I have a friend who bleeds bright red blood from his rectum. He thinks it might be an ulcer. Is that a possibility?

J.P.

Bleeding from the rectum can come from many different causes. The most likely ones depend on the patient's age, past history and other symptoms. The most common cause overall may be hemorrhoids, which often cause bright red blood on the toilet tissues, pain with defecation or small amounts of red blood around the stool. But we also worry about colon cancer, polyps (precancerous lesions), blood vessel malformations and inflammatory diseases of the bowel.

An ulcer in the duodenum (upper small intestine) can cause red blood from the rectum, but this is unusual. Normally an ulcer will cause a darkening of the stool from slow bleeding. The only way to tell for sure is to investigate, not speculate. Your friend should see a doctor.