Which of the following is most likely to validate that a client is experiencing intestinal bleeding?

What are Salmonella?

Salmonella are bacteria that make people sick.

What illness do people get from Salmonella infection?

Most types of Salmonella cause an illness called salmonellosis, which is the focus of this website. Some other types of Salmonella cause typhoid fever or paratyphoid fever.

What are the symptoms of infection?

Most people with Salmonella infection have diarrhea, fever, and stomach cramps.

Symptoms usually begin six hours to six days after infection and last four to seven days. However, some people do not develop symptoms for several weeks after infection and others experience symptoms for several weeks.

Salmonella strains sometimes cause infection in urine, blood, bones, joints, or the nervous system (spinal fluid and brain), and can cause severe disease.

How is Salmonella infection diagnosed?

Salmonella infection is diagnosed when a laboratory test detects Salmonella bacteria in a person’s stool (poop), body tissue, or fluids.

How is infection treated?

Most people recover from Salmonella infection within four to seven days without antibiotics. People who are sick with a Salmonella infection should drink extra fluids as long as diarrhea lasts.

Antibiotic treatment is recommended for:

• People with severe illness
• People with a weakened immune system, such as from HIV infection or chemotherapy treatment
• Adults older than 50 who have medical problems, such as heart disease
• Infants (children younger than 12 months).
• Adults age 65 or older

Can infection cause long-term health problems?

Most people with diarrhea caused by Salmonella recover completely, although some people’s bowel habits (frequency and consistency of poop) may not return to normal for a few months.

Some people with Salmonella infection develop pain in their joints, called reactive arthritis, after the infection has ended. Reactive arthritis can last for months or years and can be difficult to treat. Some people with reactive arthritis develop irritation of the eyes and pain when urinating.

How do people get infected?

Salmonella live in the intestines of people and animals. People can get Salmonella infection from a variety of sources, including

• Eating contaminated food or drinking contaminated water
• Touching infected animals, their feces, or their environment

Who is more likely to get an infection and severe illness?

• Children under 5 years old are the most likely to get a Salmonella infection.
• Infants (children younger than 12 months) who are not breast fed are more likely to get a Salmonella infection.
• Infants, adults aged 65 and older, and people with a weakened immune system are the most likely to have severe infections.
• People taking certain medicines (for example, stomach acid reducers) are at increased risk of infection.

What should I know about antibiotic resistance and Salmonella?

Resistance to essential antibiotics is increasing in Salmonella, which can limit treatment options for people with severe infections.  One way to slow down the development of antibiotic resistance is by appropriate use of antibiotics.

What can be done to prevent antibiotic resistance and resistant bacteria?

Appropriate use of antibiotics in people and animals (use only when needed and exactly as prescribed) can help prevent antibiotic resistance and the spread of resistant bacteria.

How common is Salmonella infection?

CDC estimates Salmonella cause about 1.35 million illnesses, 26,500 hospitalizations, and 420 deaths in the United States every year.

Diagnosis

Your doctor will take a medical history, including a history of previous bleeding, conduct a physical exam and possibly order tests. Tests might include:

• Blood tests. You may need a complete blood count, a test to see how fast your blood clots, a platelet count and liver function tests.
• Stool tests. Analyzing your stool can help determine the cause of occult bleeding.
• Nasogastric lavage. A tube is passed through your nose into your stomach to remove your stomach contents. This might help determine the source of your bleed.
• Upper endoscopy. This procedure uses a tiny camera on the end of a long tube, which is passed through your mouth to enable your doctor to examine your upper gastrointestinal tract.
• Colonoscopy. This procedure uses a tiny camera on the end of a long tube, which is passed through your rectum to enable your doctor to examine your large intestine and rectum.
• Capsule endoscopy. In this procedure, you swallow a vitamin-size capsule with a tiny camera inside. The capsule travels through your digestive tract taking thousands of pictures that are sent to a recorder you wear on a belt around your waist. This enables your doctor to see inside your small intestine.
• Flexible sigmoidoscopy. A tube with a light and camera is placed in your rectum to look at your rectum and the last part of the large intestine that leads to your rectum (sigmoid colon).
• Balloon-assisted enteroscopy. A specialized scope inspects parts of your small intestine that other tests using an endoscope can't reach. Sometimes, the source of bleeding can be controlled or treated during this test.
• Angiography. A contrast dye is injected into an artery, and a series of X-rays are taken to look for and treat bleeding vessels or other abnormalities.
• Imaging tests. A variety of other imaging tests, such as an abdominal CT scan, might be used to find the source of the bleed.

If your GI bleeding is severe, and noninvasive tests can't find the source, you might need surgery so that doctors can view the entire small intestine. Fortunately, this is rare.

Treatment

Often, GI bleeding stops on its own. If it doesn't, treatment depends on where the bleed is from. In many cases, medication or a procedure to control the bleeding can be given during some tests. For example, it's sometimes possible to treat a bleeding peptic ulcer during an upper endoscopy or to remove polyps during a colonoscopy.

If you have an upper GI bleed, you might be given an IV drug known as a proton pump inhibitor (PPI) to suppress stomach acid production. Once the source of the bleeding is identified, your doctor will determine whether you need to continue taking a PPI.

Depending on the amount of blood loss and whether you continue to bleed, you might require fluids through a needle (IV) and, possibly, blood transfusions. If you take blood-thinning medications, including aspirin or nonsteroidal anti-inflammatory medications, you might need to stop.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

If your bleeding is not severe, you might start by seeing your primary care provider. Or you might be referred immediately to a specialist in gastrointestinal disorders (gastroenterologist).

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before a specific test. Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment and when they began
• All medications, vitamins or other supplements you take, including doses
• History of digestive disease you've been diagnosed with, such as GERD, peptic ulcers or IBD
• Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For gastrointestinal bleeding, basic questions to ask your doctor include:

• I'm not seeing blood, so why do you suspect a GI bleed?
• What's likely causing my symptoms?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What tests do I need?
• Is my condition likely temporary or chronic?
• What's the best course of action?
• What are the alternatives to the primary approach you're suggesting?
• I have other health conditions. How can I best manage them while my bleeding is treated?
• Are there restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do you take non-steroidal anti-inflammatory medication, either over-the –counter or prescribed, or do you take aspirin?
• Do you drink alcohol?

Oct. 15, 2020

Which of the following should be included in patient teaching to prevent constipation?

Which treatment is discouraged for a patient who reports constipation?

Which tube is appropriate as an intervention for bleeding esophageal varices?

Which client would digital removal of stool be contraindicated?