histopathology, inflammatory cell infiltration (LCA/MPO staining), inflammatory cytokines (Ccl2, Cxcl1, Ptgs2, Nf-κb), and intestinal microbiota (16S rRNA sequencing) were determined
- result both ZMLpp and TMLpp significantly reduced DAI, mitigated weight loss and hematochezia/diarrhea, restored colon length, attenuated mucosal damage, and preserved goblet cells and crypts, inflammatory cell infiltration, downregulated cytokine expression, improved fecal microbiota dysbiosis
Int J Mol Sci · PMID 41683826 · Read it on PubMed ↗
Elhoseeny et al. 2026
Bleeding rectal polyp as an atypical presentation of intestinal schistosomiasis: A case report from Egypt
Rare parasite infection caused bleeding polyp.Case seriesVery low qualityRelated question
1 peoplenot reported beyond stating full clinical recovery after therapy
a solitary bleeding rectal polyp was found to be caused by intestinal schistosomiasis (a parasite infection), confirmed on tissue exam, and the patient fully recovered after removal of the polyp and praziquantel therapy
Who was studied
28-year-old man from rural Egypt with rectal bleeding and abdominal pain for 3 months
What they received
removal of the rectal polyp followed by praziquantel treatment for schistosomiasis
Compared with
none
Main outcome
finding the cause of rectal bleeding and recovery after treatment
Quality
this is a single patient case report, so it cannot show how common this cause is or how well treatment generally works
Limitations
only one patient; stool tests for the parasite were repeatedly negative despite the infection being present, so this cause may be easily missed or may not apply to most people with this symptom
Taken word for word from the abstract
- n A 28-year-old Egyptian male from a rural area presented with a 3-month history of intermittent lower abdominal pain and rectal bleeding.
- population A 28-year-old Egyptian male from a rural area presented with a 3-month history of intermittent lower abdominal pain and rectal bleeding.
- intervention which was completely resected
- intervention The patient achieved full clinical recovery after praziquantel therapy
- comparator CASE PRESENTATION
- primaryOutcome Histopathological examination confirmed the diagnosis by demonstrating viable Schistosoma mansoni ova within eosinophilic granulomas and, critically, an adult worm residing in the submucosal vasculature, confirming active infection.
- result Colonoscopy identified a solitary, pedunculated, and ulcerated rectal polyp (1.5 × 3.0 cm) at 20 cm from the anal verge, which was completely resected. Histopathological examination confirmed the diagnosis by demonstrating viable Schistosoma mansoni ova within eosinophilic granulomas and, critically, an adult worm residing in the submucosal vasculature, confirming active infection.The patient achieved full clinical recovery after praziquantel therapy
PLoS Negl Trop Dis · PMID 41662285 · Read it on PubMed ↗
Zhang et al. 2026
Human Intestinal Spirochetosis as a Cause of Chronic Diarrhea in an Immunocompetent Patient: A Case Report
Rare gut infection, diarrhea cured with antibioticsCase seriesVery low qualityRelated question
1 people2026
complete remission of diarrhea after metronidazole treatment
Who was studied
an immunocompetent patient without risk factors with chronic watery diarrhea and weight loss
What they received
a 10-day course of metronidazole
Compared with
none reported
Main outcome
resolution of chronic diarrhea
Quality
This is a single patient case report, which cannot show whether this applies to other people or to bleeding specifically.
Limitations
Single case report; the abstract's patient had chronic diarrhea and weight loss, not rectal bleeding as the main problem, and rectal bleeding was only mentioned as a rare possible symptom of the underlying condition in general.
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)
- comparator The patient was treated with a 10-day course of metronidazole (500 mg, three times a day) with complete remission of diarrhea.
- primaryOutcome with complete remission of diarrhea
- result with complete remission of diarrhea
- n an immunocompetent patient without risk factors presented with chronic watery diarrhea
Cureus · PMID 41658837 · Read it on PubMed ↗
Zhao et al. 2025
[Rare massive upper gastrointestinal bleeding: Three cases of Dieulafoy's disease within diverticula of the descending duodenal and a literature review]
Rare bleeding lesion stopped with clips.Case seriesVery low qualityRelated question
3 people2025
Hemostasis was achieved in all 3 cases using endoscopic clips after medical treatment failed
Who was studied
3 patients with massive upper gastrointestinal bleeding from Dieulafoy's lesions within duodenal diverticula
What they received
endoscopic hemoclip placement after diagnosis by emergency gastroscopy/duodenoscopy
Compared with
medical therapy alone (which was unsatisfactory)
Main outcome
successful stopping of bleeding
Quality
This is a tiny report of just 3 cases, so it cannot show what causes bleeding in most people or how common this is.
Limitations
Only 3 cases from two hospitals, a rare and severe condition with massive bleeding and hematemesis, not matching typical bright red blood seen only on wiping.
Taken word for word from the abstract
- n 3 patients with Dieulafoy's disease within diverticula of the descending duodenum complicated by upper gastrointestinal bleeding were admitted
- population 3 patients with Dieulafoy's disease within diverticula of the descending duodenum complicated by upper gastrointestinal bleeding
- intervention Hemostasis was successfully achieved in all cases by endoscopic hemoclip placement.
- comparator After medical therapy, the outcomes were unsatisfactory in all 3 cases.
- primaryOutcome Hemostasis was successfully achieved in all cases by endoscopic hemoclip placement.
- result Hemostasis was successfully achieved in all cases by endoscopic hemoclip placement.
