139
J Gandhara Med Dent Sci
October - December 2026
ORIGINAL ARTICLE
How to cite this article
FREQUENCY OF COMMON CAUSES OF BLEEDING PER RECTUM AMONG PATIENTS
PRESENTING TO SURGICAL OPD AT A TERTIARY CARE HOSPITAL
rangzeb A
Au
hmad
1
, Muhammad Shah
2
, Shimee Shehzadi
3
, Shehzad Akbar Khan
4
Ahmad A, Shah M, Shehzadi S, Khan
SA.
Frequency of Common Causes of
Bleeding Per Rectum Among Patients
Presenting to Surgical OPD at A
Tertiary Care Hospital. J Gandhara
Med Dent Sci. 2026;13(4): 139-143.
Date Submission:
05-05-2026
Date Revised:
04-09-2026
Date Acceptance:
07-09-2026
1
Consultant General Surgeon,
Department of Surgery, Hayatabad
Medical Complex, Peshawar
3
Assistant Professor, Department of
omplex, Pe
Anatomy, Hayatabad Medical
C
shawar
4
Professor, Department of Surgery,
Hayatabad Medical Complex,
Peshawar
Correspondence
2
Muhammad Shah, Associate
Professor, Department of General
Surgery,
Hayatabad
Medical
Complex,
Peshawar
:
:
+92-333-5829224
drmuhammadshah@yahoo.com
ABSTRACT
OBJECTIVES
This study aimed to estimate the frequency and 95% condence intervals of
harmonised,
clinician-recorded
etiological
categories
among
adults
presenting with bleeding per rectum to the surgical outpatient department of a
tertiary-care hospital.
METHODOLOGY
This descriptive cross-sectional study was conducted at Hayatabad Medical
Complex, Peshawar, from September 2022 to March 2024. The patients were
consecutively sampled during a xed period of six months, with an age range
of 20-60 years (all patients within the age range were included in the study, n
=
164).
Laboratory
testing
and
imaging
were
used
selectively.
Since
inammatory
bowel
disease,
ulcerative
colitis
and
colitis
are
conceptually
similar, post hoc (after the data were collected), these three mutually exclusive
source codes were pooled together into inammatory colitis.
RESULTS
The
mean
age
was
38.7
±
12.8
years;
107
(65.2%)
patients
were
male.
Inammatory
colitis
was
recorded in 83 patients
(50.6%;
95%
CI,
43.0%-
58.2%),
hemorrhoids
in
54
(32.9%;
95%
CI,
26.2%-40.4%),
abdominal
tuberculosis in 17 (10.4%; 95% CI, 6.6%-16.0%), and diverticular disease in
10 (6.1%; 95% CI, 3.3%-10.9%). Etiological distribution was not signicantly
dierent in the various age
groups (Monte Carlo exact p = 0.695; Cramer's V
=
0.116).
Complete
colon
evaluation
was
not
always
done,
and
colorectal
carcinoma was not detected via the selective diagnostic pathway.
CONCLUSION
The most common categories were inammatory colitis and hemorrhoids. The
combined inammatory estimate should not be interpreted as the prevalence
of conrmed inammatory bowel disease, and the selective diagnostic pathway
does not
exclude undetected proximal colonic disease.
KEYWORDS:
Lower
Gastrointestinal
Bleeding;
Bleeding
Per
Rectum;
Hemorrhoids; Inammatory Colitis; Abdominal Tuberculosis; Proctoscopy
INTRODUCTION
Bleeding per rectum (BPR) is defined as the passage of
blood out of the anus, and can be a symptom of either
inammatory or neoplastic colorectal disease. Its clinical
significance
depends
on
associated
symptoms,
age,
examination
ndings,
and
the
extent
of
evaluation.
1
While most presentations are not malignant, colitis and
colorectal
neoplasia
are
important
conditions
to
consider,
especially
when
accompanied
by
changes
in
bowel habit,
weight loss,
anemia
or a
palpable
mass.
2
The range of etiological factors reported is dependent on
clinical
context
and
population.
3,4
In
population-based
studies
in
the
West,
diverticular
disease
and
ischemic
colitis
have
been
the
more
common
causes
of
acute
lower
gastrointestinal
bleeding
(ALGIB),
while
in
Pakistan and other South Asian settings, haemorrhoids
and other anorectal disorders have been reported as more
common
causes
of
ALGIB
in
patients
undergoing
colonoscopy
or
attending
surgical
outpatient
departments.
