General practice

Rectal bleeding: prevalence and consultation behaviour

^a Department of Primary Health Care, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, ^b Department of General Practice, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London SE11 6SP

Correspondence to: Dr Crosland.

Abstract

Objectives: To determine prevalence of rectal bleeding in the community and to examine factors that lead some patients to consult their general practitioner about rectal bleeding while others do not.
Design: Questionnaire survey followed by semistructured interviews of sample of respondents with rectal bleeding.
Setting: Two general practices on Tyneside.
Subjects: 2000 adult patients registered with the general practices were sent a validated questionnaire. Respondents with rectal bleeding were divided into consulters and non-consulters, and 30 patients from each group (matched for age, sex, and characteristics of bleeding) were interviewed.
Main outcome measures: Prevalence of rectal bleeding, proportion of subjects with rectal bleeding who sought medical advice, and reasons for consulting or not consulting a doctor about rectal bleeding.
Results: 287 of the 1200 respondents to the questionnaire had noticed rectal bleeding at some time in their lives, and 231 had noticed it within previous 12 months. Only 118 (41%) of all respondents with rectal bleeding had ever sought medical advice for the problem. Those aged over 60 were most likely to have consulted, as were those who reported blood mixed with their stools. Main difference between those who had sought medical advice and those who had not was that consulters were more likely than non-consulters to perceive their symptoms as serious.
Conclusions: Although rectal bleeding is common, only minority of patients seek medical advice for their bleeding. Perception of seriousness of symptoms seems to be most important factor in deciding whether to consult a doctor for rectal bleeding.

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