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Hello Mrs. Wilson, I'm Dr. Mercer. I
understand that Dr. Raijman has sent you over to see me.
This is one of our medical students, Dr. Costelloe. She
will be assisting me with your case. What seems to be the
trouble?




I have been having a peculiar problem
lately. My stools are a funny color. First they were black
and almost sticky and then they became maroon
yesterday. In fact, today I saw some bright red blood.


How long has this been going on?




The black stools began about 3 weeks ago, but only lasted a few days. It went
away and then came back last week. The stools have been maroon for about 24 hours.


How many times have you gone in the last 24 hours?




About 3 times.


Have you been feeling any weakness or fatigue?




That's another thing I wanted to talk to you about. I feel tired all the time. I sleep a
lot more, and have not been getting as much done as I used to. I think it started a few months
ago, but has gotten worse within the last week or two.


Any dizziness or fainting?




No, not at all. Just a general run-down
feeling.


Another question about the rectal blood.
When you finish stooling and wiping, if you put the toilet
paper back again, would you still see red blood?




No, it is just in the stools.


Do you have any history of peptic ulcer disease or hemorrhoids?




No.
 
Have you had any pain in your belly?




Just an occasional cramp.


Can you point to the area where you get
these cramps?




Right here, just above my navel.


When did these cramps start?




It's hard to remember. I only get them a few times per week, and they are gone in
a second. I suppose it has been 5 or 6 months.


Have these cramps gotten any worse lately?




They may be a little sharper now. Now that I think about it, they are coming a bit
more frequently, but it still is not bad at all.

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