Question 89 · LEK · Lower gastrointestinal bleeding
A 70-year-old patient comes to his family doctor complaining of the recurrent bleeding from the lower gastrointestinal tract. He usually has normal stools but occasionally mucous diarrhea occurs. The patient suspects bleeding from the hemorrhoids. Indicate the optimal diagnostics and treatment:
- A. rectal examination and then referring the patient to colonoscopy in order to exclude pathological lesions in the upper segments of the colon.
- B. rectal examination, calming the patient down because the symptoms are typical of bleeding hemorrhoids, referral to a surgeon.
- C. referral to CT imaging, because it is the most precise examination to assess the colon.
- D. rectal swab for parasite examination, because the symptoms may suggest enterobiasis.
- E. referral to colonoscopy, as rectal examination may be omitted if the patient is to undergo endoscopic examination.
Hint
In an elderly patient with rectal bleeding and altered bowel habits, consider what must be ruled out before blaming haemorrhoids.
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