ROSH Gastrointestinal Practice Exam

What is the leading cause of rectal bleeding in adults?

1. Colon cancer

2. Diverticulitis

3. Hemorrhoids

4. Inflammatory bowel disease

The correct answer is: Hemorrhoids

Hemorrhoids are the leading cause of rectal bleeding in adults due to their prevalence and the commonality with which individuals experience them. Hemorrhoids can develop from increased pressure in the rectal area, often exacerbated by factors such as constipation, straining during bowel movements, or prolonged sitting. They can either be internal or external and may lead to symptoms such as painless bright red blood during bowel movements or discomfort in the anal region. While colon cancer, diverticulitis, and inflammatory bowel disease can also cause rectal bleeding, they are less common compared to hemorrhoids in the general adult population. Colon cancer, although serious, presents more commonly with additional symptoms like changes in bowel habits or weight loss. Diverticulitis is typically associated with abdominal pain and fever, while inflammatory bowel disease also includes symptoms such as diarrhea and abdominal cramping. Thus, in terms of frequency and the overall population, hemorrhoids are the most common cause of rectal bleeding in adults, making their identification and management critical in primary care.