Case 7. A 45 year old male presents with blood in the stool
Written by Elshami Elamin, MD, Oncologist, Jeddah, KSA Reviewed by Mohamed Akoad, MD, Liver and Transplant Surgeon, Boston, MA, USAHistory
A 45 years old male presented to his family physician complaining of blood in his stool. He was found to have hemorrhoids, reassured and prescribed anti-hemorrhoid therapy. The bleeding stopped but he presented 2 months later with worsening abdominal pain. He had no other symptoms, apart from the chronic irregular bowel habit attribuated to his known history of Irritable Bowel Syndrome (IBS). No hematemesis or melena.
PMH: Irritable Bowel Syndrome for several years
Social History: Non smoker, no history of alcohol, narcotic use
Drug History: No known drug allergies, not on any long term medication
Physical Examination
Vital signs, and physical examination was unremarkable
Rectal examination: no palpable masses, bedside fecal occult blood testing positive.
|
Test |
Result |
Reference |
|
Hemoglobin |
11.5 gm/dl |
14-17 in males |
|
Mean Corpuscular Volume |
75 fl |
80-100 |
|
Ferritin |
9 mg/l |
15-200 |
|
BMP Na, K, Cl, HCO3, BUN, Cr |
Within normal limits |