Bright red blood per rectum.
Sinus pressure, sore throat.
S
The patient is a 62-year-old female who tells me that about a week ago she noticed bright red blood per rectum. She states she had a fairly normal stool, which was brown in color followed by drops of bright red blood into the toilet. She is quite certain this came from her rectum and not her vagina. She states the next day there was even a little bit more blood, and the third day continued. She then had several days where she did not have blood but then did have another day after this. For the last two days, however she has had normal bowel movements with no blood whatsoever. Her stools have been darker in color, but not black. She denies any epigastric pain, she does continue on her omeprazole 40 mg one p.o. daily with good success for her reflux symptoms. She did have a colonoscopy last in April of 2011, which was normal except for some left-sided diverticulosis. This has never caused her a problem before. Previous colonoscopy did show a moderate-sized polyp, which was an adenoma. She does have a family …show more content…
She does have a history of a moderate sized adenoma in the past, as well as diverticulosis. She has not been known to have hemorrhoids. She has not had any pain passing stools to think that this is a fissure. I do suspect this likely is bleeding related to the diverticulosis, but will have her see a gastroenterologist for possible need to repeat her colonoscopy a little bit earlier than they had desired, initially. Certainly, if the bleeding picks up a lot, she will go to the emergency room. We also discussed that with a history of diverticulosis, she is at risk for diverticulitis, although at this point, she is not having any fevers, and although she does have some pain in her left lower quadrant, it is very mild. If the pain does increase, fevers develop, she will certainly either go to the emergency room or give me a