Episode 10 - Bright Red Blood Per Rectum

Vitals & Useful Links:

• Learn about one etiology of lower GI bleeding. See spoilers below if you want to know which one.
• Podcast: Approach to GI Bleed - EM Clerkship Podcast 
• Clinical Reference: Approach to Acute Lower GI Bleed

This week the gang is back together to pay homage to Episode 1. Kyle (MS4) leads Arman (MS4) and Adam (MS3) through a case of an elderly male with bright red blood per rectum (bloody poops part 2). How would you approach this case? As always, we learn a couple very important points about evaluating GI bleeds. If you have any questions, concerns, or comments, please email us at [email protected].

*EPISODE SPOILERS BELOW*

UpToDate Page on Radiation Proctitis

Friedman, L., & Hong, T. (2019). Clinical manifestations, diagnosis, and treatment of radiation proctitis. In C. G. Willett (Ed.), UpToDate. Retrieved November 16, 2020.

Here's the article on prophylactic sucralfate

Hovdenak, N., Sørbye, H., & Dahl, O. (2005). Sucralfate does not ameliorate acute radiation proctitis: randomised study and meta-analysis. Clinical Oncology, 17(6), 485-491.

And here's the article on sucralfate paste enemas

McElvanna, K., Wilson, A., & Irwin, T. (2014). Sucralfate paste enema: a new method of topical treatment for haemorrhagic radiation proctitis. Colorectal Disease, 16(4), 281-284.

Lastly, here's the article on hyperbaric oxygen therapy

Clarke, R. E., Tenorio, L. C., Hussey, J. R., Toklu, A. S., Cone, D. L., Hinojosa, J. G., ... & Walker, M. B. (2008). Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up. International Journal of Radiation Oncology* Biology* Physics, 72(1), 134-143.

DISCLAIMER:

The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at [email protected].

Intro Music: "Walk Through the Park" by Track Tribe