An 84-Year-Old Woman Comes to the Office Due to 2

An 84-year-old woman comes to the office due to 2 months of bright red bleeding from the rectum.  The patient also has intermittent crampy abdominal pain and a 6-kg (13.2-lb) unintentional weight loss.  She reports no fevers, tenesmus, chest pain, palpitations, or vomiting.  Medical history is significant for obesity and chronic kidney disease.  Temperature is 37.6 C (99.7 F) , blood pressure is 130/80 mm Hg, and pulse is 70/min.  The patient appears cachectic.  There is no palpable lymphadenopathy.  Cardiac auscultation reveals normal rate and rhythm and no heart murmurs.  Lung sounds are normal.  The abdomen is nontender and nondistended.  Which of the following is the most likely diagnosis?

A) Angiodysplasia
B) Cecal adenocarcinoma
C) Diverticular bleeding
D) Internal hemorrhoids
E) Sigmoid colon adenocarcinoma