PC: Rectal bleeding Flashcards
For rectal bleeding what questions is it important to ask to explore the symptom
timing
- when it started, acute or gradual onset, duration, progression, intermittent or continuous
rectal bleeding
- is the blood fresh/altered melaena and when does it occur
stool
- any mucus
- how much, how often, consistency
what important systems review questions should you ask
GI
- weight: any weight loss, appetite changes
- work down the body: dysphagia, N&V, indigestion/heartburn, abdo pain, bowel habit change, mucus in stool
list the differentials from fresh blood (distal cause) to melaena (proximal)
anal fissure haemorrhoids diverticular haemorrhage distil polyp/cancer IBD haemorrhage infective gastroenteritis angiodysplasia (vascular malformation of the gut) proximal polyp/cancer hemorrhagic peptic ulcer/gastritis Oesophageal varices
what are the clues/symptoms of the following disease:
anal fissure
bleeding on defecation
bright red on tissue paper
intense anal pain
constipation history
what are the clues/symptoms of the following disease:
haemorrhoids
bleeding on defecation
bright red on tissue paper
constipation history
what are the clues/symptoms of the following disease:
diverticular haemorrhage
sudden painless rectal bleeding
elderly
what are the clues/symptoms of the following disease:
polyp/cancer
alternating bowel habit
weight loss
urgency/ tenesmus
what are the clues/symptoms of the following disease:
IBD
blood mixed with stools
mucus
diarrhoea
abdominal pain
what are the clues/symptoms of the following disease:
haemorrhage infective gastroenteritis
acute diarrhoea and vomitting
history of suspicious food intake
what are the clues/symptoms of the following disease:
haemorrhage peptic ulcer/gastritis
gastric symptoms
risk factors eg NSAID alcohol spicy foods
what are the clues/symptoms of the following disease:
oesophageal varices
history of liver disease/alcoholism
may be encephalopathic or alcohol withdrawal
Haematemesis
what do the following symptoms make you think of
bleeding on defecation
bright red on tissue paper
intense anal pain
constipation history
anal fissure
what do the following symptoms make you think of
bleeding on defecation
bright red on tissue paper
constipation history
haemorrhoids
what do the following symptoms make you think of
sudden painless rectal bleeding
elderly
diverticular disease
what do the following symptoms make you think of
alternating bowel habit
weight loss
urgency/ tenesmus
polyp/cancer
