What questions would you have to ask for systems review
N and v Abdo pain Bloating Change in bowel habits Rectal bleeding Dysphagia
Relevant PMH/FHx
Antibiotic exposure
Smoking
Polyps
IBD
IBS
Diet - processed foods, lactose, gluten, fibre
Genetics: HLA-27, APC mutation, Lynch syndrome
What questions might you ask about change in bowel habits?
Frequency Volume Colour Mucus Blood Consistency Floating, difficult to flush away? Smell? Pain on defecation? Tenesmus?
What is Tenemus?
A feeling of fully evacuating faeces
What might you want to ask about PR bleeding?
When did it start? Previous episodes? Last episode? Time between latest episodes? Volume of blood per motion? One-off or all the time? Continuous or intermittent Colour Drip into pain, toilet paper or does it coat the stools?