5,6
The
estimates
are
not
directly
comparable as they are based on dierent populations,
diagnostic routes and category denitions. The size of
the investigation also inuences the detection of causes.
Distal anorectal lesions can be identied by proctoscopy,
but
the
proximal
colon
cannot.
For
any
suspected
inammatory, infective
or
neoplastic
colonic disorder,
colonoscopy is key, and when needed, biopsy or imaging
is
performed.
7,8
Consequently,
studies
using
selective
rather
than uniform colonoscopy should
describe
their
diagnostic
pathway
explicitly
and
avoid
treating
an
unobserved diagnosis as denitively absent. Published
Pakistani
data
have
been
obtained
from
colonoscopy
cohorts from other centers and, as far as we know, the
frequency distribution of the
clinician-recorded causes
of
consecutive
surgical
outpatients
at
Hayatabad
Medical
Complex,
Peshawar,
has
not
been
reported
using
a
transparent
harmonised
classication.
9
Therefore, the local distribution and the impact of the
diagnostic
pathway
of
the
institution
were
unknown.
http://doi.org/10.37762/jgmds.13-4.928
140
J Gandhara Med Dent Sci
October - December 2026
Thus,
the
purpose
of
this
study
was
to
provide
an
estimate of the prevalence and 95% condence intervals
of
the
harmonised
etiological
categories
of
adults
presenting for BPR in the surgical outpatient department.
METHODOLOGY
This descriptive cross-sectional study was conducted in
the
Department
of
Surgery,
Hayatabad
Medical
Complex,
Peshawar,
with
ethical
approval
(Ref
No.
781/HMC/HR,
dated
02-09-2021),
from
September
2022
to
March
2024.
All
eligible
consenting
patients
presenting during this xed period were enrolled by non-
probability
consecutive
sampling,
yielding
164
participants. Due to the xed-period consecutive census,
a
formal
a
priori
probability-based
sample-size
calculation is not reported. With n = 164, the maximum
two-sided
95%
condence-interval
half-width
for
a
proportion near 50% was approximately 7.7 percentage
points, representing the achieved precision. Any patient,
of either sex, between 20 and 60 years of age, with new
onset of rectal bleeding, blood mixed with stool, blood-
stained
stool,
or
passage
of
clots
suggesting
lower
gastrointestinal
bleeding,
was
included.
Patients
requiring
emergency
admission
for
hemodynamic
instability,
those
with
a
history
suggestive
of
upper
gastrointestinal
bleeding,
previously
diagnosed
colorectal
malignancy,
history
of
bleeding
due
to
anticoagulant
use,
and
those
who
did
not
consent
to
participate
were
excluded. Following enrollment,
each
patient received a detailed clinical history, including age,
gender, symptom duration, bloody diarrhea volume and
pattern,
pain
during
defecation,
bowel
habits
change,
constipation,
weight
loss,
prolapse,
family
history
of
colorectal
disease,
and
past
anorectal
surgeries.
In
all
cases, a full physical examination was done, including
general
physical
exam,
abdominal
exam,
and
digital
rectal exam. All 164 subjects (100%) had a digital rectal
examination and proctoscopy to evaluate the anal canal
and palpable rectal mucosa. If compatible hemorrhoidal
cushions were noted during examination or proctoscopy,
and these were deemed to be the source of bleeding, then
the
haemorrhoids
were
recorded.
Selective
additional
investigations
were
done.
When
there
was
still
a
suspicion
of
distal
colonic/rectal
pathology,
sigmoidoscopy
was
used.
Persistent
or
unexplained
bleeding,
altered
bowel
habit,
weight
loss,
anaemia,
family
history,
older
age
or
clinical
suspicion
of
proximal colonic disease were all considered indications
for colonoscopy. Biopsy was used if there was abnormal
mucosa or a lesion which needed histological analysis.
Laboratory
tests,
stool
analysis
and
imaging
were
ordered based on the suspected diagnosis. Diverticular
disease
was
documented
either
endoscopically
or
on
imaging. The inammatory and abdominal-tuberculosis
labels were assigned by the nal diagnosis of the treating
clinician,
based
on
the
clinical,
endoscopic,
histopathological,
microbiological,
laboratory
and
imaging evidence available. The provisional procedure
counts
were:
sigmoidoscopy
60
(36.6%),
colonoscopy
40
(24.4%),
and
biopsy
30
(18.3%).
There
was
no
patient-level
evidence
supporting
each
diagnosis
available, and diagnostic criteria were not uniform, so
diagnoses could not be independently re-adjudicated.
