DIAGNOSIS CHECKLIST
for Bloody stool

Why: to establish if acute or chronic.

Why: presence of severe rectal bleeding would suggest angiodysplasia, ulcerative colitis, amebic dysentery, bacillary dysentery, intussusception, mesenteric thrombosis or embolism, diverticulitis, ischemic colitis and coagulation disorders. The site of the bleeding can be anywhere in the gastrointestinal tract since massive bleeding even from the stomach or duodenum may pass rapidly to rectum without becoming discolored to form melena (black tarry stool).

Why: suggests colon cancer, ulcerative colitis, Crohn's disease, Meckel's diverticulum, diverticulitis, large polyp and coagulation disorder. If blood is on the toilet paper only it suggests anal cause.

Why: usually due to bleeding from the upper gastrointestinal tract.

Why: suggests rectal endometriosis.

Why: e.g. ischemic colitis occurs in the setting of widespread peripheral vascular disease or cardiac disease; bleeding disorders.

Why: colon or rectal cancer; bleeding disorders, inflammatory bowel disease.

Why: some medications can increase the risk of bleeding and bloody stools e.g. high dose aspirin, non-steroidal anti-inflammatory medication, certain antibiotics including clindomycin, gentamycin, erythromycin.

Why: to establish risk of chronic liver disease and portal hypertension and resultant varices and hemorrhoids.

Why: would suggest ulcerative colitis, Crohn's disease, amebic dysentery or bacterial dysentery (e.g. shigella, salmonella, campylobacter jejuni, yersinia enterocolitica, enteroinvasive and enterohemorrhagic E.Coli).

Why: may suggest bacterial dysentery, amebic dysentery, chronic liver disease secondary to alcoholism, ulcerative colitis.

Why: e.g. colicky abdominal pain, vomiting, abdominal distension and absolute constipation - would suggest intussusception, mesenteric thrombosis, or embolism.

Why: anal fissure or thrombosed hemorrhoid.

Why: suggest a rectal cause.

Why: suggests hemorrhoids, fissure or diarrhea causing irritation.

Why: may suggest hemorrhoids, anal fissure, diverticulitis, cancer of the rectum or left side of colon.

Why: e.g. lethargy, dizziness, depression, shortness of breath or angina.

Why: e.g. easy bruising, bleeding gums, bleeding nose, blood in the urine, swollen painful joints.