title: The value of colonoscopy to assess rectal bleeding in patients referred from Primary Care Units.
abstract: OBJECTIVE
  Rectal bleeding is very common in the general population. It is produced mainly because of benign disease originating in the anus and the rectum. Our aim was to evaluate the need for colonoscopy in patients presenting with rectal bleeding.
  
  
  METHODS
  Patients referred from Primary Care Units and complaining of rectal bleeding were included prospectively in a three-month study. All patients underwent a careful medical history along with physical examination, laboratory tests, and colonoscopy.
  
  
  RESULTS
  126 patients with a mean age of 49.2 years (range: 19-80) were studied. Rectal digital examination was abnormal in 75 cases (59.5%). Severe disease was encountered in 22 patients (neoplasm, angiodysplasia, and inflammatory bowel disease); 10 patients had polyps, 6 had colorectal cancer, and 6 had inflammatory bowel disease. Out of 63 patients younger than 50 years, 5 had severe disease, all of them in the form of inflammatory bowel disease.
  
  
  CONCLUSIONS
  A neoplasm of the rectum and colon in patients younger than 50 years is a rare event. A colonoscopy must be performed in this group of patients to rule out inflammatory bowel disease.
authors.affiliation: Department of Gastroenterology, Hospital San Eloy, Baracaldo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez
authors.forename: C
authors.initials: C
authors.lastname: Muñoz
authors.forename: L
authors.initials: L
authors.lastname: Bujanda
authors.forename: C
authors.initials: C
authors.lastname: Iriondo
authors.forename: A
authors.initials: A
authors.lastname: Gil-Molet
authors.forename: A
authors.initials: A
authors.lastname: Cosme
authors.forename: C
authors.initials: C
authors.lastname: Sarasqueta
authors.forename: M
authors.initials: M
authors.lastname: Echenique-Elizondo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012002:Rectal Diseases / Q000150:complications* / Q000175:diagnosis*; D012007:Rectum