Blood in Stool: When to Seek Further Gastrointestinal Evaluation

Blood in the stool?

Hello, doctor.
About two years ago, I underwent a colonoscopy due to mucus and blood in my stool.
The findings showed diverticula and hemorrhoids, and the doctor said it was not a concern.
However, I still occasionally notice mucus and blood in my stool (the blood is mixed with the stool and mucus, and the color is dark red, not bright red).
I would like to know if my shouting in pain during the colonoscopy could have distracted the physician.
Do I need to undergo another colonoscopy? I also frequently experience gastric discomfort and have excessive and foul-smelling gas.
Should I consider getting an upper endoscopy or other examinations?

W, 20~29 year old female. Ask Date: 2018/04/18

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It may not be necessary, but a fecal occult blood test can be performed.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/04/18

More Info

When it comes to gastrointestinal health, the presence of blood in stool can be a concerning symptom that warrants further evaluation. In your case, you have a history of experiencing blood mixed with mucus in your stool, which was previously attributed to diverticula and hemorrhoids during a colonoscopy. However, the recurrence of these symptoms, especially with the change in color of the blood to dark red, raises several important considerations.

Firstly, it is essential to understand that the color and consistency of blood in stool can provide clues about the source of bleeding. Dark red blood often indicates that the bleeding is occurring from a source that is higher up in the gastrointestinal tract, such as the colon or even the upper gastrointestinal tract, while bright red blood typically suggests bleeding from the lower rectum or anus. Given that you have experienced dark red blood mixed with stool, it is prudent to consider a re-evaluation of your gastrointestinal health.

The discomfort you experienced during your previous colonoscopy could indeed have affected the physician's ability to thoroughly examine your colon. Pain can lead to involuntary movements and tension, which may hinder the procedure. If there were any areas that were not adequately visualized due to discomfort, it is possible that some lesions or abnormalities could have been missed. Therefore, if you continue to experience symptoms such as blood in your stool, it is advisable to discuss the possibility of undergoing another colonoscopy with your healthcare provider. They may also consider using sedation or other pain management techniques to ensure a more thorough examination.

In addition to the colonoscopy, your symptoms of persistent gastric discomfort and excessive foul-smelling gas could indicate an underlying issue that may require further investigation. Conditions such as gastritis, peptic ulcers, or even gastrointestinal infections could contribute to these symptoms. A gastroscopy (upper endoscopy) could be beneficial in evaluating the upper gastrointestinal tract, especially if you are experiencing ongoing discomfort in the stomach area. This procedure allows for direct visualization of the esophagus, stomach, and duodenum, and can help identify any abnormalities such as inflammation, ulcers, or lesions.

Moreover, it is important to consider other diagnostic tests that may provide additional insights into your gastrointestinal health. For instance, stool tests can help identify infections or the presence of blood that may not be visible to the naked eye. Imaging studies, such as abdominal ultrasound or CT scans, can also be useful in assessing for any structural abnormalities or complications related to diverticulitis or other gastrointestinal conditions.

In summary, given your history and the recurrence of symptoms, it is advisable to seek further evaluation from your healthcare provider. A repeat colonoscopy may be warranted to ensure that no significant lesions have been overlooked, especially considering the discomfort you experienced during the previous procedure. Additionally, a gastroscopy could help address your gastric symptoms. Open communication with your physician about your symptoms, concerns, and the need for further testing is crucial in managing your gastrointestinal health effectively. Remember, early detection and intervention can significantly improve outcomes in gastrointestinal disorders.

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