Bleeding per rectum history taking Questions per rectal bleed history taking per-rectal bleeding question

1. BLEEDING PER RECTUM HISTORY TAKING
o Duration – “How long has the problem
been present?”.
o Onset – “How did it start?”.
o Progression –“is it getting worse?”.
ABCO-PUT(mnemonic):
o Amount= “one teaspoon or tablespoon or a full Cup?”
o Blood (in relation to defecation):
 Mixed with the feces – (possiblesourceof blood aboveSigmoid
colon).
 On the feces – (usually fromrectum or anal canal).
 Separate fromthe feces – (Hemorrhoids, or if with intense desire to
defecate is Suggestiveof diverticular diseaseor angiodysplasia).
 On the toilet paper – (condition close to anal margin e.g.
hemorrhoids or fissure).
o Color = “bright red or altered in color (black, tarry [sticky & shiny])?”.
o Odor = “does it has any characteristic smell?”
o Pain = “is it associated with pain (during defecation)?”.
o Urgency = “do you haveto rush to defecate?”.
o Tenesmus = “do you experience, constant desireto defecate or incomplete
evacuation after passing stool?”.
AssociatedSymptoms:
 Abdominal pain
 Altered bowel habits - diarrhea, constipation
 Weight loss, fatigue, anorexia
 History of peptic ulcer disease, CLD
DOP = these 3 questionsisbasicfor
almosteveryHistoryfora Symptom.