SPSS version 26 was used to analyse the data. Age is
presented
as
mean
SD.
The
frequencies
and
percentages
were
reported
for
gender
and
etiological
categories, and the principal etiological proportions were
reported
as
Wilson
95%
condence
intervals.
Each
participant was assigned to one of six mutually exclusive
primary diagnostic codes (54 + 39 + 29 + 17 + 15 + 10 =
164),
and
the
frequencies
for
these
codes
totaled
the
entire sample. Therefore, in the present study, there were
29 ulcerative colitis records, which did not exist within
the 39 records labeled inammatory bowel disease. The
three inammatory source
codes
(inammatory bowel
disease, ulcerative colitis, and colitis) were not clinically
mutually exclusive, and so the three inammatory source
codes were united post hoc as inflammatory colitis. The
term
inammatory
bowel
disease
was
not
translated
back to Crohn's disease. Since a few cell counts were less
than ve, Monte Carlo exact test of independence with
fixed
margins
and
100,000
sampled
tables
were
performed
to
compare
age-stratified
frequencies.
Cramer's V was reported as the eect-size measure, and
the
estimated
p-value
was
given
with
its
99%
Monte
Carlo
condence
interval.
A
two-sided
p-value
<0.05
was
considered
statistically
signicant.
Etiological
testing was not carried out separately by gender due to
not
having
any
gender-specific
counts
for
the
full
harmonised inflammatory category.
Table 1A: Investigations Used in the Diagnostic Pathway (n = 164)
Investigation
Number
Role / Clinical Indication
Proctoscopy
164
(100%)
Routine assessment of the anal
canal and visible rectal mucosa in
every participant.
Sigmoidoscopy
60 (36.6%)
Selective use when distal colonic or
rectal pathology remained suspected
beyond proctoscopy.
Colonoscopy
40 (24.4%)
Selective use for persistent or
unexplained bleeding, altered bowel
habit, weight loss, anemia, family
history, older age, or suspected
proximal disease.
Biopsy
30 (18.3%)
Selective use for abnormal mucosa
or a lesion requiring
histopathological characterisation.
Note: Proctoscopy was documented for all 164 participants
(%age)
Frequency of Common Causes of Bleeding Per Rectum among Patients
141
J Gandhara Med Dent Sci
October - December 2026
RESULTS
The participants had a mean age of 38.7 12.8 years,
with an observed age range of 2060 years. Most were
aged 2030 years (38.4%), and 107 (65.2%) were male.
Table 1: Demographic Characteristics of the Study Population
(n = 164)
Variable
Frequency (n)
%age
Age groups (years)
2030
63
38.4
3040
30
18.3
4050
26
15.9
5060
45
27.4
Gender
Male
107
65.2
Female
57
34.8
The most common harmonised etiological category was
inammatory colitis (50.6%) followed by haemorrhoids
(32.9%),
abdominal
tuberculosis
(10.4%)
and
diverticular
disease
(6.1%).
There
was
no
signicant
dierence
in
etiological
distribution
by
age
group
(Monte Carlo exact p = 0.695; Cramer's V = 0.116). No
cases of colorectal carcinoma were identied, but it can
not be ruled out as not occurring, since colonoscopy was
not carried out uniformly.
(Table-2)
Table
2:
Frequency
and Age-Wise
Distribution
of
Harmonised
Etiological Categories
Cause
Overall
n(%)
20-30
n(%)
83 (50.6)
32 (50.8)
16 (53.3)
17 (65.4)
18 (40.0)
54 (32.9)
20 (31.7)
09 (30.0)
07 (26.9)
18 (40.0)
17 (10.4)
07 (11.1)
02 (6.7)
02 (7.7)
06 (13.3)
Inammatory
colitis
Hemorrhoids
Abdominal
tuberculosis
Diverticular
disease
10 (6.1)
04 (6.3)
03 (10.0)
00 (0.0)
03 (6.7)
Inflammatory colitis is a combination of three dierent
source
codes:
inammatory
bowel
disease
(n
=
39),
ulcerative
colitis
(n
=
29),
colitis
(n
=
15).
Only
one
primary
source
code
was
assigned
to
each
patient;
therefore,
the
29
patients
whose
source
codes
were
ulcerative colitis did not appear in the 39 cases labeled
as inammatory bowel
disease. Unfortunately, the post
hoc
combination
of
the
terms
corrects
conceptual
confusion in the terminology, but it is not a diagnosis of
inammatory bowel disease conrmed by uniformity.
