Differential diagnoses of hematochezia (blood stool, rectal bleeding)
Blood, blood-forming organs-immune system (D50-D90).
- Blood coagulation disorder, unspecified.
Cardiovascular system (I00-I99)
- Angiodysplasia of the intestine, unspecified – Vascular malformations of the intestine.
Infectious and parasitic diseases (A00-B99).
- Infectious colitis (inflammation of the intestine caused by bacteria, viruses, or parasites):
- Aeromonas spp.
- Amoebae
- Balantidium coli
- Clostridium spp.
- Crytosporidium
- Lamblia
Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93).
- Acute mesenteric ischemia (AMI; intestinal infarction, mesenteric artery occlusion, mesenteric infarction, mesenteric occlusive disease, angina abdominalis).
- Anal fissure – painful tear in the mucosa of the anus.
- Angiodysplasia of the colon – mucosal or submucosal vascular excess.
- Ulcerative colitis – chronic inflammatory disease of the mucosa of the colon (large intestine) or rectum (rectum).
- Diverticulitis – disease of the colon in which inflammation forms in protrusions of the mucosa (diverticula).
- Diverticulosis – protrusions in the area of the intestinal wall.
- Small intestinal varices – dilatation of veins in the small intestine.
- Hemorrhoids
- Invagination – invagination of a portion of the intestine into the aborally following intestinal segment.
- Ischemic colitis – inflammation of the mucosa of the colon due to vascular occlusion of the supplying arteries.
- Meckel’s diverticulum – protrusion of the ileum (scimitar or hip bowel; part of the small intestine) that represents a remnant of the embryonic yolk duct (omphaloenteric duct)
- Crohn’s disease – chronic inflammatory bowel disease; it usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, several intestinal sections may be affected, which are separated by healthy sections from each other
- Proctitis (rectal inflammation)
- Rectal ulcers – ulcers in the rectum.
Neoplasms – tumor diseases (C00-D48)
- Colorectal tumors, unspecified.
- Tumors of the small intestine, unspecified
- Colon carcinoma (carcinoma of the large intestine)
- Polyps of the colon / large intestine (colonic polyps).
- Rectal carcinoma (rectal cancer)
- Villous adenoma (intestinal polyp)
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Endometriosis – Occurrence of endometrium (lining of the uterus) outside the uterus, such as in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder, or bowel.
Injuries, poisoning, and other sequelae of external causes (S00-T98).
- Iatrogenic (caused by medical intervention) damage (anorectal injuries).
- Foreign body
- Injuries, unspecified (e.g., including child abuse).
Operations
- State after polyectomy (polyp removal).
Other causes
- Consumption of beet
Differential diagnoses of melena (tarry stools, pitch stools)
Blood, blood-forming organs – immune system (D50-D90).
- Blood coagulation disorder, unspecified.
Cardiovascular system (I00-I99)
- Angiodysplasia of the intestine, unspecified – Vascular malformations of the intestine.
- Aorto-intestinal fistula (AEF) (connection between the aorta and the gastrointestinal tract) – rare but life-threatening complication in the spontaneous course of an aortic aneurysm (primary form) or else as a postoperative event after prosthetic replacement of the aorto-iliac vascular segment (secondary fistula)
- Vascular lesions (vascular injuries), unspecified.
- Osler-Weber-Rendu disease (synonyms: Osler disease; Osler syndrome; Osler-Weber-Rendu disease; Osler-Rendu-Weber disease; hereditary hemorrhagic telangiectasia, HHT) – autosomal-dominant inherited disorder in which telangiectasias (abnormal dilation of blood vessels) occur. These can occur anywhere, but are found particularly in the nose (leading symptom: epistaxis (nosebleed)), mouth, face and the mucous membranes of the gastrointestinal tract.Because the telangiectasias are very vulnerable, it is easy to tear and therefore bleed.
Infectious and parasitic diseases (A00-B99).
- Gastroenteritis (gastroenteritis).
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).
- Acute gastritis (inflammation of the gastric mucosa).
- Boerhaave syndrome – spontaneous rupture of the esophagus (food pipe); usually after massive vomiting.
- Fundus varices – varicose veins in the upper part of the stomach.
- Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
- Mallory-Weiss syndrome – clustered longitudinal (elongated) tears of the mucosa (mucous membrane) and submucosa (submucosal connective tissue) of the esophagus occurring in alcoholics, which may be associated with potentially life-threatening hemorrhage of the external esophagus and/or gastric inlet (gastrointestinal hemorrhage/GIB) as a complication
- Esophageal varices – varicose veins in the esophagus, usually due to liver cirrhosis (irreversible damage to the liver leading to gradual connective tissue remodeling of the liver with impairment of liver function)
- Peptic ulcer (ulcer in the gastrointestinal tract caused by hydrochloric acid):
- Ulcus ventriculi (gastric ulcer).
- Duodenal ulcer (duodenal ulcer)
- Ulcus pepticum jejuni (jejunum (empty intestine; one of the three sections of the small intestine; connects to the duodenum (duodenum)).
Neoplasms – tumor diseases (C00-D48).
- Colorectal tumors, unspecified.
- Tumors of the small intestine, unspecified
- Gastric carcinoma (stomach cancer)
- Colon carcinoma (colon cancer)
- Esophageal carcinoma (cancer of the esophagus)
Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).
- Intestinal endometriosis (dispersed endometrium in the intestine).
Injuries, poisoning, and other consequences of external causes (S00-T98).
- Injuries, unspecified
Other causes
- Foreign body
- Blueberries
- Licorice
Medicines
- Anticoagulants (drugs that inhibit blood clotting).
- Nonsteroidal anti-inflammatory drugs (NSAIDs) result in a three- to fivefold increase in the risk of upper gastrointestinal tract complications (upper GI bleeding, perforation/breakthrough, ulcer/ulcer); complications are dose-dependent
- Iron supplements
- Coal preparations
- Bismuth preparations
- See also drug side effects, under:
- “Bleeding due to medications”
- “Platelet dysfunction due to drugs”