Blood in Stool and GERD: When to Consider a Colonoscopy?

Blood in stool and gastroesophageal reflux?

Hello doctor, in August, I underwent an endoscopy due to chest tightness and was diagnosed with gastroesophageal reflux and inflammation.
Currently, I no longer have symptoms of chest tightness and have been taking pantoprazole regularly.
However, a month ago, I had a fecal occult blood test that showed a positive reaction.
My bowel movements are normal, occurring once a day, mostly in the form of logs or soft stools, with a normal color (yellow-brown).
However, I often notice objects resembling red fruit skins attached to the toilet paper and the surface of the stool.
Recently, my diet has been greasier, and I frequently experience mild abdominal bloating and pain.
Blood tests and a 24-hour urine test have returned normal results.
After using the restroom, I experience intermittent pain in the anal area that lasts for a short while, and I also feel pain while riding a bike.
Do I need to undergo a colonoscopy?

shang, 20~29 year old female. Ask Date: 2016/11/03

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It is recommended to undergo a (non-painful) colonoscopy to check for any lesions.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/11/03

More Info

When it comes to the presence of blood in stool, especially in the context of a history of gastrointestinal issues like gastroesophageal reflux disease (GERD), it is essential to approach the situation with caution and thoroughness. Your symptoms, including the presence of blood in your stool and the discomfort you experience, warrant a detailed evaluation.

Firstly, the presence of blood in the stool can arise from various sources within the gastrointestinal tract. It can be due to hemorrhoids, anal fissures, diverticular disease, or more serious conditions such as colorectal cancer or inflammatory bowel disease. Given your history of GERD and the recent findings of blood in your stool, it is prudent to consider a colonoscopy. This procedure allows for direct visualization of the colon and rectum, enabling the identification of any abnormalities such as polyps, inflammation, or lesions that could be causing the bleeding.

Your description of the stool being mostly normal in color but occasionally having red fruit-like debris could suggest several things. It might be remnants of undigested food, particularly if you have been consuming more fibrous or fruit-based foods. However, the fact that you have also had a positive fecal occult blood test indicates that there is indeed some bleeding occurring, which should not be ignored.

The abdominal discomfort and pain you experience, particularly after bowel movements and during activities like riding a bike, could be indicative of several conditions, including hemorrhoids or anal fissures, which are common and can cause pain and bleeding. However, given your symptoms and the potential for more serious underlying conditions, it is essential to rule out any significant pathology.

In terms of your gastrointestinal health, it is also important to consider dietary factors. You mentioned an increase in oily foods, which can exacerbate symptoms of GERD and may contribute to gastrointestinal discomfort. A diet high in fiber, adequate hydration, and avoiding irritants such as spicy or fatty foods can help alleviate some of your symptoms.

In summary, given your symptoms of blood in the stool, abdominal pain, and a history of GERD, it is advisable to consult with a gastroenterologist about the need for a colonoscopy. This procedure is a critical step in diagnosing the cause of your symptoms and ensuring that any potential issues are addressed promptly. Additionally, maintaining a healthy diet and monitoring your symptoms closely will be beneficial as you navigate this situation. Always prioritize open communication with your healthcare provider to ensure that you receive the appropriate care and follow-up necessary for your health.

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