DISCUSSION
The most common harmonised category in this surgical
outpatient cohort was inammatory colitis (50.6%; 95%
CI, 43.0%-58.2%), followed by
haemorrhoids (32.9%;
95% CI, 26.2%-40.4%), abdominal tuberculosis (10.4%)
and
diverticular
disease
(6.1%).
The
prevalence
of
haemorrhoids
in
this
study
is
comparable
in
general
terms
with
the
other
parts
of
the
region.
In
Pakistan,
years
30-40
n(%)
years
40-50
n(%)
years
50-60
n(%)
years
Nayab et al identified haemorrhoids in 28.8% of patients
who underwent
colonoscopy for
lower
gastrointestinal
bleeding, whereas in Bangladesh Mahmud et al detected
haemorrhoids in 34.6% of patients presenting with rectal
bleeding to a surgical outpatient department.
10,11
Some
variations in results between studies may be due to the
dierent
age
distributions,
referral
patterns,
inclusion
criteria and the level of endoscopic evaluation.
12,13
The
category of combined inammatory colitis is a special
case in which caution must be used. Ulcerative colitis is
a
type
of
inammatory
bowel
disease,
while
the
term
"colitis" is used in the case of inammatory, infectious,
ischemic, or other causes.
14
These were not nested fields
in the source proforma, and no patient was counted more
than
once;
however,
the
codes
lacked
sucient
diagnostic detail to dierentiate the labels reliably, or did
not
even
have
standardised
definitions.
They
can
be
combined
to
avoid
any
misleading
comparative
description
of
the
disease,
but
the
combined
gure
of
50.6%
should
not
be
described
as
the
proportion/prevalence of conrmed inammatory bowel
disease
or
used
to
infer
the
proportions
of
ulcerative
colitis and Crohn's disease. Abdominal tuberculosis was
recorded in 10.4% of patients. Gastrointestinal TB is an
important
dierential
diagnosis
in
endemic
areas,
and
the clinical and endoscopic features may mimic those of
Crohn's
disease
and
other
inammatory
diseases.
Histopathological
and
microbiological
ndings,
combined
with
endoscopic
and
radiological
evidence,
increase
the
condence
level
of
a
diagnosis.
15,16
The
proportion
of
recorded
diagnoses
due
to
diverticular
disease was 6.1% in our study. Contemporary reviews
identify
diverticular
bleeding
as
a
leading
cause
of
acute
lower
gastrointestinal
bleeding,
particularly
in
older
populations
in
higher-income
settings.
17,18
This
study
was
limited
by
the
fact
that
it
was
conducted
with
a
younger,
stable
outpatient
population
and
was
not
performed with standardised colonoscopy, which is why
it
cannot
be
directly
compared
with
other
studies.
In
this
study, the frequencies were age-stratified, and a Monte
Carlo exact test was used because of the violation of the
assumptions
of
a
conventional
Pearson
chi-square
approximation.
The
age
group
to
etiological
category
association was not
statistically signicant (p = 0.695),
and
the
observed
association
was
small
(Cramer's
V
=
0.116).
Such
exploratory
results
should
be
considered
with
caution,
given
that
the
study's
primary
objective
was
not
to
compare
subgroups.
The
original
gender-
specific
comparison
for
ulcerative
colitis
was
not
included.
Once
the
overlapping
inammatory
labels
were
harmonised,
patient-level
gender
counts
for
the
complete combined category were unavailable. If only
one component was ambiguously classied, then the test
would
be
selective
and
would
not
reect
the
new
mutually exclusive outcome. None of the nal diagnoses
recorded resulted in a diagnosis of colorectal carcinoma.
Frequency of Common Causes of Bleeding Per Rectum among Patients
142
J Gandhara Med Dent Sci
October - December 2026
Rectal
bleeding
may
indicate
colorectal
cancer,
particularly when persistent or accompanied by altered
bowel
habits,
abdominal
pain,
diarrhoea
or
iron-
deciency
anaemia.
19
The
ndings
of
our
study
may
help
identify
priorities
for
future
studies
that
use
standardised
case
denitions
and
uniform
endoscopic
pathways.
A
strength
of
this
study
was
that
the
outpatient
population was dened consecutively and digital rectal
examination (DRE) and proctoscopy were performed in
each of the 164 participants. Further harmonisation of
the 3 inammatory codes with similar terminology, after
the interviews had been conducted, helps to strengthen
the
internal
interpretation
of
the
reported
frequencies,
as
each participant had only one primary source code.
