Debrief - Rectal bleeding
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Patients who present with abdominal pain and altered stools or bleeding from the anus can prove to be quite challenging. However, any bleeding needs to be seen in A&E. With red blood, particularly red blood in the pan, this can be from haemorrhoids or maybe fissure or more than one fissure and is often bleeding nearer to the anal sphincter. If there is blood in the stools but the stools are formed or loose and sloppy, but if there is blood with the stools, that can indicate bleeding from higher up and the blood will not be quite so red, but the blood would have to be mixed in with the stools. And this patient that we triaged had black tarry sticky stools that smelled funny. So this is known as Melena and it is digested blood coming from higher up the digestive tract. And it has its own particular smell. Patients will often remark on the smell that it did not smell like poo. This is serious. All these bleeding conditions need to be seen in A&E promptly.