22nd July 2023

A 73-year-old man is referred to the acute medical unit with a 2-month history of intermittent painless PR bleeding

A 73-year-old man is referred to the acute medical unit with a 2-month history of intermittent painless PR bleeding. He denies any associated abdominal pain, weight loss, change in bowel habit, or haematemesis. He has a history of hypertension and aortic stenosis. His only regular medication is ramipril 5mg OD. He has no known medication allergies. There is no relevant family history. He is a non-smoker and drinks no alcohol. Blood tests show an iron deficiency anaemia. He undergoes a colonoscopy which shows abnormal epithelium with multiple dilated thin walled blood vessels but no active bleeding.

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