Zhong Nan Da Xue Xue Bao Yi Xue Ban · PMID 41656847 · Read it on PubMed ↗
Hui et al. 2026
Colonic diverticular hemorrhage: Etiology, diagnostic challenges, and evolving therapeutic strategies
Band ligation beats clipping for diverticular bleeding.Narrative reviewLow qualityRelated question
size not given2026
Band ligation worked better than clipping at preventing rebleeding, and artery embolization was an effective backup when endoscopy failed
Who was studied
older adults with colon diverticulosis and lower gastrointestinal bleeding
What they received
endoscopic treatments (band ligation, clipping) and transcatheter arterial embolization for diverticular bleeding
Compared with
different treatment approaches compared with each other (band ligation vs clipping, endoscopy vs embolization vs surgery)
Main outcome
rebleeding and successful control of diverticular bleeding
Quality
This is an editorial summarizing other research rather than presenting new patient data, so it cannot be weighed like a primary study.
Limitations
No original patient data, sample size, or study methodology reported; it is an editorial synthesis of existing evidence.
Taken word for word from the abstract
- population Colonic diverticular hemorrhage is a major cause of acute lower gastrointestinal bleeding, particularly in aging populations with increasing prevalence of diverticulosis
- intervention Endoscopic therapy, especially band ligation, has demonstrated superiority over clipping in reducing rebleeding, while transcatheter arterial embolization has emerged as an effective salvage approach when endoscopic treatment fails
- comparator band ligation, has demonstrated superiority over clipping in reducing rebleeding
- primaryOutcome reducing rebleeding
- result Endoscopic therapy, especially band ligation, has demonstrated superiority over clipping in reducing rebleeding, while transcatheter arterial embolization has emerged as an effective salvage approach when endoscopic treatment fails
World J Gastroenterol · PMID 41640869 · Read it on PubMed ↗
Wong et al. 2026
Infliximab and Upadacitinib Demonstrate Superior Early Onset of Efficacy in Biologic-Naïve Ulcerative Colitis With Severe Endoscopic Disease
Two UC drugs sped up relief of bleeding.Meta-analysisModerate qualityRelated question
1,781 people2 weeks
infliximab and upadacitinib had the highest rates of early symptom improvement compared with placebo
Who was studied
biologic-naïve patients with severe ulcerative colitis (endoscopic score 3)
What they received
advanced UC drugs (infliximab, adalimumab, golimumab, vedolizumab, ustekinumab, mirikizumab, tofacitinib, upadacitinib)
Compared with
placebo
Main outcome
early reduction in stool frequency and rectal bleeding at 2 weeks
Quality
This pools real trial data from thousands of patients, but it's an after-the-fact comparison across different trials rather than a head-to-head test.
Limitations
Post hoc analysis combining separate trials with adjustment for baseline differences, not a direct head-to-head trial design.
Taken word for word from the abstract
- population Biologic-naïve patients with MES 3 disease
- n A total of 1,781 biologic-naïve patients with MES 3 disease were included.
- intervention receiving standard induction regimens of infliximab, adalimumab, golimumab, vedolizumab, ustekinumab, mirikizumab, tofacitinib, or upadacitinib
- comparator Compared with placebo, the highest odds of response were observed with upadacitinib
- primaryOutcome The primary outcome was early PRO-2 response, defined as ≥50% reduction in stool frequency and rectal bleeding scores at 2 weeks postbaseline.
- result Infliximab (35.1%) and upadacitinib (32.4%) demonstrated the highest early PRO-2 response rates.
- followUp at 2 weeks postbaseline
Am J Gastroenterol · PMID 41626838 · Read it on PubMed ↗
Nikolovski et al. 2026
Perforated solitary mid-rectal diverticulum diagnosed with colonoscopy: a case report and literature review
Rare diverticulum caused bleeding and infection.Case seriesVery low qualityRelated question
1 people2026
the bleeding was caused by a rare perforated rectal diverticulum that led to pelvic infection, treated successfully with surgery and antibiotics
Who was studied
a woman with rectal bleeding and anemia
What they received
surgery combined with antibiotics and supportive care for a perforated rectal diverticulum
Main outcome
diagnosis and outcome of rectal bleeding caused by a perforated rectal diverticulum
Quality
this is a single patient's case report, so it cannot show how common this cause is or whether treatments generally work.
Limitations
single case report; findings cannot be generalized to typical causes of bright red rectal bleeding
Taken word for word from the abstract
- population a female patient presented with rectal bleeding and secondary anemia
- n a female patient presented with rectal bleeding and secondary anemia
- primaryOutcome This case highlights the importance of considering rectal diverticulum in the differential diagnosis of lower gastrointestinal bleeding and pelvic infections.
- result the patient developed pelvic sepsis secondary to rectal diverticulitis. Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome.
- intervention Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome.
J Surg Case Rep · PMID 41608549 · Read it on PubMed ↗
Takahashi et al. 2026
Uncommon cause of hematochezia in older adults: a solitary juvenile polyp in the transverse colon
Rare polyp caused the bleeding.Case seriesVery low qualityRelated question
1 peoplenot specified beyond 'no recurrence of bleeding'
a rare benign juvenile polyp was found and removed, bleeding stopped with no recurrence
Who was studied
a 78-year-old woman with rectal bleeding
What they received
endoscopic removal of a colon polyp
Compared with
none
Main outcome
stopping the bleeding and identifying its cause
Quality
this is a single patient case report, so it cannot show what causes bleeding in general or how well treatment works overall
Limitations
only one patient; a case report cannot establish how common this cause is or predict outcomes for other people
Taken word for word from the abstract
- n A 78-year-old woman presented with hematochezia.
- population A 78-year-old woman presented with hematochezia.
- intervention the lesion was removed via endoscopic mucosal resection
- comparator A 78-year-old woman presented with hematochezia.
- primaryOutcome After confirming the cessation of bleeding, the lesion was removed via endoscopic mucosal resection.
- result The patient remained asymptomatic after the procedure and experienced no recurrence of bleeding.
