Pain in the Bottom
I have a young patient coming in this morning for a consultation. His name is Mark, and he's 11 years old. He arrived with his mother, who is clearly concerned.
Dr. Tanaka: Good morning Mrs. Clancy. Hello Mark.
Mrs. Clancy: Good morning doctor.
Mark: Hi.
Dr. Tanaka: So, what seems to be the problem?
Mrs. Clancy: The other day Mark noticed that he was dripping blood from his bottom when he was going to the bathroom. He showed it to me. It was not a lot, but I could easily see it.
Dr. Tanaka: I see. Mark, did you feel pain when you were pooping?
Mark: Yeah, a little. I have pain in my stomach sometimes too.
Dr. Tanaka: Whereabouts do you feel the pain?
Mark pointed to his lower abdomen.
Dr. Tanaka: Ok, and you say you feel some pain when you poop. Is that all the time, or sometimes?
Mark: Just sometimes.
Dr. Tanaka: OK, I'd like to do a rectal exam, Mrs. Clancy. Could you wait outside in the lobby for a few minutes or so?
Mrs. Clancy: Sure. Mark, I'll be back soon.
Dr. Tanaka: Sorry buddy, but I'd like to take a quick look in there. Could you drop your pants and lie down on the exam table with your back side facing me? This will be a little uncomfortable but not too bad. If you feel any pain let me know.
Mark nodded, and reluctantly jumped up on the exam table. Dr. Tanaka was able to examine the anus and part of the rectum.
After the exam, Dr. Tanaka called Mrs. Clancy back into the room. Dr. Tanaka looked at Mrs. Clancy and told her what he found.
Dr. Tanaka: Ok, I didn't notice anything obviously wrong, but I would like a specialist to see Mark. Just to be sure it's not something more serious.
Mrs. Clancy: Could it be hemorrhoids? Or Crohn's disease? His uncle had that.
Dr. Tanaka: No, I saw no evidence of that. It could be that he ate something particularly abrasive, and it caused some bleeding. I'm not sure, so let's get Mark a full checkup. I will send a referral to one of our gastroenterologists, and they will contact you to schedule an appointment. In the meantime, if it gets worse, contact me. I've ordered a couple of blood tests. You can go right down to the lab and take care of those now.
Mrs. Clancy: Ok, thank you doctor.
Mrs. Clancy and Mark went to their gastro appointment, and met Dr. Jetson. The doctor performed a flexible sigmoidoscopy on Mark, took a biopsy, and unfortunately found evidence of bowel disease. No polyps were found. After an X-RAY and additional blood tests, Mark was diagnosed with ulcerative colitis. He was prescribed medicine to reduce inflammation, as well as a low fiber diet until the inflammation subsides.
フラッシュカードドリル
- The surgeon performed a biopsy on a polyp he found in the man's colon.
- The doctor examined the patient's abdomen for tenderness and swelling.
- After an anal examination, the doctor diagnosed Mr. Jones' condition as hemorrhoids.
- I see my gastroenterologist every 2 years for a sigmoidoscopy.
- Folks who have ulcerative colitis have to go through the indignity of a sigmoidoscopy very often.
- He moved his bowels over ten times a day, which caused us to worry about his health.
- He was diagnosed with ulcerative colitis at a very young age, which apparently is not as unusual as you might think.
- The results of the examination revealed significant ulceration in his large intestine.
- Although a number of polyps were found, fortunately they were all benign.
- She needed surgery to remove a part of her small intestine due to Crohn's Disease.
- His rectum was perforated and there was considerable blood inside.
- His stomach was bloated with gas, probably from drinking too many carbonated beverages.
- Grade II hemorrhoids are larger in size, but still within the anus.
