Summary of Dutch College of General Practitioners guidelines on "Rectal bleeding"

Rectal bleeding is often caused by a harmless disorder such as haemorrhoids or an anal fissure, but may be a symptom of colorectal cancer or inflammatory bowel disease. Risk factors for colorectal cancer are: older age (arbitrary > 50 years), a first-degree relative aged < 70 years with colorectal cancer, change in bowel habit, blood mixed with stools and the absence of anal or perianal symptoms. Colonoscopy should be performed when colorectal cancer is suspected. Treatment of haemorrhoids and anal fissures by the general practitioner especially includes education, treatment of comorbidity and, if necessary, local treatment. Proctoscopy is feasible in general practice.