J Rural Med · PMID 41568119 · Read it on PubMed ↗
Kirchweger et al. 2026
Rectal melanoma: managing a rare cause of rectal bleeding: case report and review of the literature
Rare melanoma found; bleeding stopped with embolization.Case seriesVery low qualityRelated question
1 peoplethree months
Embolization stopped the bleeding, but the patient died three months later from the cancer spreading
Who was studied
90-year-old woman with rectal bleeding and changes in bowel habits
What they received
palliative coil embolization of the tumor-supplying arteries to control bleeding
Compared with
no surgical treatment (not feasible due to poor health)
Main outcome
control of rectal bleeding from a rectal tumor
Quality
This is a single case report of one very old patient with a rare cancer, so it tells us little about common causes of bleeding.
Limitations
Single patient case report of an extremely rare cancer (rectal melanoma), not representative of typical causes of rectal bleeding like hemorrhoids.
Taken word for word from the abstract
- n A 90-year-old female sought emergency care due to rectal bleeding and changes in bowel habits.
- population A 90-year-old female sought emergency care due to rectal bleeding and changes in bowel habits.
- intervention palliative endovascular coil embolization of the tumor -supplying arteries was successfully performed for bleeding control
- comparator surgical intervention for symptom control was not feasible due to her general health
- primaryOutcome Recurrent severe bleeding necessitated transfusions
- result the patient died from disease progression three months later without further bleeding
World J Surg Oncol · PMID 41555436 · Read it on PubMed ↗
Uemura et al. 2025
[Laparoscopic Resection of an Ectopic Endometriosis-Associated Carcinoma Arising in the Rectum-A Case Report]
Rare cancer found, no recurrence after surgery.Case seriesVery low qualityRelated question
1 people3 years and 9 months
no cancer recurrence after nearly 4 years of follow-up
Who was studied
a woman in her seventies with blood and mucus in stool
What they received
surgery to remove rectal tumor (laparoscopic resection with hysterectomy) plus chemotherapy
Compared with
none
Main outcome
cancer recurrence after treatment
Quality
this is a single patient case report, which cannot show what causes bleeding in general or how well treatments work.
Limitations
single case report; findings from one patient cannot be generalized to explain a symptom or predict treatment outcomes broadly.
Taken word for word from the abstract
- population A woman in her seventies presented with mucous hematochezia.
- n A woman in her seventies presented with mucous hematochezia.
- intervention Laparoscopic low anterior resection with D3 lymphadenectomy was performed along with total hysterectomy and bilateral salpingo-oophorectomy.
- comparator The patient received 6 courses of adjuvant chemotherapy with docetaxel and carboplatin.
- primaryOutcome No recurrence has been detected during 3 years and 9 months of postoperative follow-up.
- result No recurrence has been detected during 3 years and 9 months of postoperative follow-up.
- followUp 3 years and 9 months of postoperative follow-up
Gan To Kagaku Ryoho · PMID 41546333 · Read it on PubMed ↗
Zelelew et al. 2025
A rare presentation of adult colonic intussusception secondary to a descending colon lipoma: A case report
Rare colon lipoma caused bleeding.Case seriesVery low qualityRelated question
1 people2025
bleeding was caused by a benign colon lipoma causing bowel telescoping (intussusception); surgery removed it with no cancer found and full recovery
Who was studied
54-year-old woman with abdominal pain and rectal bleeding
What they received
surgical removal of colon segment (left hemicolectomy)
Compared with
none
Main outcome
diagnosis and recovery after surgery
Quality
this is a single patient case report, so it cannot show how common this cause is or how well treatment works in general.
Limitations
single case report; not generalizable; specific rare anatomical cause rather than common cause of rectal bleeding
Taken word for word from the abstract
- population a 54-year-old woman presenting with intermittent left lower abdominal pain and recent rectal bleeding
- intervention She underwent a left hemicolectomy.
- comparator Surgical resection remains the mainstay of treatment.
- primaryOutcome Her postoperative course was uneventful, and she made a full recovery.
- result Histopathology revealed a 4.2 × 4.3 cm pedunculated submucosal lipoma with no malignancy.
- n a 54-year-old woman
Int J Surg Case Rep · PMID 41541172 · Read it on PubMed ↗
Kim et al. 2026
Urgent fertility preservation following second trimester termination in a patient with pregnancy-associated colorectal cancer: a case report and literature review
Not relevant to rectal bleeding cause.Case seriesVery low qualityRelated question
1 people2026
19 eggs retrieved, 11 fertilized, all reached blastocyst stage, and 5 were genetically normal
Who was studied
a 32-year-old pregnant patient diagnosed with advanced colorectal cancer after hematochezia
What they received
urgent fertility preservation using ovarian stimulation and embryo freezing after pregnancy termination
Compared with
no comparator
Main outcome
feasibility of fertility preservation (oocyte retrieval, fertilization, and euploid embryo creation) before starting chemotherapy
Quality
This is a single patient case report, so it cannot show what causes bleeding or how common it is.
Limitations
Single case report; no control group; not designed to study causes of rectal bleeding.
Taken word for word from the abstract
- n A 32-year-old patient at 17 weeks of gestation was diagnosed with advanced colorectal cancer
- population A 32-year-old patient at 17 weeks of gestation was diagnosed with advanced colorectal cancer after presenting with hematochezia and acute blood loss anemia.
- intervention Random-start controlled ovarian stimulation (COS) was initiated seven days later using a gonadotropin-releasing hormone antagonist protocol.
- comparator We report a case of fertility preservation using random-start controlled ovarian stimulation and embryo cryopreservation in a patient with a recent second trimester termination.
