History and Physical Examination

The focus initially should be to establish the quantity and color of blood and elicit any symptoms of hemodynamic instability that would require immediate intervention. The medical history can then evaluate previous GI bleeding episodes and diagnoses associated with recurrent episodes of bleeding. These include diverticulosis, angiodysplasias, hemorrhoids, ulcers, varices, or inflammatory bowel disease. Other important history findings include comorbid diseases, coagulopathies, liver disease, nonsteroidal antiinflammatory drug use (NSAID), and radiation therapy affecting the abdomen or rectum (prostate). NSAID use is a very important risk factor, now recognized as the cause of not only upper GI bleeding, but also increased lower GI bleeding.

Why Gluten Free

Why Gluten Free

What Is The Gluten Free Diet And What You Need To Know Before You Try It. You may have heard the term gluten free, and you may even have a general idea as to what it means to eat a gluten free diet. Most people believe this type of diet is a curse for those who simply cannot tolerate the protein known as gluten, as they will never be able to eat any food that contains wheat, rye, barley, malts, or triticale.

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