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Surgery General d0e1f276

A young office executive, on tour, presents with bright red painless bleed since 7 days and abdominal pain. External and perrectal examinations are normal. As attending general practioner what will be your next step:

A
proctoscopy
B
do a barium enema
C
refer to surgeon for sigmoidoscopy
D
refer to gastroenterologist for colonoscopy
High-Yield Explanation
Proctoscopy Hemorrhoids is most likely the cause of fresh, painless bleed in this young patient. (Other causes of fresh lower GI bleed are- fissures, diveicula, ischemic colitis, and aerio-venous malformations). So the next step would be to check for hemorrhoids using a proctoscope, before going for more invasive procedures like sigmoidoscopy or colonoscopy to diagnose other conditions.

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