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The patient with lower GI bleeding may complain of abdominal pain, fresh blood passed with the stool (haematochezia), lack of appetite, shortness of breath, fainting episodes or fatigue.
On examination, there may be conspicuous bleeding from the rectum, peritonism, shock, orthostatic hypotension and abdominal distention.
The freshness of the blood passed per rectum should be noted - this may be of help in determining the site of bleeding.
Also, faeces should be examined to see if there is fresh blood streaking the stool, which is typical of bleeding from haemorrhoids, or whether there is a mixture of blood and diarrhoea, as in ulcerative colitis.