- primaryOutcome This case highlights the feasibility of random-start COS and embryo cryopreservation for fertility preservation immediately after a second trimester termination in a patient with newly diagnosed colorectal cancer.
- result Nineteen oocytes were retrieved after 10 days of ovarian stimulation, of which 15 were mature. Eleven mature oocytes fertilized successfully using intracytoplasmic sperm injection. All 11 embryos developed into the blastocyst stage and underwent biopsy for preimplantation genetic testing for aneuploidy screening. Five blastocysts were found to be euploid.
J Assist Reprod Genet · PMID 41493736 · Read it on PubMed ↗
Jin et al. 2025
Total alkaloids of Corydalis saxicola Bunting ameliorate ulcerative colitis through regulation of metabolite networks and gut microbiota
Herb extract reduced bleeding in colitis mice.Animal studyVery low qualityRelated question
size not given7 days
the herbal extract reduced weight loss, diarrhea, and bloody stool, reduced inflammation, and restored gut bacteria balance in mice with induced colitis
Who was studied
mice with chemically-induced colitis (not human patients)
What they received
total alkaloids from Corydalis saxicola herb (YTA)
Compared with
untreated colitis mice
Main outcome
colitis severity including weight loss, diarrhea, and bloody stool, plus gut bacteria and metabolite changes
Quality
this is an animal study using mice with chemically induced colitis, not a human study of rectal bleeding causes or treatments
Limitations
study was done in mice with drug-induced colitis, not humans, and does not address the original question of why a person bleeds when wiping
Taken word for word from the abstract
- population DSS-induced colitis mice
- intervention Three graded doses of YTA were introduced to DSS-induced colitis mice for 7 days to evaluate the anti-colitis effect.
- comparator DSS-induced colitis mice
- primaryOutcome YTA alleviated weight loss, diarrhea, and hematochezia in colitis mice, reducing inflammation and oxidative stress while restoring intestinal barrier impairment.
- result YTA alleviated weight loss, diarrhea, and hematochezia in colitis mice, reducing inflammation and oxidative stress while restoring intestinal barrier impairment.
Front Pharmacol · PMID 41476793 · Read it on PubMed ↗
Appolo et al. 2026
Frequency of Synchronous Polyp in Colorectal Carcinoma and Clinicopathological Profile: a Cross Sectional Analytical Study in Dhaka Medical College Hospital
Bleeding is a common colon cancer symptom.Case seriesVery low qualityRelated question
60 people2026
61.7% of colorectal cancer patients had rectal bleeding as a symptom, and 18.3% also had a synchronous polyp
Who was studied
patients diagnosed with colorectal cancer at a hospital
What they received
none - this was an observational study describing symptoms and polyps, not a treatplanned intervention
Compared with
colorectal cancer patients with synchronous polyps versus those without polyps
Main outcome
how often colorectal cancer patients also had polyps, and their clinical features
Quality
This is a small, single-hospital descriptive study of cancer patients, not a study designed to find the cause of rectal bleeding in the general population.
Limitations
Small sample size (60 patients), single hospital, and histopathology of the polyp was not done in over a third of synchronous polyp cases.
Taken word for word from the abstract
- population sixty colorectal cancer patients who met the selection criteria and attended in Gastroenterology, Surgery, Medicine and Radiotherapy departments of Dhaka Medical College Hospital
- n sixty colorectal cancer patients
- primaryOutcome to characterize the demographic profile, clinical features and frequency of synchronous polyp in patients with colorectal cancer
- result Most frequent clinical presentations were altered bowel habit (81.7%), weight loss (78.3%), tenesmus (76.7%) and per rectal bleeding (61.7%)
- result Out of 60 cases, 11(18.3%) had synchronous polyp
- comparator Comparison of clinical, demographic and pathological characteristics between synchronous polyp group and non-polyp group of colorectal cancer patients were done
- intervention This was a hospital based cross sectional analytical study
Mymensingh Med J · PMID 41474906 · Read it on PubMed ↗
Chen et al. 2025
Fulminant disseminated human parvovirus B19 infection: Case report
Rare severe viral infection, not typical causeCase seriesVery low qualityRelated question
1 people32 days to improvement (illness Day 32 confirmation, improved after four weeks of care)
After four weeks of treatment, kidney, liver, and lung function recovered and the rectal lesions resolved
Who was studied
A 35-year-old man with multi-organ illness and rectal bleeding
What they received
Supportive care and intravenous immunoglobulin for disseminated parvovirus B19 infection
Compared with
None (single case, no comparison group)
Main outcome
Recovery of organ function and resolution of rectal bleeding/lesions
Quality
This is a single patient case report, so it cannot show whether this treatment works for anyone else or explain most causes of rectal bleeding.
Limitations
Single case report of a rare, severe infection; findings may not generalize to typical causes of bright red rectal bleeding.
Taken word for word from the abstract
- n A 35-year-old man developed abrupt confusion on the second day of incarceration.
- population A 35-year-old man developed abrupt confusion on the second day of incarceration.
- intervention the patient improved after four weeks of supportive care and two courses of intravenous immunoglobulin
- comparator CASE PRESENTATION
- primaryOutcome with recovery of renal, hepatic, and respiratory function and resolution of rectal lesions
- result the patient improved after four weeks of supportive care and two courses of intravenous immunoglobulin, with recovery of renal, hepatic, and respiratory function and resolution of rectal lesions
IDCases · PMID 41473479 · Read it on PubMed ↗
Fernández-Sánchez et al. 2026
Immune thrombocytopenia triggered by dostarlimab in a patient with endometrial carcinoma: first reported case
Rare drug-caused bleeding disorder, not relevant here.Case seriesVery low qualityRelated question
1 people2026
the patient had a partial response to steroids and immunoglobulin, with full platelet recovery only after adding romiplostim
Who was studied
a 55-year-old woman with relapsed endometrial carcinoma treated with the immunotherapy drug dostarlimab
What they received
treatment of severe low platelet count (immune thrombocytopenia) with corticosteroids, immunoglobulin, and later romiplostim
Main outcome
recovery of platelet count and resolution of bleeding
Quality
this is a single patient case report, so it cannot show whether this applies to other people with rectal bleeding.
