Rectal bleeding Flashcards
What is the medical name for rectal bleeding?
Haematochezia
What is rectal bleeding?
the passage of fresh red blood per rectum, usually from lower GI tract
What may cause rectal bleeding?
Diverticulosis, haemorrhoids, ischaemic or infective colitis, malignancy, angiodysplasia, IBD, radiation procititis
What is Diverticulosis?
most common cause of lower GI bleeding, diverticula are outpouchings of the bowel wall that are composed of mucosa most commonly in the descending and sigmoid colon
What are haemorrhoids?
engorged vascular cushions in the anal canal, blood is usually on the surface of the poo
What should be asked if rectal bleeding may be malignancy related?
other symptoms, weight loss, relevant family history
What would you have to ask about rectal bleeding?
duration, frequency, colour of the bleeding, relation to stool and defecation, pain, haematemesis, PR mucus, previous episodes, family history of bowel cancer or IBD
What imaging should be done after PR bleeding?
flexible sigmoidoscopy for further assessment if stable, colonoscopy if inconclusive, upper GI endoscopy if unstable and CT angiography if colonscopy was non diagnostic
What is the management for PR bleeding?
resuscitation, A-E, IV fluid, blood products cross matched, most people will settle spontaneously but if not then endoscopic haemostasis methods and arterial embolisation, may need surgery if this fails
If someone has a large fresh rectal bleed and is haemodynamically unstable what are they expected to have till proven otherwise?
Upper GI bleed
