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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Possible causes include:

  • haemorrhoids
  • diverticular disease - from inflamed areas
  • large bowel polyps or carcinoma
  • angiodysplasia - a common cause in the elderly

Other causes:

  • inflammatory bowel disease
  • ulcers
  • radiation proctitis
  • ischaemic colitis
  • trauma
  • haematological abnormality - e.g. secondary to immunosuppressants or cytotoxics
  • bleeding Meckels diverticulum

Always examine for an anal fissure, particularly if the rectal bleeding is associated with painful bowel motions; haemorrhoids do not usually cause pain unless thrombosed (1)


  1. Walsh CJ, Delaney S, Rowlands A. Rectal bleeding in general practice: new guidance on commissioning. Br J Gen Pract. 2018 Nov;68(676):514-515.

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