Bloody stools, think VTEC rules!

Acute bloody diarrhoea usually infective –

• Shigella/salmonella (non typhoid strains)
• Campylobacter
• E coli (some, eg EHEC)

Usually worse abdominal pain than usually seen in gastroenteritis, can also be high fever. If severe, shigella/campylobacter can be treated with antibiotics.

If chronic, consider

• constipation (stools might be soft but would expect them then to be massive)
• cow’s milk protein allergy in babies (even breast fed only)
• rectal polyp

Some serious causes:

• VTEC/STEC eg E coli O157 (causing haemolytic uraemic syndrome)
• Intussusception
• Acute colitis (ie ulcerative colitis, whether diagnosed or not)