Lower GI Bleeding: Anorectal causes

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Lower GI BleedingAnorectal causes

• SEMINAR
• Lower GIT Bleed
• Friday, 1 July 2005

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Clinical Approach

• History
• Physical Examination
• Investigation
• Diagnosis
• Management

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Lower Gastrointestinal Bleeding

• Lower GI bleeding originates in the portions of
  the GI tract farther down the digestive
  systemthe segment of the small intestine farther
  from the stomach, large intestine, rectum, and
  anus.

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Causes of Lower GI Bleed

• Diverticulosis
• Angiodysplasia (AVM)
• Cancer/polyps
• Anorectal disorders lesions
• Inflammatory Bowel Disease (IBS)
• Aortoenteric fistula
• Infectious diarrhoea
• Iatrogenic
• Trauma
• etc

ANORECTAL CAUSES

• Rectal CA
• Rectal polyps

• Haemorrhoids
• Anal fissures
• Anal fistulas
• Proctitis
• Gonorrheal or mycoplasmal infections
• Rectal trauma
• Foreign objects

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ANORECTAL CAUSES

• Rectal CA
• Rectal polyps
• Haemorrhoids
• Anal fissures
• Anal fistulas
• Proctitis
• Gonorrheal or mycoplasmal infections
• Rectal trauma
• Foreign objects

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History

• Presenting complaint(s)
• History of presenting illness
• Systemic review
• Past medical and surgical history
• Medication history (iatrogenic factors)
• Family history
• Social history

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Presentation of Lower GI Bleeding

• Symptoms range from occult, microscopic bleeding
  or minor blood on toilet paper to bloody stools
• Haematochezia (bright red blood per rectum)
• Hypovolaemia due to haemorrhage (e.g. pallor,
  dizziness, weakness, syncope) and signs of shock
  may be present
• Nonspecific complaints may include dyspnoea,
  abdominal pain, chest pain, and fatigue

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History Questions to ask
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History Questions to ask
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History Questions to ask
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History Questions to ask