Which patients with constipation should be screened for colorectal cancer?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

Rectal bleeding should be taken seriously and evaluated carefully, particularly in patients who are older than 50 years or have a family history of colorectal disease. Patients with hemorrhoids may also have rectosigmoid cancer. Both cancer and hemorrhoids can produce bright red blood from the rectum. Most patients older than 50 years or with a family history of colorectal disease should be screened for colorectal cancer. A full colonoscopy is preferable, although in some cases flexible sigmoidoscopy or barium enema may be used if colonoscopy cannot be performed. The role of computed tomography (CT) colography in this setting awaits definition, although it offers an attractive alternative in the patient in whom a colonoscopy is attempted and fails.


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