History taking - Rectal bleeding.
Introduction:
Since when have you been passing blood per rectum?
Is this the first episode?
Is it frank blood or blood in the stool? Are you passing any slime?
How many times do you open your bowel?
Do you feel any thing coming down while passing bowels?
Do you have to strain to pass your motion (Tenesmus)? Pain while passing the bowels? Fever?
Abdominal pain? Do you fell well after opening the bowel?
Appetite? Weight loss? Arthritis?
Are you on any medication?
Medical history of IBD, Ca and bleeding disorders?
Alcohol, smoking and drugs?
Do any one in your family have similar complaints?
DD: diverticulitis, colorectal carcinoma, haemorrhoids, polyps, trauma, fissure in ano, angiodysplasia, arteriovenous malformation, radiation proctitis.
Reference: Diarrhoea and rectal bleeding.