Common abdominal histories - Rectal bleeding Flashcards
What would you want to ask about rectal bleeding?
- Duration, Onset, progression (how often), timing
- Blood/malaena
- On tissue or mixed in
- When does it occur
- Any mucus
- How often are bowels moving
What would you want to ask about on systemic enquiry?
- Weight loss
- Appetite change
- Dysphagia
- N + V
- Dyspepsia
- Bowel habit change
- Mucus in stool
What features assocaited with rectal bleeding would suggest anal fissures as the cause?
- Bleeding on defecation
- Bright red on tissue papaer
- Intense anal pain
- Constipation history
What features associated with rectal bleeding would suggest haemorrhoids?
- Bleeding on defecation
- Bright red on tissue
- Constipation history
- Anal pruritis
What features associated with rectal bleeding suggest diverticular haemorrhage?
- Sudden painless rectal bleeding
- Elderly
What features assocaited with rectal bleeding may suggest dital polyps/malignancy as the casue?
- Alternating bowel habit
- Weight loss
- Urgency/tenesmus
- Anal discomfort/pruritis
What features assocaited with rectal bleeding would suggest IBD as a cause?
- Blood mixed with stool
- Mucus
- Diarrhoea
- Abdominal pain
- Weight loss
What features assocaited with rectal bleeding would suggest haemorrhagic infective gastroeneteritis as the cause?
- Acute diarrhoea and vomiting
- History of high risk food intake
What features assocaited with rectal bleeding would suggest angiodysplasia as the cause?
- Elderly
- Painless
- Subtle
What features of rectal bleeding suggest proximal polyp/malignancy?
- WEight loss
- Anaemia symtpoms
What features assocaited with rectal bleeding suggest haemorrhagic peptic ulcer/gastritis as the cause?
What features of rectal bleeding would suggest oesophageal varcies as a cause?
- History of liver disease/alcoholism
- May have encephalopathy/alcohol withdrawal
- HAematemesis
