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Compliments of American Academy Of  Family Physicians

Elimination Problems

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Use this chart when you or a family member has pain, itching or blood with a bowel movement.


 

SYMPTOMS   DIAGNOSIS   SELF-CARE
Begin here        
1. Is the person a child or infant? Yes --> See Elimination Problems in Infants and Children    
No, go down        
2. Do you have pain with your bowel movements? No --> Go to Question 6.*    
Yes, go down        
3. Do you have intense pain even without a bowel movement? Yes --> You may have a PERIRECTAL ABSCESS. --> See your doctor.
No, go down        
4. Is there itching when you have a bowel movement and/or is there occasional blood? No --> Go to Question 6.*    
Yes, go down        
5. Do you have a small, tender lump near the rectum? Yes --> You probably have an external or thrombosed HEMORRHOID. --> Treat yourself with hemorrhoidal cream or suppositories. Soak the area two or three times a day in warm water. If there's no improvement in one to two weeks or if the bleeding continues, see your doctor.
No --> You may have an ANAL FISSURE. -->
*6. Do you have blood on or mixed in your bowel movements? Yes --> The blood may be from simple internal HEMORRHOIDS, but RECTAL CANCER is another possibility, especially if you're over age 40. --> A hemorrhoid medicine can help. See your doctor.
No, go down        
7. Are the bowel movements hard and dry? Yes --> CONSTIPATION can cause these symptoms. --> Increase the fiber in your diet. Use bulk-forming laxatives and drink lots of fluid. Check to see if any medicine could be causing constipation.
No, go down        
8. Are your bowel movements gray or whitish? Yes --> You may have a BLOCKAGE in or near your gallbladder, or you may have a LIVER DISEASE or INFECTION. --> See your doctor.
No, go down        
9. Do you have itching around your rectum? Yes --> Itching can be caused by a YEAST INFECTION, ALLERGY to toilet paper, PINWORMS or HEMORRHOIDS. --> Try a hemorrhoid ointment or hydrocortisone cream. If there's no improvement, use white, unscented toilet paper. See your doctor if your symptoms don't improve.
No, go down        
10. Do you have problems moving your bowels without a laxative or enema? Yes --> Overuse of laxatives can cause dependence on them. --> It's normal to have bowel movements two to three times weekly. Don't use laxatives just to have a daily bowel movement.
No, go down        
11. Do you have a sensation of something displaced with a bowel movement, or a feeling of incomplete evacuation? Yes --> You may have a RECTAL PROLAPSE or a PROLAPSED HEMORRHOID. --> See your doctor.
No, go down        
For more information, please consult your doctor. If you think the problem is serious, call right away.        

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

Copyright © 2006 American Academy of Family Physicians
 

 
 
 

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