Severe Symptoms: Blood in Stool, Fever, and Chest Pain

Blood in the stool, fever, and shortness of breath?

Hello doctor, on August 31, I experienced muscle soreness, and on September 1, I developed a fever.
I went to the clinic for a consultation and received medication.
On September 2, I still had a fever, along with chest tightness and difficulty breathing, so I went to the emergency room.
Blood tests, X-rays, and an electrocardiogram all came back normal.
The emergency department prescribed acetaminophen for pain relief.
On September 3 and 4, I continued to have a fever, but I also started to notice blood in my stool, with the toilet bowl filled with fresh blood.
As of September 5, there is still blood in the toilet, but I no longer have difficulty breathing.
What could be causing this situation? I am very concerned.
Thank you, doctor.

Ni, 20~29 year old female. Ask Date: 2018/09/05

Dr. Xu Kaixi reply Surgery

Rectal bleeding is considered an abnormal symptom and can range from common conditions like hemorrhoids to more serious gastrointestinal diseases.
Although emergency blood tests, electrocardiograms, and X-rays may return normal results, the cause of persistent and significant rectal bleeding remains unclear.
It is recommended to seek further evaluation at a surgical or gastroenterology outpatient clinic.

Reply Date: 2018/09/05

More Info

Hello, thank you for reaching out with your concerns. The symptoms you are experiencing—muscle pain, fever, chest pain, and particularly the presence of blood in your stool—are indeed alarming and warrant immediate medical attention.
Firstly, the combination of fever and chest pain can indicate several potential issues, ranging from infections to more serious conditions such as pneumonia or even cardiac issues. The fact that your initial tests (blood work, X-ray, and ECG) returned normal is a positive sign, but it does not rule out all possible causes. The presence of muscle pain could suggest a viral infection, which is common, especially if you have been experiencing fever.

However, the most concerning symptom in your case is the blood in your stool. This can be caused by a variety of conditions, some of which can be serious. Possible causes include:
1. Gastrointestinal Bleeding: This could be due to conditions such as hemorrhoids, diverticulosis, or more serious issues like inflammatory bowel disease (IBD) or colorectal cancer. The fact that you are seeing bright red blood typically suggests that the bleeding is occurring in the lower gastrointestinal tract.

2. Infections: Certain infections, particularly gastrointestinal infections, can lead to bloody diarrhea. This could be viral, bacterial, or parasitic in nature.

3. Medication Side Effects: If you have been taking any medications, especially non-steroidal anti-inflammatory drugs (NSAIDs) or blood thinners, these could contribute to gastrointestinal bleeding.

4. Vascular Issues: Conditions affecting blood vessels in the gastrointestinal tract can also lead to bleeding.

Given that you have been experiencing these symptoms for several days, it is crucial to seek further evaluation. I recommend that you return to the emergency department or consult a gastroenterologist as soon as possible. They may recommend additional tests such as a colonoscopy, which can help visualize the source of the bleeding and provide a definitive diagnosis.

In the meantime, monitor your symptoms closely. If you experience any worsening of your condition, such as increased pain, dizziness, or fainting, seek emergency care immediately.
It is understandable to feel anxious about these symptoms, but timely medical intervention is key. Please prioritize your health and ensure that you receive the appropriate care. Thank you for your question, and I wish you a swift recovery.

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