A 62-year-old man presents to the emergency department with significant bright red rectal bleeding for the last 6 h. He has no abdominal pain and has not vomited. There is no previous history of altered bowel habit. His appetite is normal and he reports no recent weight loss. He has regular oesophagogastroduodenoscopy (OGD) because of a strong family history of stomach cancer. The last endoscopy was 2 months ago and was clear. He has recently been diagnosed with mild hypertension.
He takes bendroflumethiazide 2.5 mg once daily and smokes 5 cigarettes per day. Examination He appears pale and sweaty. His blood pressure is 92/60 mmHg and his pulse is thready with a rate of 116/min. His temperature is normal. His abdomen is soft with no evidence of distension. The rest of his examination is unremarkable. Rectal examination reveals altered blood mixed with the stool and there are some blood…
