Hematochezia causes

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Hematochezia Microchapters


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S. Alberto Plate [2]


In adults, the most common causes are hemorrhoids and diverticulosis, both of which are relatively benign; however, it can also be caused by colorectal cancer. In a newborn infant (neonate), hematochezia may be the result of swallowed maternal blood at the time of delivery, but can also be an initial symptom of necrotizing enterocolitis, a serious condition affecting premature infants. In adolescents and young adults, inflammatory bowel disease, particularly ulcerative colitis, is a serious cause of hematochezia that must be considered and excluded.

Hematochezia can be due to upper gastrointestinal bleeding. However, as the blood from such a bleeding is usually chemically modified by action of acid and enzymes, it presents more commonly as melena.


Common Causes

The lower part of the GI tract will usually cause maroon or bright red, bloody stools due to:

Causes by Organ System

Cardiovascular Arteriovenous malformations , Bowel ischemia, Bowel strangulation, Cholesterol embolism, Degos disease, Esophageal varices, Hemorrhoids , Hepatic arterioportal fistula, Hereditary haemorrhagic telangiectasia, Idiopathic colonic varices, Leukocytoclastic angiitis, Microscopic polyangiitis, Oesophageal varices, Portal hypertension, Ruptured esophageal varices, Superior mesenteric artery occlusion, Vascular malformation, Vasculitis
Chemical/Poisoning Arsenicals, Brown snake poisoning , Ethylene glycol, Mercury
Dental No underlying causes
Dermatologic Henoch-schönlein purpura
Drug Side Effect Alosetron, Bevacizumab, Clopidogrel, Cobimetinib, Colchicine, Dicoumarol, Doxorubicin hydrochloride, Hydroxocobalamin, Indomethacin, Melarsoprol, Phenprocoumon, Phenylbutazone, Warfarin, Ziv-aflibercept
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Angiodysplasia, Angiostrongyliasis, Bacillary dysentery, Bacterial enterocolitis, Blue rubber bleb nevus syndrome, Bowel ischemia, Bowel strangulation, Colon polyps , Colonic diverticulitis, Colonic diverticulosis, Colonic tubular adenomata, Colonic villous adenomata, Colonoscopy, Colorectal cancer, Crohn's disease, Dieulafoy's ulcer, Diverticulitis, Diverticulosis, Familial adenomatous polyposis, Gardner's syndrome, Gastric antral vascular ectasia, Gastric cancer, Gastric volvulus, Gastroduodenal ulcers, Hemorrhoids , Idiopathic colonic varices, Inflammatory bowel disease , Inflammatory myoglandular polyp, Intususception of intestine, Mallory-weiss syndrome, Meckel diverticulitis, Necrotizing enterocolitis, Oesophageal cancer, Oesophageal foreign body, Oesophageal varices, Peptic ulcer, Peutz-jeghers syndrome, Pneumatosis cystoides intestinalis, Polypectomy, Portal hypertension, Proctitis, Proctosigmoidoscopy, Pseudoxanthoma elasticum recessive type 1, Pseudoxanthoma elasticum, Rectal cancer, Rectal foreign body, Rectal gastric mucosa heterotopia, Ruptured esophageal varices, Salmonellosis, Sigmoid colon cancer, Small bowel lymphoma, Small bowel tumor, Solitary rectal ulcer syndrome, Staphylococcal food poisoning, Strongyloidiasis, Trichuriasis, Ulcerative colitis, Ulcerative proctitis, Upper gastrointestinal bleeding, Vascular malformation, Vasculitis, Watermelon stomach
Genetic Craniomandibular dermatodysostosis, Ehlers-danlos syndrome, Endometriosis, Familial adenomatous polyposis, Hereditary haemorrhagic telangiectasia, Meckel diverticulitis, Peutz-jeghers syndrome, Pseudoxanthoma elasticum recessive type 1, Pseudoxanthoma elasticum, Wiskott-aldrich syndrome
Hematologic Angiodysplasia, Blue rubber bleb nevus syndrome, Clopidogrel, Coagulation disorders, Gastric antral vascular ectasia, Leukocytoclastic angiitis, Upper gastrointestinal bleeding, Warfarin, Watermelon stomach, Wiskott-aldrich syndrome
Iatrogenic Colonoscopy, Intususception of intestine, Polypectomy, Proctosigmoidoscopy
Infectious Disease Acanthocephaliasis, Ancylostoma ceylanicum, Ancylostoma duodenale, Angiostrongyliasis, Bacillary dysentery, Bacterial enterocolitis, Balantidiasis, Colitis cystica profunda, Colitis, Entamoeba histolytica, Esophageal cyst, Inflammatory bowel disease , Leptospirosis, Necator americanus , Necrotizing enterocolitis, Salmonellosis, Schistosoma mansoni, Shigella, Staphylococcal food poisoning, Strongyloidiasis, Trichuriasis, Typhoid fever, Ulcerative colitis, Ulcerative proctitis
Musculoskeletal/Orthopedic Pelvic fracture,
Neurologic Labrune syndrome, Neurofibromatosis type 1
Nutritional/Metabolic Carbamoylphosphate synthetase deficiency, Iron compounds, Zinc
Obstetric/Gynecologic Endometriosis,
Oncologic Anal cancer, Colon polyps , Colorectal cancer, Gardner's syndrome, Gastric cancer, Inflammatory myoglandular polyp, Kaposi's sarcoma, Labrune syndrome, Oesophageal cancer, Rectal cancer, Sigmoid colon cancer, Small bowel lymphoma, Small bowel tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Anthrax, Arsenic trioxide
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Renal failure
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Anal fissure, Foreign body, Intense exercise, Mallory-weiss syndrome, Oesophageal foreign body, Pelvic fracture, Rectal foreign body, Rectal gastric mucosa heterotopia
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order