Blood in Diarrhea: Is It Inflammatory Bowel Disease?

Bloody diarrhea

I previously experienced diarrhea with blood.
Recently, I visited the hospital, and the doctor mentioned that it might be colitis.
I was prescribed gastrointestinal medication and probiotics, and I was advised to monitor my stool.
I would like to ask if colitis can lead to intestinal changes.
I have had episodes of diarrhea with blood in the past; could this be chronic colitis or ulcerative colitis? (I had a colonoscopy two years ago, and the doctor did not mention any abnormalities or specifically check for these conditions.) On the day of my visit, the doctor seemed to notice that I was very anxious and told me that if I wanted to have another colonoscopy, I should wait for a while because inflammation in the intestines is not suitable for the procedure.
How necessary is it to undergo another colonoscopy?

S, 20~29 year old female. Ask Date: 2018/06/06

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like irritable bowel syndrome (IBS).
I recommend starting with a light diet and maintaining a good lifestyle routine.
Spicy, irritating, and greasy foods should be avoided, and increasing plant fiber intake can also be beneficial.
Although the likelihood is low, the age of 25 is also a common age for ulcerative colitis or Crohn's disease to manifest.
If symptoms persist without improvement, you may want to consult a physician for medication or to undergo a colonoscopy.
If you had a colonoscopy two years ago with no abnormalities, I personally believe there is no need to repeat it.
However, if there are changes in clinical symptoms or if the patient is very anxious, it would be appropriate to consider another colonoscopy.

Reply Date: 2018/06/06

More Info

When it comes to the presence of blood in diarrhea, it can be quite alarming and is often indicative of underlying gastrointestinal issues. Your recent experience with bloody diarrhea and the diagnosis of colitis (inflammation of the colon) raises several important considerations regarding your health.

Firstly, it’s essential to understand that blood in the stool can arise from various causes, including but not limited to inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn's disease, infections, hemorrhoids, or even anal fissures. Given your history of bloody diarrhea and the recent diagnosis of colitis, it is reasonable to consider the possibility of IBD.
Inflammatory bowel diseases are chronic conditions characterized by inflammation of the gastrointestinal tract. Ulcerative colitis specifically affects the colon and rectum, leading to symptoms such as diarrhea (often bloody), abdominal pain, and urgency. Crohn's disease can affect any part of the gastrointestinal tract and may also present with similar symptoms. The fact that you have experienced bloody diarrhea on multiple occasions, coupled with your previous colonoscopy results showing no abnormalities, suggests that ongoing monitoring and evaluation are warranted.

Your physician's recommendation to observe your stool and to start treatment with gastrointestinal medications and probiotics is a common approach. These treatments can help manage inflammation and restore gut flora, which may alleviate some symptoms. However, the concern about potential long-term damage to the intestines due to chronic inflammation is valid. Chronic inflammation can lead to complications such as strictures, fistulas, or even an increased risk of colorectal cancer over time.

Regarding the necessity of repeating a colonoscopy, it is a nuanced decision. While your previous colonoscopy did not reveal any abnormalities, the presence of ongoing symptoms, especially bloody diarrhea, may warrant further investigation. Your doctor mentioned that performing a colonoscopy during active inflammation is not ideal, as it can increase the risk of complications and discomfort. Therefore, it may be prudent to wait until your symptoms stabilize before considering another colonoscopy.

In the interim, keeping a detailed record of your symptoms, dietary habits, and any potential triggers can be beneficial. This information can help your healthcare provider make more informed decisions regarding your treatment and the timing of any further diagnostic procedures. Additionally, if your symptoms worsen or new symptoms arise (such as significant weight loss, persistent fever, or severe abdominal pain), it is crucial to seek medical attention promptly.

In conclusion, while your current treatment plan is a reasonable first step, ongoing communication with your healthcare provider is essential. Discuss your concerns about the potential for chronic conditions like ulcerative colitis or Crohn's disease, and consider scheduling a follow-up appointment to reassess your symptoms and the need for further diagnostic testing. Early detection and management of inflammatory bowel diseases can significantly improve outcomes and quality of life.

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