Step II Painless BRBPR anyone?

[Diana_UC]

Does anyone know how to tell the difference between painless BRBPR caused by a bleeding divertic in the sigmoid? versus a bleeding AVM? based on presentation..... 😕

 

[Idiopathic]

AVM would be painless, I would think. Tics hurt...

 

[Diana_UC]

I thought only diverticulitis caused pain, but that bleeding diverticulosis was painless?? Anyone else know if this is right? Also, I guess painless BRBPR could be caused by internal hemorroids, too?

 

[Idiopathic]

Youre right, -losis is painless and the one that bleeds. Angiodysplasia is a less common cause of GI bleeding than diverticulosis in px over 60 years, but history is the best way to distinguish (low fiber diet, chronic constipation, etc = diverticulosis)

Internal hemorrhoids will still be uncomfortable, and the patient wont have blood in the stool, but on the tissue (in trousers).

 

[gibber09]

Thought internal hemorrhoids presented with painless stool streaked with bright red blood while external hemorrhoids presented with blood on toilet paper and in the bowl.

 

[Idiopathic]

Thought internal hemorrhoids presented with painless stool streaked with bright red blood while external hemorrhoids presented with blood on toilet paper and in the bowl.

I think thats what i said...it will still be bright red blood per rectum, just not in the stool.