Occasional Blood in Stool: A Gastrointestinal Concern

Occasionally, there is a small amount of blood in the stool?

Hello, doctor.
At the beginning of February this year, I started feeling a tremor in my head, and on two occasions while standing, I felt blood rushing to my head.
At that time, I was regularly donating blood, and my blood pressure was consistently a bit high, around 160/90.
My weight was 116 kg, and after returning from vacation on March 5, my weight increased to 118 kg.
At the end of March, due to discomfort in my head, I visited a doctor who prescribed Forxiga for weight loss (I do not have diabetes).
A week later, on April 5, I returned for a follow-up due to discomfort near my heart.
An ECG showed no issues, but my blood pressure was still high at 155/101.
The doctor prescribed Olmetec for blood pressure management.
I took it for two days, and on the morning of April 7 at 11 AM, I felt numbness in the back of my head, dizziness, and numbness in my limbs.
A friend called an ambulance, and after examination at the hospital, the doctor said it was a side effect of the medication.
The next day, April 8, during a follow-up, the doctor advised me to stop taking the blood pressure medication.
On April 9, I stopped the weight loss medication; at that time, my weight was 110 kg, and I had lost about 6 kg in two weeks.
After that, I continued to feel heaviness in the back of my head and occasional tremors.
On April 10 and 11, I experienced insomnia and felt a pulsing sensation in the back of my head while trying to sleep.
By April 12, I started to regain my sleep, but the heaviness and tremors persisted, leading to increased anxiety.
During this month, I underwent a brain CT scan due to head discomfort, which showed no abnormalities.
I also had kidney and liver ultrasounds that were normal.
Concerned about potential kidney issues, I had blood and urine tests done, which were also normal.
I consulted two doctors, both of whom said there were no issues and that I was just too anxious.
However, the discomfort in my head continued.
Recently, I have been monitoring my blood pressure frequently due to my walking exercise, arm swinging, and reduced food intake, managing to control my weight to around 100 kg.
My blood pressure is now not too high, approximately 130/80, but my heart rate has been consistently low, around 40-50 beats per minute.
On August 5, 2016, I started taking herbal medicine for body regulation, which led to diarrhea and some gastric discomfort.
I have been having bowel movements once in the morning and once at night.
Last week, on May 22, 2016, I finished the herbal treatment, and on May 23, 2016, I started feeling a bit cold-like symptoms.
On May 24, 2016, I noticed some red in my stool, unsure if it was blood, but there was no blood on the toilet paper.
In the following days, there was no red, but in the last two days during bowel movements, I noticed red again, although there was no blood on the toilet paper.
The stool was small and elongated.
The cold symptoms have persisted until now, and for the past two days, I have felt a warm sensation in my stomach.
I have been feeling strange for this entire month.
Is there something wrong with my gastrointestinal system, doctor?

Alvin, 40~49 year old female. Ask Date: 2016/05/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
You may first visit the gastroenterology department to check for occult blood in your stool, and medication adjustments will be made based on the findings.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/05/30

More Info

Experiencing occasional blood in the stool can be concerning and often indicates an underlying gastrointestinal issue that requires attention. Based on the symptoms you've described, including the presence of red streaks in your stool, changes in bowel habits, and gastrointestinal discomfort, it is essential to consider several potential causes and the necessary steps for evaluation and management.

First, the presence of blood in the stool can arise from various sources within the gastrointestinal tract. The blood may be bright red, indicating a lower gastrointestinal source, such as hemorrhoids, anal fissures, or diverticular disease. Alternatively, darker blood or "tarry" stools can suggest bleeding from higher up in the digestive tract, such as the stomach or small intestine, potentially due to conditions like peptic ulcers or gastritis.

Given your history of gastrointestinal symptoms, including discomfort and changes in bowel habits, it is crucial to consider the possibility of conditions such as gastritis or inflammatory bowel disease (IBD). Your previous diagnosis of superficial gastritis, as noted in your endoscopy report, could contribute to gastrointestinal discomfort and changes in stool appearance. Additionally, the use of medications, including those for blood pressure and diabetes management, can sometimes lead to gastrointestinal side effects, including nausea, diarrhea, or changes in bowel habits.

The fact that you have experienced significant weight fluctuations and have been under stress may also contribute to gastrointestinal symptoms. Stress can exacerbate conditions like irritable bowel syndrome (IBS), leading to changes in bowel habits, including diarrhea or constipation, and can sometimes cause a sensation of urgency or discomfort.

It is also important to consider the role of diet and hydration in your symptoms. Changes in diet, particularly if you have recently altered your eating habits or reduced caloric intake, can lead to changes in stool consistency and frequency. Additionally, dehydration can result from diarrhea, which may further complicate your gastrointestinal health.

In your case, the intermittent presence of red streaks in your stool, coupled with gastrointestinal discomfort and a history of high blood pressure and weight management, warrants further investigation. It is advisable to consult a gastroenterologist for a comprehensive evaluation. This may include additional diagnostic tests, such as a colonoscopy, to assess for any potential sources of bleeding or inflammation in the gastrointestinal tract.

In summary, while occasional blood in the stool can be attributed to benign causes such as hemorrhoids or dietary changes, it is essential to rule out more serious conditions. Given your symptoms and medical history, seeking medical advice is crucial for appropriate diagnosis and management. Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and stress management, can also support your overall gastrointestinal health. Please ensure to follow up with your healthcare provider to address these concerns and receive the necessary care.

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