Rectal Bleeding (cont.)
Rectal Bleeding Diagnosis
A physical examination will be performed by the physician. If necessary, diagnostic tests may be ordered.
Physical exam: The focus is on finding the source and extent of bleeding. Priority is to identify significant low blood volume and begin appropriate treatment. This is the most life-threatening situation. The physician will focus on
- Vital signs: Low blood pressure
and elevated heart rate will indicate significant loss of blood. An elevated
temperature will suggest infection.
- Abdominal examination: The physician will search for abdominal distension, discomfort, or tenderness that may suggest a possible bleeding
ulcer. A mass the doctor can feel is cause for concern about
- Anal and digital rectal examination: The anus will be inspected for possible external sources of bleeding such as trauma, foreign body, or hemorrhoids. A finger examination is performed to assess tenderness, character of stool, and the presence of masses.
Diagnostic tests: Depending on the type and severity of bleeding, special tests may be performed to aid in diagnosis.
- Blood tests: Blood samples are taken to assess the extent of blood loss, the clotting ability of blood, and the possibility of infection.
- Nasogastric tube: A
flexible tube is passed through the nose into the stomach to check for the presence of active bleeding. This may be
uncomfortable, but can be a vital diagnostic test.
- Anoscopy: A plastic or metal scope placed into the anus allows for quick examination of the rectal vault.
sigmoidoscopy: A flexible tube inserted into the rectum is used to evaluate the rectum and lower end of the colon.
- Colonoscopy: A soft tube equipped with a light and camera is inserted into the rectum and pushed into the colon. The entire
large colon is visualized. It is used to locate areas of bleeding, masses, or irregularities.
- Barium enema X-ray: This study uses liquid barium inserted into the rectum. An
X-ray is taken to highlight problem areas such as tumors or diverticula. However, sites of active bleeding cannot be distinguished.
- Nuclear medicine
studies: A tagged red blood cell scan may be used to pinpoint areas of slow bleeding.
- CT scan: May be used to diagnose diverticulitis or tumors in the
- Angiography: A
contrast dye study is used to evaluate active areas of brisk bleeding.
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