Hemorrhoids and positive occult blood tests

Q: Hemorrhoids do not affect the prevalence of positive occult blood tests (OBT).

A) True

B) False

Answer: B

Interestingly, occult Gastrointestinal (GI) bleeding can be due to many causes but hemorrhoids rarely turn occult blood test positive. This is due to the fact that most hemorrhoidal bleeding has whole blood.

A positive occult blood test just guides a physician to the probability of underlying pathology. It can include colon cancer, esophagitis, peptic ulcers, gastritis, inflammatory bowel disease, vascular ectasias, portal hypertensive gastropathy, gastric antral vascular ectasias, GI stromal cell tumor, lymphoma, carcinoid, adenocarcinoma, or polyp.

Hemoptysis and epistaxis can also cause a positive OBT.

#GI

References:

1. van Turenhout ST, Oort FA, Terhaar sive Droste JS, et al. Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results. Gastrointest Endosc 2012; 76:136.

2. Korkis AM, McDougall CJ. Rectal bleeding in patients less than 50 years of age. Dig Dis Sci 1995; 40:1520.