Limitations
single case report with no comparison group, describing a rare drug side effect in a cancer patient, not a general explanation for rectal bleeding
Taken word for word from the abstract
- population We report the first case of ITP in a patient receiving dostarlimab for relapsed endometrial carcinoma.
- n A 55yearold woman developed severe thrombocytopenia (3 × 109/L) accompanied by rectal bleeding, resulting in a lifethreatening condition.
- intervention Initial treatment with highdose corticosteroids and intravenous immunoglobulin achieved only a partial response, while sustained platelet recovery was obtained with the addition of romiplostim.
- primaryOutcome sustained platelet recovery was obtained with the addition of romiplostim
- result Initial treatment with highdose corticosteroids and intravenous immunoglobulin achieved only a partial response, while sustained platelet recovery was obtained with the addition of romiplostim.
Platelets · PMID 41432114 · Read it on PubMed ↗
Murata et al. 2025
Pharmacodynamics of direct oral anticoagulants associated with post-endoscopic delayed mucosal resection bleeding of colorectal neoplasms
Higher blood thinner levels raise bleeding risk.Prospective cohortLow qualityRelated question
size not given2025
high anticoagulant activity was linked to a much higher chance of bleeding after the procedure
Who was studied
people taking direct oral anticoagulants who had endoscopic removal (EMR) of colon polyps
What they received
direct oral anticoagulant (DOAC) use with measured blood drug levels and anti-factor Xa activity
Compared with
patients with lower anticoagulant drug levels/activity
Main outcome
bleeding after the colon polyp removal procedure
Quality
it is a small multicenter observational study with a very wide confidence interval around the risk estimate, so the result is uncertain.
Limitations
wide confidence interval (95% CI: 1.081-137.922), observational design, specific to patients on anticoagulants undergoing a bowel procedure
Taken word for word from the abstract
- population patients receiving DOAC
- intervention Anticoagulant effects of direct oral anticoagulants (DOACs) are influenced by their plasma levels and anti-factor Xa (FXa) activity.
- comparator high anticoagulant ability was a risk factor for post-EMR delayed bleeding
- primaryOutcome Delayed bleeding is a major adverse event associated with endoscopic mucosal resection (EMR) of colorectal neoplasms.
- result Multivariate analysis showed that high anticoagulant ability was a risk factor for post-EMR delayed bleeding (adjusted OR, 12.211; 95% CI: 1.081-137.922, p = 0.043).
Sci Rep · PMID 41429902 · Read it on PubMed ↗
Abdullah et al. 2025
Left Internal Iliac Artery Aneurysm Presenting With Nephrostomy-Site and Rectal Bleeding From an Arterio-Ureteral Fistula in a Patient With Rectovesical Fistula After Colorectal Cancer Therapy: A Report of a Rare Case
Rare blood vessel cause, fixed by procedure.Case seriesVery low qualityRelated question
1 peopleone month
Bleeding completely stopped after embolization and stayed resolved at one month follow-up
Who was studied
75-year-old man with history of colorectal cancer treated with surgery and pelvic radiotherapy, with rectovesical fistula and bilateral nephrostomies
What they received
Endovascular coil embolization of an internal iliac artery aneurysm causing an arterio-ureteral fistula
Compared with
None (single case before and after treatment)
Main outcome
Resolution of bleeding from nephrostomy and rectum
Quality
This is a single patient case report, so it cannot show what causes bleeding in general or how well this treatment works in others.
Limitations
Single case report; describes a rare vascular abnormality (artery aneurysm and fistula) rather than common causes of bright red rectal bleeding seen with routine wiping.
Taken word for word from the abstract
- n a 75-year-old man with a history of colorectal carcinoma
- population a 75-year-old man with a history of colorectal carcinoma managed with surgery and adjuvant pelvic radiotherapy, complicated by a rectovesical fistula and bilateral nephrostomies for obstructive uropathy
- intervention Endovascular coil embolization of the aneurysm was performed, resulting in complete resolution of bleeding.
- comparator We describe the case of a 75-year-old man
- primaryOutcome The patient presented with intermittent bleeding from the left nephrostomy and per rectum.
- result Follow-up CT angiography performed one month after the procedure confirmed complete exclusion of the aneurysm and absence of recurrent bleeding.
- followUp Follow-up CT angiography performed one month after the procedure
Cureus · PMID 41404227 · Read it on PubMed ↗
Román-Colón et al. 2025
The Use of the Fecal Immunochemical Test in the Acute-Care Hospital Setting
Misused stool test, not bleeding explanation.RetrospectiveLow qualityRelated question
1,354 people2025
Positive FIT results were linked to rectal bleeding, weakness, and diarrhea, and often led to extra consultations and endoscopic procedures, while none of the tests had been ordered for proper screening
Who was studied
Patients in the emergency department or admitted to a VA hospital who had a fecal immunochemical test (FIT) done
What they received
Fecal immunochemical test (FIT) ordered for reasons other than routine colon cancer screening
Compared with
FIT-positive versus FIT-negative results
Main outcome
Clinical impact of FIT results, including symptoms, follow-up consultations, and endoscopic procedures
Quality
This was a single-center retrospective chart review without a control group, so it can show associations but not prove cause or effect.
Limitations
Retrospective design, single VA hospital, mostly older male patients, and no standardized indication for why tests were ordered.
