Answer:

• Hemorrhoids are the most common cause but rarely present with massive bleeding requiring hospitalization.
• Diverticulosis accounts for a significant percentage of cases. Diverticular bleeding may occur from either the right or left colon.
• Angiodysplasia or vascular ectasias are among of the more common well-recognized causes in older patients. They are commonly found in the cecum and ascending colon.
• Neoplasms of the large bowel usually present with chronic occult bleeding but occasionally bleed acutely.

Reference: Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis, and Management, 7th ed. Philadelphia, W.B. Saunders, 2003.

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