I need to know what causes his symptoms?
What is the cause of the bloody stool?
Condition of the patient?
Are there any medication interaction?
Salient Features of the Case:
45 y/o, married male with a chief complaint of bloody stools
PE: BP – 90/60; RR – 18/min; HR – 60 bpm; Temp = 37.8°C
Pertinent Physical Examination Findings:
Pupil – slightly jaundiced
Abdomen – globular abdomen, with spider angiomas
Ext: (+) varicosities, Grade I bipedal edema
Rectal Exam: (+) blood on tactating finger, no masses with bloody stools
Past Medical Hx:
• Diagnosed to have Pulmonary Tuberculosis 4 months ago currently on RHES with good compliance and follow ups check up
• Currently on the following medications
Omeprazole 40 mg/cap; cap OD since 4 months ago
Sangibion ( contains ferrous gloconate, manganese sulfate, copper sulfate, folic acid, sorbitol, vit c) 1 tab once daily x 2 months since 4 months ago
Epoietin alpha once weekly since 1yr ago
• High doses of multi-vitamins containing Niacin – intermittent
• Alcoholic beverage drinker since 20 years of age
drinks Rhum every morning