Taken word for word from the abstract
- n Of the 1,354 patients included, most were men.
- population analyzing patients who underwent the FIT in the ED or while admitted to the VA Hospital from September 2013 through December 2016
- intervention the inclusion of orders for non-indication-based FITs in medical records has led to increased inappropriate use in emergency department (ED) and inpatient settings
- comparator Positive FIT results were statistically significantly associated with rectal bleeding, weakness, and diarrhea.
- 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. Anticoagulants were associated with positive FIT results. Patients with positive tests often received gastroenterology consultations and were more likely to undergo endoscopic procedures.
P R Health Sci J · PMID 41401088 · Read it on PubMed ↗
Coppola et al. 2025
Diagnosis and Management of Food Protein-Induced Allergic Proctocolitis in the pediatric age: A position paper from the Italian Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Italian Society for Pediatric Allergy and Immunology
Guidance on diagnosing allergy-related rectal bleeding in infantsGuidelineLow qualityRelated question
size not given2025
the panel recommends a structured approach combining clinical history, elimination diet response, and food challenge to improve diagnosis and avoid overtesting and unnecessary diets
Who was studied
infants and young children with suspected food-allergy-related rectal bleeding
What they received
structured diagnostic approach using clinical history, elimination diet, and oral food challenge
Main outcome
accurate diagnosis and management of food protein-induced allergic proctocolitis
Quality
this is an expert consensus guideline based on a literature review rather than new patient data, so it cannot show whether treatments actually work.
Limitations
abstract does not describe original study data, sample size, or outcome statistics; it is a consensus recommendation document.
Taken word for word from the abstract
- population Food protein-induced allergic proctocolitis (FPIAP) is one of the most common phenotypes of food allergy in the first years of life.
- intervention The panel proposes a structured diagnostic approach emphasizing the role of a focused clinical history, response to the elimination diet, and recurrence of symptoms during the oral food challenge.
- primaryOutcome provide practical evidence-based suggestions for the best diagnostic approach and management of this condition in pediatric age
- result This position paper provides practical, evidence-based recommendations for the diagnosis and management of FPIAP in infants.
Pediatr Allergy Immunol · PMID 41399193 · Read it on PubMed ↗
Fujino et al. 2025
Behavioral changes and delayed colorectal cancer diagnosis during COVID-19: a real-world survey analysis
Delayed care linked to worse cancer stage.RetrospectiveLow qualityRelated question
83 people2025
patients who delayed care were more likely to be women and tended to have more advanced cancer stage; rectal bleeding as a symptom became more common later in the study period
Who was studied
patients who had surgery for colorectal cancer during the COVID-19 pandemic
What they received
delaying or cancelling medical visits and screenings because of the pandemic
Compared with
patients who did not delay their visits or screenings
Main outcome
whether pandemic-related delays in care were linked to more advanced cancer stage and symptoms like rectal bleeding
Quality
small survey-based study with only 83 patients and some results only reaching borderline significance, so it can't strongly prove a cause-effect link.
Limitations
small sample size, retrospective data collection combined with a survey, and some associations (like stage severity) did not reach statistical significance (P = 0.062).
Taken word for word from the abstract
- population patients who underwent colorectal cancer surgery at Osaka University Hospital and Minoh City Hospital between January 2021 and June 2023
- n 83 met the inclusion criteria
- intervention Behavioral changes were defined as pandemic-related postponements or cancellations of additional screenings and regular medical visits.
- comparator Behavioral changes due to the pandemic were observed in 8.4% of patients.
- primaryOutcome identify vulnerable populations, and determine the impact of such changes on cancer progression
- result Clinical symptoms, particularly rectal bleeding, were more common in the latter part of the study period (P = 0.014). Women were more likely to change their behavior (P = 0.038), and the disease stage tended to be more advanced in patients who changed their behavior (P = 0.062).
BMC Gastroenterol · PMID 41390368 · Read it on PubMed ↗
Lei et al. 2026
Variations in the investigation of colorectal cancer-related symptoms in Australian primary care: a retrospective cohort study
Doesn't explain why bleeding happens.RetrospectiveLow qualityRelated question
70,107 people12 months
Colonoscopy or specialist referral happened for about two-thirds of patients with rectal bleeding, while many patients with other symptoms like constipation or diarrhoea got no testing at all
Who was studied
adults aged 40 and older seen in primary care with symptoms that can signal colorectal cancer, including rectal bleeding
What they received
being investigated with colonoscopy or referred to a specialist after reporting these symptoms
Compared with
receiving no investigation, or only medication, for the same symptoms
Main outcome
how often patients got diagnostic tests, imaging, colonoscopy, or specialist referral for their symptoms
Quality
It is a retrospective records study of testing patterns, not a trial testing a treatment, so it cannot say what causes bleeding or what treatment works.
Limitations
Retrospective design, only 0.5% of patients were actually diagnosed with colorectal cancer, and the study looks at testing patterns rather than diagnoses or causes of bleeding.
Taken word for word from the abstract
- n Among 70 107 patients, 378 (0.5%) were diagnosed with colorectal cancer within 12 months.
- population patients aged ≥40 years presenting with colorectal cancer-related symptoms between 2008 and 2022
- intervention Colonoscopy or specialist referral was highest for rectal bleeding (67%; n = 4536/6772)
- comparator No investigation or treatment occurred in 20% (change in bowel habit; n = 226/1106) to 50% (constipation; n = 6028/12 128; and diarrhoea; n = 7069/14 122) of patients.
- primaryOutcome The proportion of patients receiving diagnostic actions was assessed, including medications, pathology, imaging, colonoscopy, or specialist referral.
- result Colonoscopy or specialist referral was highest for rectal bleeding (67%; n = 4536/6772) and change in bowel habit (60%; n = 662/1106).