LIMITATIONS
Certain limitations need to be addressed. It was a non-
probability
consecutive
sampling
of
a
single-center,
fixed-period
study.
No
formal
a
priori
calculation
of
sample size was documented, and the number of patients
(N = 164) was the maximum number of eligible patients
who
consented
to
participate
in
the
study,
with
a
maximum 95% margin of error of about 7.7 percentage
points
about
a
proportion
near
50%.
Patient-level
diagnostic
data
and
standardised
criteria
for
all
etiological groups were also not available. Synchronous
proximal
lesions
cannot
be
ruled
out
by
distal
lesions
seen
at
proctoscopy.
The
inammatory
codes
were
overlapping in their terms, making it impossible to make
inferences both by disease and by gender. Finally, failure
to identify colorectal carcinoma may reect incomplete
proximal
evaluation,
the
younger
outpatient
cohort,
referral
patterns,
or
sampling
variation.
Future
multicenter
studies
should
be
properly
planned
and
powered based on a prespecied sample size calculation,
mutually
exclusive
diagnostic
denitions,
and
standardised documentation of complete endoscopic and
histopathological assessment.
CONCLUSIONS
The most common harmonised etiological categories in
consecutive surgical outpatients during the study period
were
inammatory
colitis
and
hemorrhoids.
No
statistically
signicant
association
was
observed
between
age
group
and
etiological
category.
The
combined
inammatory
estimate
should
not
be
interpreted as the prevalence of conrmed inammatory
bowel
disease,
and
failure
to
identify
colorectal
carcinoma should not be interpreted as its true absence
because complete colonic evaluation was not uniform.
CONFLICT OF INTEREST:
None
FUNDING SOURCES:
None
REFERENCES
1.
Imran
H,
Alexander
JT,
Jackson
CD.
Lower
gastrointestinal
hemorrhage.
JAMA.
2024;331(19):1666-1667.
doi:10.1001/jama.2023.25841. PMID: 38656758.
2.
Colles T, Ziegelmann PK, Damin DC. The role of colonoscopy
in young patients with rectal bleeding: a systematic review and
meta-analysis.
Int
J
Colorectal
Dis.
2023;38(1):230.
doi:10.1007/s00384-023-04524-4. PMID: 37712988.
3.
Demb J, Kolb JM, Dounel J, Fritz CDL, Advani SM, Cao Y, et
al. Red ag signs and
symptoms for
patients
with
early-onset
colorectal cancer: a systematic review and meta-analysis. JAMA
Netw
Open.
2024;7(5):e2413157.
doi:10.1001/jamanetworkopen.2024.13157. PMID: 38787555.
4.
Triantafyllou K, Gkolfakis P, Gralnek IM, Oakland K, Manes G,
Radaelli
F,
et
al.
Diagnosis
and
management
of
acute
lower
gastrointestinal
bleeding:
European Society
of
Gastrointestinal
Endoscopy
(ESGE)
guideline.
Endoscopy.
2021;53(8):850-868.
doi:10.1055/a-1496-8969. PMID: 34062566.
5.
Zada I, Ahmed N, Tabassum R, Naqvi M, Dar SI, Abdullah M.
Etiological
factors
in
patients
with
lower
gastrointestinal
bleeding at a tertiary care hospital of Islamabad, Pakistan. Pak J
Health Sci. 2025;6(8):132-137. doi:10.54393/pjhs.v6i8.3168.
6.
Shaikh SS, Shaikh H, Khemchandani AK, Rizvi SAI, Zaheer S,
Sajid M. Unmasking the hidden culprits: investigating the diverse
causes of lower gastrointestinal bleeding in a younger cohort. Pak
J Med Res. 2024;63(2):69-74.
7.
Obeidat IM, Yahia Y, Chandra P, Altaiam A, Mohamed E, Sao
H, et al. Evaluating
the necessity of colonoscopy in patients under
40 with rectal bleeding: insights from a large-scale retrospective
analysis.
Int
J
Colorectal
Dis.
2024;39(1):202.
doi:10.1007/s00384-024-04784-8. PMID: 39680187.
8.
Sengupta N, Feuerstein JD, Jairath V, Shergill AK, Strate LL,
Wong
RJ,
et
al.
Management
of
patients
with
acute
lower
gastrointestinal
bleeding:
an
updated
ACG
guideline.
Am
J
Gastroenterol.
