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gi bleed question

Posted

Has 15 years experience.

Can disimpacting someone cause a gi bleed ?

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

Depends on if you know for a fact it's a GI bleed.

Dislodging impacted stool can cause small fissures around the anus or anywhere in the rectum, especially if stool keeps flowing in with nowhere to go.

Any area in the bowel can become stressed and weak, and thus, at risk for bleeding, if it's allowed to continue.

The color of the blood can give you a clue as to where the bleed is...if it's black or dark...upper GI is suspected...red to bright red...lower GI.

Disimpacting stool is a treatment...but may be a symptom of an underlying disorder, and not just a simple case of severe constipation.

If you could post more information....

calliesue

Has 15 years experience.

Blood was dark red . Pt given suppository and prune juice on 6/2,and impaction removed on 2/10 after which he had two more extra large bowel movements on his own. 2/10 nurse worried might have caused bleeding which occurred after pt had two more xlg bowel movements on his own. Bleeding occurred about an hour after last bm.

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

If it was dark red, then that was most likely lower GI. This could have been caused by damage to sphincters or intestinal/rectal wall from the straining.

All you can do at this point, since the impaction has been removed, is monitor and suggest an order to test for occult blood.

If he has somewhat regular BM's and is still bleeding, then the MD may want to consider an endo.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

can disimpacting someone cause a gi bleed ?

gi bleeding can include rectal bleeding. rectal bleeding can be due to hemorrhoids, abscesses, polyps or neoplasms, colitis, diverticula, a foreign body or an endocrine disorder and any stimulation such as an impaction or the manual removal of one could aggravate bleeding. i would consider that if the person has a history of constipation that there may be internal and/or external hemorrhoids. did anyone think to dig into the middle of these stools and test them for occult blood? another way to know if bleeding is significant is to notify the doctor and ask that blood counts be drawn first. if they show significant decrease then the doctor can order more tests. of course, the first thing the doctor is going to ask is if stools for occult blood have been done.

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