Br J Gen Pract · PMID 41344811 · Read it on PubMed ↗
Fesmire et al. 2026
Fatal Toxic Shock Syndrome Resulting from Clostridium sordellii Bacteremia after Perforation of a Low Rectal Cancer
Rare fatal infection from rectal cancer.Case seriesVery low qualityRelated question
1 people2026
She developed severe sepsis and organ failure and died despite surgery to divert stool and drain infection
Who was studied
60-year-old woman with a perforated low rectal cancer and fistula between rectum and vagina
What they received
none (describes natural disease course and emergency surgery)
Compared with
none
Main outcome
survival after infection with Clostridium sordellii bacteria in the blood
Quality
This is a single patient case report, so it cannot show what causes bleeding in general or how common this is.
Limitations
Only one patient; this is an extremely rare and severe cancer-related infection, not a typical cause of bleeding when wiping.
Taken word for word from the abstract
- population A 60-year-old female presented with 10 days of abdominal pain, loose stools, and hematochezia.
- intervention She underwent fecal diversion and drainage of the pelvic abscess.
- comparator Despite this intervention, she had refractory septic shock with multisystem organ failure resulting in death.
- primaryOutcome Blood cultures grew C. sordellii post-mortem.
- result Despite this intervention, she had refractory septic shock with multisystem organ failure resulting in death.
- n A 60-year-old female presented
Surg Infect (Larchmt) · PMID 41335039 · Read it on PubMed ↗
Truelsen et al. 2025
Longitudinal assessment of quality of life and symptom burden in locally advanced rectal cancer patients receiving IMRT-based preoperative radiotherapy: A prospective cohort study
Radiotherapy-related rectal bleeding improved within a yearProspective cohortModerate qualityRelated question
123 people1-year follow-up
Rectal bleeding and diarrhoea, which occurred during treatment, got better over the following year; other symptoms like fatigue and urinary problems worsened slightly, while overall quality of life was largely preserved at 1 year
Who was studied
people with locally advanced rectal cancer having radiotherapy before surgery
What they received
preoperative radiotherapy (IMRT-based, either short-course or long-course chemoradiotherapy)
Compared with
symptoms tracked over time within the same patients (no separate control group)
Main outcome
quality of life and treatment-related side effects, including bowel symptoms like rectal bleeding
Quality
it followed a reasonable number of patients over time with standard symptom scales, but there was no comparison group and patients all had cancer radiotherapy, not everyday rectal bleeding.
Limitations
No control group for comparison; findings apply to radiotherapy-induced symptoms in cancer patients, not to rectal bleeding from common causes like hemorrhoids.
Taken word for word from the abstract
- n This prospective cohort study included 123 RC patients treated with short-course (SCRT) or long-course chemoradiotherapy (LCRT).
- population RC patients receiving preoperative intensity modulated radiotherapy (IMRT)
- intervention preoperative radiotherapy (pRT) for rectal cancer (RC)
- comparator Patient-reported outcomes (PRO) were assessed using the EORTC QLQ-C30 and CR29 questionnaires at pretreatment, end of treatment, preoperatively, and at 1-year follow-up.
- primaryOutcome This study aimed to report longitudinal QoL and physician-assessed toxicity in RC patients receiving preoperative intensity modulated radiotherapy (IMRT).
- result CTCAE grades were predominantly mild; diarrhoea and rectal bleeding improved over time, while urinary dysfunction and fatigue increased modestly.
- followUp at pretreatment, end of treatment, preoperatively, and at 1-year follow-up
Int J Colorectal Dis · PMID 41331150 · Read it on PubMed ↗
Sinou et al. 2025
A Rare Cause of Upper Gastrointestinal Bleeding: Superior Mesenteric Artery Aneurysm
Rare artery aneurysm bleeding, successfully treated.Case seriesVery low qualityRelated question
1 people2025
the bleeding stopped and the patient's circulation fully stabilized after the procedure, with no complications
Who was studied
an 87-year-old woman with severe abdominal pain who later had rectal bleeding, vomiting blood, and blood in her stool
What they received
endovascular coil embolization of a bleeding artery aneurysm (superior mesenteric artery)
Compared with
no direct comparison treatment was used in this patient; the abstract mentions other options like open surgery or endoscopic treatment exist
Main outcome
whether bleeding stopped and the patient's blood pressure/circulation stabilized
Quality
this is a single patient case report with no comparison group, so it cannot show whether the treatment works better than alternatives.
Limitations
single case report; findings cannot be generalized; the cause of bleeding (a rare artery aneurysm) is very different from common causes of bright red blood when wiping.
Taken word for word from the abstract
- population a case of a 87-year-old female patient admitted for intense pain in the abdominal area
- intervention The patient underwent endovascular treatment with coil embolization
- comparator the available treatment options include endoscopic interventions or open surgery
- primaryOutcome achieving complete hemodynamic stabilization without complications
- result achieving complete hemodynamic stabilization without complications
- n a case of a 87-year-old female patient
Cureus · PMID 41293339 · Read it on PubMed ↗
Nahid et al. 2025
Solitary Rectal Ulcer Syndrome: Clinical, Endoscopic, and Histopathological Findings in 40 Bangladeshi Children
Straining, constipation linked to rectal ulcers in kids.Case seriesLow qualityRelated question
40 people2025
most children had straining during bowel movements, constipation, and a single rectal ulcer seen on colonoscopy, with tissue changes called fibromuscular obliteration and crypt distortion
Who was studied
children under 18 with rectal bleeding, in Bangladesh
What they received
none - researchers examined symptoms, colonoscopy, and tissue findings
Compared with
none
Main outcome
clinical, endoscopic, and tissue findings in children with solitary rectal ulcer syndrome
Quality
this is a descriptive case series with no comparison group, so it cannot tell you how common this cause is or whether anything helps it.
