Constipation and rectal bleeding

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Diseases	History and Symptoms								Physical Examination				Laboratory Findings			Other Findings	Diagnostic study of choice
	History and Symptoms								Physical Examination				Electrolyts [Ca, K, Mg]	Biochemical tests
	GI symptoms				Extra GI symptoms				Abnormal gait	Anal protruding mass	DRE	Deep tendon reflex		FBS	TSH
	Dysphagia	Abdominal pain	Anal pain	Rectal bleeding	Weight loss	Polyphagia, Polyuria, Polydipsia	Dry skin	Tremor	Abnormal gait	Anal protruding mass	DRE	Deep tendon reflex		FBS	TSH
Malignancy	–	–	+/-	+	++	–	–	–	–	–	Empty rectum	Normal	Normal	Normal	Normal	Acute change in bowel habits Rectal bleeding Anemia	Rectosigmoidoscopy with biopsy
Anal fissure	–	–	+++	+	–	–	–	–	–	–	Increased sphincter tone	Normal	Normal	Normal	Normal	Rectal bleeding after defecation Painful DRE	DRE
Diverticulosis	–	+	–	+	–	–	–	–	–	–	Normal	Normal	Normal	Normal	Normal	Chronic constipation Bowel obstruction	Colonoscopy
Hirschsprung disease	–	+	–	+	+	–	–	–	–	–	Blood tinged glove	Normal	Normal	Normal	Normal	Abdominal distention Growth retardation Vomiting	Barium enema

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