FREQUENCY AND SURGICAL CAUSES OF PATIENTS WITH BLEEDING PER RECTUM AT OUTPATIENTS DEPARTMENT OF SHAIKH ZAYED HOSPITAL LAHORE

Background: Bleeding per rectum is a prevalent clinical symptom with diverse surgical and non-surgical causes, ranging from benign anorectal conditions to life-threatening malignancies. Accurate identification of its etiology is critical for timely diagnosis and effective management. The symptom is particularly alarming to patients due to visible blood, often leading them to seek immediate medical care. This study was conducted to explore the frequency and surgical causes of bleeding per rectum in a tertiary care setting, providing insights for region-specific healthcare strategies. Objective: To determine the frequency and surgical causes of bleeding per rectum among patients presenting to the outpatient department of Shaikh Zayed Hospital, Lahore. Methods: A descriptive cross-sectional study was conducted at Shaikh Zayed Hospital, Lahore, from February 2024 to July 2024. A total of 220 patients presenting with bleeding per rectum were included using non-probability consecutive sampling. Inclusion criteria were all patients aged 12 years or older with rectal bleeding, while those with non-surgical causes, prior surgical interventions, or unwilling to participate were excluded. Demographic and clinical data, including age, gender, residence, symptom duration, type of bleeding, bowel habits, and associated pain, were recorded. Diagnostic evaluations, including digital rectal examination, proctoscopy, colonoscopy, and histopathology when indicated, were conducted. Data were analyzed using SPSS version 25, with descriptive and inferential statistics applied. Results: Out of 220 patients, 65.0% were male, and 35.0% were female, with a mean age of 36.75 ± 15.54 years. The largest age group was 21-30 years (31.4%). Urban residents comprised 58.2% of the cohort, while 41.8% were from rural areas. Hemorrhoids were the most common surgical cause (54.1%), followed by fissure-in-ano (26.8%) and colorectal carcinoma (7.7%). Other causes included ileocecal tuberculosis (2.7%), rectal prolapse (2.7%), colorectal polyps (2.3%), solitary rectal ulcer (1.4%), ulcerative colitis (1.4%), and diverticular disease (0.9%). Conclusion: Hemorrhoids and fissure-in-ano were identified as the leading causes of rectal bleeding, with colorectal carcinoma being a significant but less common etiology. These findings highlight the need for focused diagnostic and management strategies in this region to address prevalent causes effectively.