... Hemorrhoids are dilated perianal veins that become thrombosed or can rupture, producing subcutaneous or submucosal hematomas. They are usually due to chronic constipation but may be the cause of constipation also. Although they are usually
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Is it true or false melena? False melena may be induced by iron ingestion, bismuth ingestion, charcoal ingestion, red wine ingestion, and many other substances.
Is there a history of alcohol ... DIAGNOSTIC WORKUP
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Is it severe? The presence of severe rectal bleeding would suggest ulcerative colitis, amebic dysentery, bacillary dysentery, intussusception, mesenteric thrombosis or ... DIAGNOSTIC WORKUP
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Is there bleeding? The presence of bleeding with pain suggests an anal fissure, hemorrhoids, carcinoma, rectal prolapse, and ... DIAGNOSTIC WORKUP
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Hemorrhoids are not protruding “varicose veins”—they are distinct from the rectal varices of portal hypertension. Rather, hemorrhoids are downwardly displaced anal cushions, which are normal vascular... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Rectal complaints are common and distressing for patients. Although most causes of rectal pain and bleeding are benign and treatable, carcinoma must be considered and ruled out in... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Lower GI tract bleeding occurs distal to the ligament of Treitz (which separates the duodenum from the jejunum) and refers to the passage of either bright red blood per rectum (hematochezia),... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hematemesis refers to vomiting of clots, fresh blood, or “coffee grounds” and generally represents bleeding from the upper GI tract (i.e., proximal to the ligament of Treitz). May be associated with black, tarry stools (melena).... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hematochezia refers to bright red blood per rectum (BRBPR). When the blood is maroon, the bleeding source is usually colonic. Massive upper GI bleed may rarely present with... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... This discussion considers the causes of bright red or maroon stools. (The causes of melena or black stools are the same as the causes of hematemesis; the differential diagnosis is given on page 261.) Bright-red blood
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... Practically the whole specialty of proctology is devoted to taking care of patients with rectal pain. To develop the differential diagnosis it is useful first to divide the conditions into extrinsic and intrinsic. To recall
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... Hematemesis means vomiting or regurgitation of frank bright red blood or coffee-ground material that is positive for occult blood. It may be differentiated from hemoptysis because it usually gives an acidic reaction to
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...Rectal bleeding
The passage of bloody stools, also known as hematochezia, usually indicates — and may be the first sign of — GI bleeding below the ligament of Treitz However, this sign ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. The characteristic color results from bacterial degradation and hydrochloric acid... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Upper Gastrointestinal Bleeding
Inflammation
Esophageal ulcer
Gastric ulcer*
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... Hemorrhoids are varicosities in the superior or inferior hemorrhoidal venous plexus. Dilation and enlargement of the superior plexus produce internal hemorrhoids; dilation and enlargement... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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Melena
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and hydrochloric acid acting on the blood as it... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all local... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... The passage of bloody stools, also known as hematochezia, usually indicates—and may be the first sign of—GI bleeding below the ligament of Treitz. However, this sign—usually preceded by hematemesis... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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Rectal Bleeding
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Ted Epperly
Rectal bleeding is a common problem encountered by primary care providers across the United States. Annually, approximately 3% of the general population will report seeing blood in the toilet... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Mark B. Stephens
Gastrointestinal (GI) bleeding is responsible for 1% to 2% of all hospital admissions in the United States (1). Bleeding can be either acute... Approach ... History ... Physical examination ... Laboratory evaluation ... Diagnostic assessment ... Pictures
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... Differential Overview
❑ Hemorrhoid
❑ Rectal fissure
❑ Prostatitis
❑ Anal fistula... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Upper GI
❑ Peptic ulcer disease
❑ Gastritis
&... DIagnostic Approach ... Clinical Findings ... Pictures
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... Hemorrhoidal varices are part of the normal anatomy. Dilation and enlargement of the superior plexus of the superior hemorrhoidal veins located above the dentate line produce internal hemorrhoids. Enlargement of the... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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Hematochezia
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... The passage of bloody stools, also known as hematochezia, usually indicates — and may be the first sign of — GI bleeding below the ligament of Treitz. However,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Melena
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... The passage of bloody stools, also known as hematochezia, usually indicates — and may be the first sign of — GI bleeding below the ligament of Treitz. However, this sign — usually... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Melena
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and hydrochloric acid acting on the blood as it travels through the GI... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Can occuranywhere from nose and mouth to anus. Bleeding that occurs proximal to ligamentof Treitz is considered upper tract bleeding, whereas bleeding thatoccurs distal to this ligament is... Principal Causes of Gastrointestinal Bleeding ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. The characteristic color results from bacterial degradation and hydrochloric acid... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... The passage of bloody stools, also known as hematochezia, usually indicates—and may be the first sign of—GI bleeding below the ligament of Treitz. However, this sign—usually preceded by hematemesis—may also... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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This discussion considers the causes of bright red or maroon stools.
(The causes of melena or black stools are the same as the causes of
hematemesis; the differential diagnosis is... Pictures
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Practically the whole specialty of proctology is devoted to taking care
of patients with rectal pain. To develop the differential diagnosis it is
useful first to divide the conditions into extrinsic and
... Pictures
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...
Hematemesis means vomiting or regurgitation of frank bright red
blood or coffee-ground material that is positive for occult blood. It may be ... Pictures
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... Author:
Mindy Dickerman, MD
What to Do - Gather Appropriate Data
GI bleeding can be divided into upper GI hemorrhage (bleeding proximal
to the ligament... Suggested Readings
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... Author:
Laura Hufford, MD
What to Do - Interpret the Data
In newborns, one of the most common causes of blood in the stool is swallowed maternal blood. This occurs either during the delivery process or ... Suggested Readings
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... Maria R. Mascarenhas, MBBSKristin N. Fiorino, MD Lower GI Bleeding - BASICS Lower GI Bleeding - description Lower GI ... Lower GI Bleeding - DIAGNOSIS ... Lower GI Bleeding - TREATMENT ... Lower GI Bleeding - FOLLOW UP ... Lower GI Bleeding - bibliography ... Lower GI Bleeding - CODES ... Lower GI Bleeding - FAQ
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... Maria R. Mascarenhas, MBBSJudith Kelsen, MD Upper Gastrointestinal Bleeding - BASICS Upper Gastrointestinal Bleeding - description Vomiting of blood, whether bright red or dark,... Upper Gastrointestinal Bleeding - DIAGNOSIS ... Upper Gastrointestinal Bleeding - TREATMENT ... Upper Gastrointestinal Bleeding - FOLLOW UP ... Upper Gastrointestinal Bleeding - bibliography ... Upper Gastrointestinal Bleeding - CODES ... Upper Gastrointestinal Bleeding - FAQ
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