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Blood in stool

Does anyone have a problem with bright red blood being passed with a bowel movement?
My Daughter has been having this for the last few months. She has always had constipation and almost never diarrheah. I've always thought that the hard stool from constipation may have made cuts along the anal canal resulting in bleeding.
She says that the bleeding sometimes lasts for a few hours after a BM.
Any ideas, or is this something to be overly concerned with?


Tom.
 

Jennifer

Adminstrator
Staff member
Location
SLO
Hi 73monte, I'm sorry your daughter is going through this. :(

It could be a fissure or hemorrhoid but may also be bleeding somewhere higher up due to inflammation and/or ulcers (generally the blood may be mixed in with the stool). Has she had any tests done recently (colonoscopy etc)? Have you told her GI about it?

I didn't have constipation (although some do) and had bright red blood (toilet was full of blood) and was bleeding from my terminal ileum. Generally the darker the blood the further up the bleeding may be (or may be held in for a longer period of time) but bright red blood can come from the small intestine as well as the colon.

Its best to have testing done to find out the actual cause so it can be treated. If left untreated then you run the risk of anemia and if its not from a fissure or hemorrhoid then further damage will be done to the intestines which could lead to surgery.

I was bleeding a lot and was taken to the ER where they ran tests and hospitalized me. I almost needed a transfusion (other members on the forum have had to have one or many). So for me blood is always concerning and should be treated as soon as possible.
 

nogutsnoglory

Moderator
Bright red blood is indicative of an issue in the last part of the colon or rectum. The darker it is the more up in the GI. It is concerning because she shouldn't be bleeding and it had been going on for a long time. Have you discussed this with a doctor? It is possible that she is straining and the stool is ripping an already sensitive anus. Is the blood in the stool itself, in the water or on the toilet tissue? How much blood are we talking about? With continued blood loss you need to worry about iron deficiency. I would definitely get that checked out.
 
Jennifer/noguts:

Thanks for the prompt replies.

Haven't discussed this with the GI, as she just told me that this has been going on. We did discuss it once before several years ago, but the GI wasn't concerned as it was only once in a while. She said that blood is deceiving because when it hits the water it makes it look like considerably more than itis.
So not sure how much blood we're talking about, but it's in the water not the stool.
She does start Remicade in 2 weeks. Maybe that will resolve these issues.
 

Jennifer

Adminstrator
Staff member
Location
SLO
It may help but its also a good idea to have blood work done to make sure she's not anemic and if she is then she can begin supplementing now. Truthfully any visible blood should be reported to the GI. They can at least do a rectal exam to rule out hemorrhoids as the cause so if its just that then you can have some peace of mind. Even then I still recommend blood work. Keep us posted on how she's doing. :)
 
Jennifer and Mickey,

Thanks for the advice. I too figured bright red is better. She has been anemic from the time she was diagnosed. Took iron supplements for several years, but as the disease progressed, it just became too constipating for her.
We've tried different iron supplement, even the newer polyride fe, which is suppose to be much gentler. Same constipating effect though.
Our GI and GP are both against iron infusions for some reason.
As I said, we'll see how all these symptoms evolve after she starts Remicade.

Tom.
 

Jennifer

Adminstrator
Staff member
Location
SLO
I honestly don't feel that any blood is good in any way. Like I said I had bright red blood coming from my terminal ileum. Even though she's starting Remicade soon it would be a good idea to inform her GI as Remicade can take a while to start working so they may want to add another medication on top of it to get her symptoms under control faster. Maybe they'll be more inclined to try iron infusions since she's currently dealing with blood loss and has not done well with supplements. I'd ask her GI and GP about their reasoning behind not wanting to do iron infusions.
 
I'm glad I read this thread, because i'm dealing with the same thing right now. I had a colonoscopy and endoscopy two weeks ago, and have my follow up with my GI Doctor tomorrow. I was on no meds whatsoever and my Crohn's got out of control. I'm now on Prednisone and Pentasa, and while I feel better, i'm having daily bloody BM's. Bright red blood, kind of painful/burning when I go to the bathroom.

But, it could be fissures or internal hemorrhoids. I would definitely suggest reaching out to her GI Doctor to see what's going on. Hope things get better soon!
 
Twinkle Toes,

My Daughter's first Remicade infusion is today. I'm hoping that once the Remicade starts working, that the blood may stop.
Please let me know what your GI says at the follow-up to your scopes.
Thanks for your reply, and good luck.

Tom.
 
araceli,

Thanks for the good wishes. Having both a daugther and son experiencing health issues must be challenging.
It's good that your daughter has started Remicade early on. I wish in hindsight that we had done the same.
You don't want the disease to do permanent damage.
How's the Remicade working for her so far?

