A middle-aged gentleman presented with persistent hematochezia for two weeks. This was associated with diarrhea and colicky lower abdominal pain. He was afebrile and had no complaints of anorexia. The patient had a recent travel history to Philippines, a developing country, and also had recent contact with a family member who had similar presenting symptoms, but has spontaneously resolved. His physical examination and digital rectal examination were both unremarkable.The patient underwent a colonoscopy (Figure 1) and biopsies were taken (Figure 2).Colonoscopy (Figure 1) showed inflammation in the rectum and sigmoid. In addition, there is also an inflamed patch involving the cecum but the terminal ileum was normal in appearance. Macroscopic findings suggested ulcerative colitis and multiple biopsies of areas of inflammation were taken.Histology was consistent with acute colitis of the rectum; however, there were also some focal necroinflammatory debris which contained detached aggregates of round-to-oval amoeba-like organism with ingested red blood cells. The diagnosis was amoebic colitis. The patient was then treated with 10 days of oral metronidazole.