2023;118(2):208-231.
doi:10.14309/ajg.0000000000002130. PMID: 36735555.
9.
Nayab
S,
Awan
RH,
Jesrani
A,
Arain
N,
Aneela,
Khan
NA.
Utility of colonoscopy in detection of early lower gastrointestinal
bleeding
at
a
tertiary
care
hospital.
Professional
Med
J.
2022;29(4):437-441. doi:10.29309/TPMJ/2022.29.04.6776.
10.
Mathews NV, Simon EG, John A, Jeyaseelan L, Joseph AJ, Dutta
AK,
et
al.
Lower
gastrointestinal
bleeding:
etiology
and
outcomes
at
a
tertiary
care
center
in
South
Indiaare
these
dierent
from
the
West?
J
Digest
Endosc.
2025;16(2):59-67.
doi:10.1055/s-0045-1809364.
11.
Mahmud
MU,
Hossain
MM,
Ghosh
AK,
Reza
R.
Etiological
spectrum
of
diseases
among
the
patients
presenting
with
per
rectal bleeding attending at surgery
outpatient department in a
tertiary
level
hospital.
J
Chittagong
Med
Coll
Teach
Assoc.
2022;33(1):9-14. doi:10.3329/jcmcta.v33i1.66908.
12.
Adu-Darko N, Gyabaah S, Asamoah OY, Laryea TA, Oppong B,
Micah
E,
et
al.
Etiology
and
short-term
outcomes
of
upper
gastrointestinal bleeding in patients presenting at the emergency
department
in
a
tertiary
hospital
in
a
low
resource
setting:
a
prospective
cohort
study.
JGH
Open.
2025;9(5):e70167.
doi:10.1002/jgh3.70167. PMID: 40330255.
13.
Huang
L,
Xiao
A,
Li
Y.
Risk
factors
for
postoperative
acute
kidney injury in colorectal cancer: a systematic review and meta-
analysis.
Int
J
Colorectal
Dis.
2025;40(1):70.
doi:10.1007/s00384-025-04860-7. PMID: 40100411.
14.
Azer SA, Sun Y. Colitis. [Updated 2023 Aug 7]. In: StatPearls
[Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-
. PMID: 31082081.
15.
Choudhury A, Dhillon J, Sekar A, Gupta P, Singh H, Sharma V.
Differentiating gastrointestinal tuberculosis and Crohn's disease:
a
comprehensive review. BMC Gastroenterol.
2023;23(1):246.
doi:10.1186/s12876-023-02887-0. PMID: 37468869.
Frequency of Common Causes of Bleeding Per Rectum among Patients
143
J Gandhara Med Dent Sci
October - December 2026
16.
Brown
L,
Colwill
M,
Poullis
A.
Gastrointestinal
tuberculosis:
diagnostic
approaches
for
this
uncommon
pathology.
World
J
Clin
Cases.
2024;12(23):5283-5287.
doi:10.12998/wjcc.v12.i23.5283. PMID: 39156088.
17.
Long
B,
Gottlieb
M.
Emergency
medicine
updates:
lower
gastrointestinal
bleeding.
Am
J
Emerg
Med.
2024;81:62-68.
doi:10.1016/j.ajem.2024.04.022. PMID: 38670052.
18.
Sebastian
SA,
Co
EL,
Panthangi
V,
Bansal
R,
Narayanan
V,
Paudel
S,
et
al.
Colonic
diverticular
bleeding:
an
update
on
pathogenesis and management.
Dis Mon. 2023;69(11):101543.
doi:10.1016/j.disamonth.2023.101543. PMID: 36918300.
19.
Fritz CDL, Otegbeye EE, Zong X, Demb J, Nickel KB, Olsen
MA, et al. Red-ag signs and symptoms for earlier diagnosis of
early-onset
colorectal
cancer.
J
Natl
Cancer
Inst.
2023;115(8):909-916.
doi:10.1093/jnci/djad068.
PMID:
37138415.
Aurangzeb Ahmad
-
Concept & Design;
Drafting Manuscript;
Critical Revision; Final Approval
Muhammad
Shah
-
Concept
&
Design;
Data
Acquisition;
Critical Revision; Supervision; Final Approval
Shimee
Shahzadi
-
Concept
&
Design;
Data
Acquisition;
Drafting Manuscript;
Final Approval
Shehzad
Akbar
Khan
-
Concept
&
Design;
Data
Analysis/Interpretation; Critical Revision;
Final Approval
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Frequency of Common Causes of Bleeding Per Rectum among Patients
