Colorectal cancer and rectal bleeding in primary care: Rectal bleeding needs attention in primary care

doi:10.1136/bmj.333.7560.201-b

BMJ 2006;333:201 (22 July), doi:10.1136/bmj.333.7560.201-b

Letter

Colorectal cancer and rectal bleeding in primary care

Rectal bleeding needs attention in primary care

The first 150 words of the full text of this article appear below.

EDITOR—Du Toit et al emphasise the importance of rectalbleeding in primary care and try to address this important managementdilemma.¹ One potential weakness of the study, however, wasits assumption that bleeding was caused by any neoplasia found,rather than more common causes. The character of rectal bleeding(bright red v dark) was not mentioned, nor was the coexistenceof piles, probably because rigid sigmoidoscopy rather than proctoscopywas carried out. In addition, the presence of anal symptoms,usually due to piles, which is a protective factor to the findingof neoplasia, was not said to be recorded.

As Weller's editorial in the same issue says,² the specificcharacteristics of the bleeding are important to record; ifthe colour of the blood was recorded it may help plan investigations.Bright red bleeding is well investigated by flexible sigmoidoscopy,but it is generally agreed that darker bleeding usually . . . [Full text of this article]

Christopher M Newman, specialist registrar general surgery

chrisnewman@doctors.org.uk, Poole General Hospital, Poole BH15 2JB

Guy F Nash, consultant colorectal surgeon, Tom Armstrong, specialist registrar general surgery, Kieren Darcy, senior house officer general surgery

Poole General Hospital, Poole BH15 2JB

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