Peer Reviewed
Clinical case review

A man with rectal bleeding who wishes to avoid colonoscopy

Donald Frommer
Abstract
A man with rectal bleeding, haemorrhoids and diverticular disease is reluctant to have a colonoscopy. His brother developed bowel cancer at 45 years of age. Is faecal occult blood testing worth doing? Can colonoscopy be avoided?
Key Points
    Case scenario

    I have a patient whose brother developed bowel cancer at 45 years of age. My patient is reluctant to have a colonoscopy because he has heard that it can perforate the bowel. When he was in his thirties, he had a barium enema for abdominal pain, which showed quite marked diverticular disease for a young man. Recently, he has had some bright red rectal bleeding and on inspection had definite external haemorrhoids. Is it worthwhile doing faecal occult blood tests in a patient with diverticular disease and haemorrhoids?

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