Tom.
 
She started remicade 6 months ago due to anal fissures. It worked very good and still does. Only problem, its raising her liver enzymes to soon. So we will know by next dose if she has to stop treatment or not.
 
Hi Monte -

After my appointment with my GI Doc yesterday, she had the following:
-I have a lot of inflammation, which has been going on for quite some time now. While Prednisone and Pentasa have obviously been working, she is concerned that with the level of inflammation that I have that Pentasa may not be strong enough.
-She is going to wean me off of the Prednisone and move me from Pentasa to Remicade or Humira depending on what I choose.
-She thinks that the bleeding may be coming from my fistulas or my colon area, because that area is inflamed and "thicker" than it should be. She thinks that the changes in my BM's from being mostly runny to now partially solid may have irritated it. I also think it's from when I had a fiber-binge last week and strained out 3 HUGE BM's (like, felt like I was giving birth) and started bleeding after that. She recommended that I follow up with my surgeon who works with that stuff and have him do a small exam to see and make sure i'm okay. But, she does not believe that it is colon cancer, just the fistulas (which I obviously have).

Let me know if you have any other questions - hope this helps. :)

Twinkle Toes,

My Daughter's first Remicade infusion is today. I'm hoping that once the Remicade starts working, that the blood may stop.
Please let me know what your GI says at the follow-up to your scopes.
Thanks for your reply, and good luck.

Tom.
 
Hi T.T.,

Sound like you have the information that you need to make a decision on which course of action to take now. This will make the choice of going to anti-TNF's much easier.
We too were given the choice of Remicade or Humira, but I think most of the studies indicate that Remicade has a higher success rate.
Yesterday, my Daughters first infusion went well. No apparent side effects. She even said the pain/tenderness that's been in her lower ride side, (TI), for years stopped. Not sure if it's just a coincidence, but it was good to hear. Good luck again.

Tom.
 
That sounds good! I am still researching my options. I like Humira because I like that it is convenient. Ultimately I want to go with what will help me heal best. Lots to choose from.
 
Just a quick update. My Daughter had her first Remicade infusion, (loading dose), on Tuesday, as I previously indicated. Today is the first time in four months that she had a BM without having passed blood.
So far no apparent side effects. I'm still pretty worried, but I think this is good news.

Tom.
 
Hey Tom, today is also the first time in a week that I have passed a stool without blood. So glad to hear the Remicade is working so far! Keep us posted.
 
Scratch that - just had one with blood. Sigh. Either way, i'm going to see my other doctor in a couple weeks to find out what's up.
 
I pass blood off and on. At the last scope my disease is of course at the terminal ileum and for the next 2 feet up from there. The Doc always look at me funny when I tell them the color is "maroon". Not sure they know what I'm talking about:lol2:

I can usually tell when it's going to show up. Feels like the poo is passing over sand paper inside me. Kind of like open sores.

Anyone else get this? :eek2:
 
Hi Tom. I am glad she is doing a lot better. It is great that with the first infusion, she is feeling better. I hope she keeps improving. Let us know.
 
T.T.,

Sounded good for a second there. Hopefully, once you decide on which anti-TNF you're going with, you'll see these improvements quickly as well.



araceli:

Thanks for the support. I'll certainly keep you posted.

Tom.
 
Update:

Just wanted to add, that yesterday was my Daughter's second infusion. It also went well, with no apparent negatives
She's hasn't had any blood passing in the last 2 weeks now. That's after blood in every BM for four months.

Tom.
 
I completely understand. A few days ago I had a BM with minimal blood and felt optimistic. Then, 30 min later had another with blood. It just doesn't ever end!

Try to stay positive though. :)
 
Not too much. Still have bloody stools, but they don't hurt as much as they used to like a couple weeks ago.

I go to see my surgeon next week to see what it is. I do have fistulas, but I've had fissures before, or who knows, maybe it's a hemorrhoid. Honestly, I try not to stress about it anymore. When I spoke with my GI a couple weeks ago, she told me that the area down there was "thickened" and I think it's just from going to runny BM's for 6 months to solid BM's now, that i'm just not used to it.

Other than that (and my insomnia, weight gain, and feeling like a weirdo on the prednisone), I meet with my GI again on June 4th to discuss my next medication options. She told me that i'll have a choice of Imuran, Remicade or Humira. Still not sure which ones I want to do...
 
My Daughter too has fistulas going on, perhaps even multiple fistulas. That was one of the reasons for choosing Remicade. It seems to have the best track record for that sort of thing.
At least June 4th isn't too far off. Good luck with your decision.
 
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