Document Detail


An objective measure of stool color for differentiating upper from lower gastrointestinal bleeding.
MedLine Citation:
PMID:  7648958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Subjective reporting of the color of blood passed per rectum has been used to predict the location of gastrointestinal bleeding, but the validity of this clinical approach has never been evaluated systematically. In this study we determined the spectrum of patient and physician descriptors used to characterize the color of blood passed per rectum and evaluated prospectively if an objective test of stool color would correlate with or improve upon subjective descriptions in predicting bleeding locations. The objective test employed was a card containing five numbered colors that typify the spectrum of stool blood colors. One hundred twenty patients used 23 different descriptors or terms to verbalize the color of blood they passed per rectum, and in 22% of cases there was a seeming discrepancy between their verbalized color and the color they pointed to on the test card. Patients pointing to card color 4 (the black color) resulted in closer matching to an upper bleeding source than physicians using terminology such as melena or tarry stools. Likewise, patients picking card colors 1 and 2 (the brightest red colors) resulted in closer matching to a coloanorectal bleeding source than physicians using the terms hematochezia or bright red blood per rectum (P < 0.02 for each comparison). The positive predictive value of card color 4 for an upper bleeding source was very high both when patients pointed to this color or when it was determined from the available stool (0.95 and 0.98, respectively). The positive predictive value of card color 1 for lower bleeding was greater for patients selecting this color than for a direct stool comparison (1.00 vs 0.83).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
G R Zuckerman; D R Trellis; T M Sherman; R E Clouse
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  40     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-09-28     Completed Date:  1995-09-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1614-21     Citation Subset:  AIM; IM    
Affiliation:
Washington University School of Medicine, Department of Internal Medicine, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Colonic Diseases
Color
Diagnosis, Differential
Feces*
Female
Gastrointestinal Hemorrhage / diagnosis*,  etiology
Humans
Intestine, Small
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Stomach Diseases / diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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