Blood in Stool: Causes and When to Seek Help - Surgery

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Blood in stool can be a concerning symptom, and it’s important to understand the potential causes and when to seek medical help. Given your medical history of lupus erythematosus and the medications you are currently taking, it’s crucial to approach this symptom with caution.


Possible Causes of Blood in Stool
1. Hemorrhoids: While you mentioned you have no prior history of hemorrhoids, they are a common cause of bright red blood in the stool. Hemorrhoids can develop due to increased pressure in the rectal area, often exacerbated by straining during bowel movements or prolonged sitting.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to bright red blood and may cause pain during bowel movements.

3. Gastrointestinal Inflammation: Conditions such as ulcerative colitis or Crohn's disease can cause inflammation in the digestive tract, leading to symptoms like blood in the stool, abdominal pain, and diarrhea. Given your autoimmune background, this could be a consideration.

4. Diverticular Disease: Diverticulosis can lead to diverticulitis, which may cause bleeding. This condition is characterized by small pouches that can form in the colon wall.

5. Polyps or Colorectal Cancer: Although less common, polyps can bleed, and colorectal cancer can present with blood in the stool. Given your age and medical history, this is a less likely cause, but it should not be ruled out.

6. Medication Side Effects: Some medications, including those used to treat lupus, can cause gastrointestinal issues. Methotrexate (MTX) and steroids can lead to gastrointestinal irritation, which might contribute to bleeding.


When to Seek Help
You should seek medical attention if you experience any of the following:
- Persistent Blood in Stool: Since you have been experiencing this symptom weekly, it is advisable to consult a healthcare provider.

- Abdominal Pain: While you mentioned localized pain, any significant or worsening abdominal pain should be evaluated.

- Changes in Bowel Habits: If you notice changes in your bowel habits, such as increased frequency or consistency changes, it warrants further investigation.

- Associated Symptoms: Symptoms like fever, weight loss, or severe fatigue alongside blood in the stool should prompt immediate medical evaluation.


Diagnostic Considerations
Given your symptoms and medical history, a colonoscopy may be warranted. This procedure allows for direct visualization of the colon and rectum, enabling the physician to identify any abnormalities such as hemorrhoids, fissures, polyps, or signs of inflammatory bowel disease.

Conclusion
In summary, while there are several potential causes for blood in your stool, some of which may be benign, it is essential to consult with a healthcare provider for a thorough evaluation. Given your history of lupus and current medications, it is particularly important to rule out any serious gastrointestinal issues. Early diagnosis and management can help prevent complications and ensure appropriate treatment. Please do not hesitate to reach out to your healthcare provider for further assessment and guidance.