Limitations
single center, children only, no control group, and this covers only one specific diagnosis (solitary rectal ulcer syndrome) among many possible causes of rectal bleeding.
Taken word for word from the abstract
- n Among them, 40 met the inclusion criteria for SRUS.
- population A total of 260 children aged <18 years with rectal bleeding were admitted for a full evaluation
- intervention The collected data contained clinical characteristics and macroscopic and microscopic findings
- comparator This study aimed to evaluate the clinical, endoscopic, and histopathological findings of SRUS in Bangladeshi children.
- primaryOutcome This study aimed to evaluate the clinical, endoscopic, and histopathological findings of SRUS in Bangladeshi children.
- result straining during defecation (85.0%), followed by constipation (82.5%)
- result Colonoscopy revealed that most lesions were located in the rectum (97.6%) and ulcerative (65.9%)
- result Histologically, most lesions showed fibromuscular obliteration (95.0%) and crypt distortion (85.0%).
Pediatr Gastroenterol Hepatol Nutr · PMID 41282523 · Read it on PubMed ↗
Yu et al. 2025
Uncommon causes of acute small intestinal bleeding-invasive mole: A case report and review of literature
Rare tumor caused bleeding in one woman.Case seriesVery low qualityRelated question
1 people2025
bleeding was caused by a rare tumor (invasive mole) that had spread to the small intestine
Who was studied
a 22-year-old woman with bloody stool and a pregnancy hormone that was high even though she wasn't pregnant
What they received
not applicable (diagnostic case report, not a treatment study)
Main outcome
finding the cause of gastrointestinal bleeding
Quality
this is a single patient case report, so it cannot show what causes bright red blood in general or how common this is
Limitations
only one patient; this is an extremely rare cause of bleeding and not relevant to typical bright red blood on wiping, which is usually from hemorrhoids or anal fissures
Taken word for word from the abstract
- population A 22-year-old female patient presented with bloody stool and elevated human chorionic gonadotropin.
- n A 22-year-old female patient presented with bloody stool and elevated human chorionic gonadotropin.
- primaryOutcome Upper gastrointestinal endoscopy and colonoscopy were performed, but no bleeding focus was detected.
- result The postoperative pathology confirmed the preoperative diagnosis of invasive mole.
- intervention The patient underwent surgical resection of the diseased jejunum.
World J Gastroenterol · PMID 41257278 · 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 2026-10-13
The exact search — paste this into PubMed to repeat it: ("Gastrointestinal Hemorrhage"[Mesh] OR hematochezia[tiab] OR "rectal bleeding"[tiab] OR (blood[tiab] AND wiping[tiab]) OR (blood[tiab] AND toilet[tiab] AND paper[tiab])) AND ("Hemorrhoids"[Mesh] OR "Fissure in Ano"[Mesh] OR "Colorectal Neoplasms"[Mesh] OR etiology[tiab] OR causes[tiab] OR differential[tiab]); PubMed expanded that to: ("Gastrointestinal Hemorrhage"[MeSH Terms] OR "hematochezia"[Title/Abstract] OR "rectal bleeding"[Title/Abstract] OR ("blood"[Title/Abstract] AND "wiping"[Title/Abstract]) OR ("blood"[Title/Abstract] AND "toilet"[Title/Abstract] AND "paper"[Title/Abstract])) AND ("Hemorrhoids"[MeSH Terms] OR "Fissure in Ano"[MeSH Terms] OR "Colorectal Neoplasms"[MeSH Terms] OR "etiology"[Title/Abstract] OR "causes"[Title/Abstract] OR "differential"[Title/Abstract])
What came back: 7772 records found · 199 read · 95 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
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.

7772records came back from the search
199were read
95actually answered the question

Why people try thisThe reasoning behind the question — not a claim that it works.

Hemorrhoids are extremely common and cause exactly this kind of bright red bleeding, so people assume that must be the cause without getting it checked.
The bleeding is usually painless and stops on its own after the toilet visit, which makes it easy to shrug off.
Embarrassment about anal symptoms stops many people from mentioning the bleeding to a doctor at all.

Common questionsShort answers, drawn from the same studies.

When I wipe my bum I feel a lump — what is it?: This is most often a hemorrhoid, a swollen vein around the anus, which can bleed bright red when you wipe. A review of anorectal symptoms found that a lump plus bright red bleeding fits this pattern, but ongoing pain, a lump that changes, or weight loss are reasons to get it looked at rather than assume.
Is bright red blood on toilet paper always from hemorrhoids?: No. It's the most common cause described in the evidence, but studies also found that reporting rectal bleeding was linked to a higher chance of finding a pre-cancerous growth or early bowel cancer, particularly in adults under 50. The pattern of the blood and any other symptoms matter.
What should I do instead of just assuming it's hemorrhoids?: Mention it to a doctor, especially if it's new, keeps happening, or you're under 50 — studies found that bleeding in this group was linked to meaningfully higher odds of a serious growth, and that people often delay seeking help by a month or more. A doctor can examine you or arrange a simple stool test rather than you guessing.
Can rectal bleeding be a sign of bowel cancer in young people?: Yes, it can. Studies of adults under 50 found rectal bleeding was linked to more than double the odds of an advanced pre-cancerous growth, and to higher odds of early-onset bowel cancer diagnosis, even though the absolute number of people with cancer among those who bleed stayed low.
What tests can find out what's actually causing the bleeding?: A simple stool blood test (FIT) can help show who is at low risk and may not need further tests, while a direct examination such as anoscopy or colonoscopy can look inside and find the exact cause. A review proposed starting with a basic anal exam before moving to more invasive tests.

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.

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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.