ETHOS

I'm straining to have a bowel movement and I see blood on the toilet tissue.

Patient

Hi, I'm having an issue and would like some advice.

Triage Assistant

Sure, where does it hurt?

Patient

I don't have any pain, but I'm experiencing some concerning symptoms.

Triage Assistant

What symptoms are you experiencing?

Patient

I've been straining a lot when I try to have a bowel movement and noticed something that worried me.

Triage Assistant

Understood. I'll use the Constipation protocol to guide our next steps.

Triage Assistant

How often do you have a bowel movement and when was your last one? Normal frequency ranges from 3 times a day to every 3 days.

Patient

I usually have a bowel movement every 2-3 days. My last one was two days ago.

Triage Assistant

Do you have to strain to have a bowel movement?

Patient

Yes, I've been straining a lot recently.

Triage Assistant

Does your rectum hurt when the stool comes out? If yes, on a scale of 1-10, how bad is the pain? Do you have hemorrhoids?

Patient

No, I don't feel any pain when the stool comes out. I haven't been diagnosed with hemorrhoids, so I'm not sure if I have them.

Triage Assistant

Are the stools hard?

Patient

Yes, they're usually quite hard.

Triage Assistant

Has there been any blood on the toilet tissue or on the surface of the bowel movements? If yes, when was the last time you noticed it?

Patient

Yes, there has been blood on the toilet tissue. I last noticed it today.

Triage Assistant

Is this a new problem for you, or have you had issues with constipation before? If not new, how long have you had this problem?

Patient

This is a relatively new problem for me. It started happening about a month ago.

Triage Assistant

Have there been any recent changes in your diet or how much fluids you are drinking daily? How much have you had to drink today?

Patient

I haven't made any significant changes to my diet, and I usually drink about 6-8 glasses of water a day. Today, I've had about 5 glasses so far.

Triage Assistant

Have you been taking any new medicines or narcotic pain medicines recently?

Dispositions

  • See More Appropriate Protocol

  • Go to ED/UCC Now (or to Office With PCP Approval)

  • Go to Office Now

  • See in Office Today

  • See in Office Within 3 Days

  • See in Office Within 2 Weeks

  • Home Care

  • Triage result should be See in Office Within 2 Weeks.

  • First aid advice was given.

  • Some assessment questions asked.