Post-Colonoscopy Blood in Stool: Causes and Concerns

Blood in stool after colonoscopy?

Hello, doctor.
I apologize for the interruption.
Two months ago, I had a diagnosis of excessive sweating and dampness, and I consulted a traditional Chinese medicine practitioner.
The doctor prescribed some herbs that were intended to eliminate dampness, but one of the side effects was diarrhea.
After taking the medication for two weeks, my sweating and skin condition improved, but I also experienced continuous diarrhea for two weeks.
During this time, I had a company health check, and the results showed an abnormal fecal occult blood test (400).
Later, I returned to the hospital for a follow-up, and the doctor recommended an upper endoscopy and a colonoscopy, which I completed this past Tuesday.
The doctor indicated that everything was normal.
However, during the colonoscopy, I noticed on the screen that there was bleeding from the colon wall, and the doctor explained that it was due to abrasion from the colonoscope and advised not to worry.
The day after the procedure, I had a total of 4-5 bowel movements, each with only a small amount, and when wiping, there was a bit of blood on the toilet paper, though not much—just a faint pink color.
For the next two days, my bowel movements returned to the normal frequency of once a day, but the stools were small and loose, and there was still a bit of blood on the toilet paper.
This morning, my stool was black, although only a small amount, and in the evening, I noticed blood in my stool (not much), with the stool appearing bright red.

My questions are:
1.
Could the abnormal fecal occult blood test be caused by diarrhea?
2.
Since the upper endoscopy and colonoscopy showed no issues, could the daily presence of blood (though minimal) be due to the abrasion?
3.
If I continue to have bloody stools over the next few days, will I need to undergo another colonoscopy to determine the cause of the bleeding?
I appreciate your time in addressing these questions.
Thank you.

Rex, 20~29 year old female. Ask Date: 2016/07/23

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Mr.
REX, your fecal occult blood test result suggests that there may be bleeding in the gastrointestinal tract.
If you have scheduled an endoscopy, there is likely no need for concern; however, if the bleeding persists, it is advisable to discuss this further with your doctor to reassess the bleeding situation.
As for whether it is caused by a abrasion, if that is the case, it should heal within a week.
Changhua Hospital cares about your health.

Reply Date: 2016/07/23

More Info

Post-colonoscopy bleeding can be a concerning issue for many patients, especially when it manifests as blood in the stool. Understanding the causes and implications of this symptom is crucial for managing your health effectively.
1. Potential Causes of Blood in Stool: After a colonoscopy, it is not uncommon for patients to experience some bleeding, particularly if biopsies were taken or if there was any manipulation of the bowel during the procedure. The bleeding you observed, described as light pink on toilet paper, could indeed be attributed to minor abrasions or irritation of the bowel wall from the colonoscopy. This is generally considered normal and should resolve on its own within a few days. However, if the bleeding persists or worsens, it could indicate a more significant issue that requires further investigation.

2. Impact of Diarrhea on Fecal Occult Blood Test: The abnormal fecal occult blood test result you received prior to the colonoscopy could potentially be influenced by diarrhea. Diarrhea can cause irritation and inflammation of the intestinal lining, which may lead to small amounts of blood being present in the stool. However, it is essential to note that while diarrhea can contribute to false positives in fecal occult blood tests, it does not rule out the possibility of other underlying conditions that could cause bleeding, such as polyps or inflammatory bowel disease.

3. Ongoing Symptoms and Further Evaluation: The presence of black stools (melena) and fresh red blood in your stool after the colonoscopy raises some concerns. Black stools can indicate bleeding from the upper gastrointestinal tract, while fresh red blood typically suggests bleeding from the lower gastrointestinal tract. Given that you have experienced ongoing bleeding, it is advisable to follow up with your healthcare provider. They may recommend another colonoscopy or additional imaging studies to determine the source of the bleeding, especially if it continues for more than a few days or if the volume of blood increases.

4. When to Seek Immediate Care: If you experience significant changes in your symptoms, such as increased volume of blood, severe abdominal pain, dizziness, or fainting, you should seek immediate medical attention. These could be signs of a more serious condition that requires urgent intervention.

5. Management and Follow-Up: In the meantime, it is essential to monitor your symptoms closely. Keeping a record of the frequency and characteristics of your bowel movements, as well as any associated symptoms, can be helpful for your healthcare provider in assessing your condition. Additionally, maintaining hydration is crucial, especially if you are experiencing diarrhea.

In summary, while some bleeding after a colonoscopy can be normal, ongoing or worsening symptoms should not be ignored. It is essential to communicate with your healthcare provider about your concerns and follow their recommendations for further evaluation and management. Regular follow-ups and open communication about your symptoms will help ensure that any potential issues are addressed promptly.

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