one of the weakest areas in the muscular wall of the colon, and thus a common site of diverticular formation, is the point at which perforating mesenteric arterial vessels penetrate. Because of the close association of the diverticula to the adjacent artery, erosion can occur resulting in significant blood loss. Despite the fact that only a thin membrane of mucosa separates the lumen of the colon from the peritoneal cavity within the diverticulum, bleeding is virtually always into the colon rather than the peritoneal cavity. Blood is a cathartic and moves quickly through the colon. Thus, brisk bleeding in the colon is usually evident relatively soon after it starts and presents as the passage of large amounts of bright red blood per rectum. It is important to differentiate diverticular bleeding from that of other sources of colonic bleeding and from upper gastrointestinal (GI) bleeding. There is a separate chapter on lower GI bleeding (see Chapter 101, "Lower Gastrointestinal Bleeding"). Acute lower GI bleeding most often occurs in patients older than 60 years, and although medical management combined with colonscopy and interventional radiology is most often effective in controlling the blood loss, surgical intervention is necessary in 10 to 25% of patients.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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