[77M] Experiencing anemia, low blood pressure, dizziness, and blood in stool

Patient Description

A 77-year-old male has been experiencing significant lightheadedness rated 7/10, particularly when standing or exercising, for the past four weeks. The dizziness is immediate upon standing and improves with rest. Additionally, the patient has noticed black stools for 2-3 weeks, which has been confirmed as blood by a doctor. The patient also reports increased fatigue and near-fainting episodes. Medical history includes stage 3B kidney disease, high cholesterol, transient ischemic attack (TIA) strokes, and monoclonal gammopathy of undetermined significance (MGUS), all diagnosed within the last decade. Current medications include blood pressure medication, eloquis, and gout medication, with no known drug allergies.

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Arora's Assessment

What might be happening

Based on your symptoms, you may be experiencing:

  • Orthostatic Hypotension: This condition is characterized by a sudden drop in blood pressure when you stand up from a sitting or lying position, leading to dizziness or lightheadedness. It's more common in older adults and those with certain health conditions, including high blood pressure and heart diseases.

    • Treatment usually involves lifestyle changes, such as standing up slowly and avoiding dehydration. Medications may also be prescribed to manage blood pressure levels.
  • Gastrointestinal Bleeding: The presence of black stools, known as melena, is often a sign of bleeding in the upper gastrointestinal tract. This could be due to a variety of conditions, such as peptic ulcers, gastritis, or esophageal varices.

    • Treatment depends on the underlying cause. It may involve medications to reduce stomach acid, endoscopic procedures to stop the bleeding, or surgery in severe cases.
  • Anemia: This is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. It can cause fatigue and dizziness. In your case, it could be related to the gastrointestinal bleeding.

    • Treatment may involve dietary changes, iron supplements, or medications to stimulate red blood cell production.

What you can do

  1. Make an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may want to perform tests to confirm these diagnoses, such as a blood pressure test, blood tests, or an endoscopy to check for gastrointestinal bleeding.

  2. In the meantime, try to stand up slowly from sitting or lying positions to help manage your dizziness.

  3. Stay hydrated and eat a balanced diet. This can help manage your blood pressure and ensure you're getting enough nutrients, which is especially important if you're losing blood.

  4. Monitor your symptoms. If you notice any changes or if your symptoms worsen, seek medical attention immediately.

What you should look out for

Seek immediate medical attention if you:

  • Notice a significant increase in the amount of blood in your stool
  • Experience severe dizziness or fainting
  • Develop chest pain or shortness of breath
  • Have severe abdominal pain

Remember, I'm an AI and this advice is based on the information you provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

Top picked over-the-counter products for Orthostatic Hypotension: American Heart Association Guidelines

People Also Ask


What causes orthostatic hypotension and how can it be managed?

Orthostatic hypotension is caused by a sudden drop in blood pressure when standing up, often due to dehydration, prolonged bed rest, or certain medications. It can be managed by standing up slowly, staying hydrated, and sometimes using medications to stabilize blood pressure.


What are the common causes of black stools and how are they treated?

Black stools, or melena, are often caused by bleeding in the upper gastrointestinal tract, such as from peptic ulcers or gastritis. Treatment depends on the cause and may include medications to reduce stomach acid, endoscopic procedures, or surgery.


How does gastrointestinal bleeding lead to anemia?

Gastrointestinal bleeding can lead to anemia because the loss of blood reduces the number of red blood cells, which are necessary for carrying oxygen throughout the body. This can cause symptoms like fatigue and dizziness.


What are the risks of taking blood thinners like eloquis with gastrointestinal bleeding?

Blood thinners like eloquis increase the risk of bleeding, including gastrointestinal bleeding. It's important to monitor for signs of bleeding and consult a healthcare provider to balance the benefits and risks of continuing the medication.


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