Defining the role of fiberoptic sigmoidoscopy in the investigation of patients presenting with bright red rectal bleeding

OBJECTIVE: This study was done to determine whether sigmoidoscopy could the oretically constitute sufficient investigation for some patients with brigh t red rectal bleeding. METHODS: One hundred and forty-three patients undergoing investigative colo noscopy for bright red rectal bleeding and whose source of bleeding was ide ntified were studied. The investigation took place in a large urban hospita l over an Ii-month period. Data obtained included changes in stool pattern, characteristics of the bleeding, lesions identified, and the distance of t he lesion from the anus. RESULTS: In patients younger than 55 yr, all serious lesions except for one malignancy in a patient with massive bleeding lay within 60 cm of the anus and theoretically within reach of the fiberoptic sigmoidoscope. The mixing of red blood with stool was commonly due to distal lesions, especially hem orrhoids. CONCLUSIONS: In young persons with bright red rectal bleeding, fiberoptic s igmoidoscopy may prove to constitute appropriate initial investigation. (C) 2000 by Am. Coll. of Gastroenterology.