Blood in Diarrhea: Causes and When to Seek Help

Bloody diarrhea

Hello, doctor.
Two days ago, I drank avocado milk, and that night I had diarrhea twice.
The first stool was formed and had no blood, but the second time there was some mucus mixed with blood.
I consulted two doctors; one told me it might not necessarily be blood and advised me to test for fecal occult blood, while the other said it was intestinal inflammation and that the fecal occult blood test would definitely be positive.
Should I wait until I feel better to get tested, or should I test for fecal occult blood immediately? Also, could you explain why drinking milk might cause blood in the stool? Last year, I had a similar issue with blood in my stool after eating yogurt.
When I was younger, I could drink a lot of milk without any problems.
I'm worried it could be an autoimmune disease like ulcerative colitis or Crohn's disease, but the doctors said it probably isn't.
Additionally, isn't intestinal inflammation caused by bacteria, viruses, or autoimmune conditions? Could drinking milk trigger autoimmune enteritis? Since I discovered blood in my stool three years ago, I had a colonoscopy, which showed hemorrhoids and diverticula, but I still experienced blood in my stool several times afterward, with two instances of more severe diarrhea with mucus and blood.
After seeing multiple doctors, I still feel very worried and helpless.
If it were ulcerative colitis, would it have been detected three years ago? If it wasn't present then, could it develop now? I'm sorry for the many questions, but I would appreciate your help.
Thank you.

W, 20~29 year old female. Ask Date: 2019/08/05

Dr. Ke Fangxu reply Surgery

Drinking milk and experiencing diarrhea is generally caused by lactose intolerance.
However, at your age, it could also be due to ulcerative colitis or Crohn's disease.
Since you had a colonoscopy three years ago, this possibility should be ruled out.
I recommend that you avoid dairy products for now and monitor your symptoms.
If bleeding occurs again, you may consider having another colonoscopy.

Reply Date: 2019/08/05

More Info

Blood in diarrhea can be alarming and may indicate a range of underlying conditions, some of which require immediate medical attention. Understanding the potential causes and when to seek help is crucial for managing your health effectively.

Causes of Blood in Diarrhea
1. Infections: Bacterial, viral, or parasitic infections can lead to inflammation of the intestines, resulting in diarrhea that may contain blood or mucus. Common culprits include Salmonella, Shigella, and E. coli.

2. Inflammatory Bowel Disease (IBD): Conditions such as ulcerative colitis and Crohn's disease are characterized by chronic inflammation of the gastrointestinal tract. These conditions can cause symptoms like abdominal pain, diarrhea, and blood in the stool.

3. Diverticular Disease: Diverticulitis, which occurs when diverticula (small pouches) in the colon become inflamed or infected, can lead to bleeding and changes in bowel habits.

4. Hemorrhoids: While not a serious condition, hemorrhoids can cause bright red blood in the stool, especially during bowel movements.

5. Polyps or Colorectal Cancer: Abnormal growths in the colon can lead to bleeding. While less common, it is essential to rule out these serious conditions, especially if you have a family history of colorectal cancer.

6. Food Intolerances: Some individuals may experience gastrointestinal symptoms, including blood in the stool, due to intolerances or allergies to certain foods, such as dairy products.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Blood in your stool, especially if it is persistent or accompanied by other symptoms like severe abdominal pain, fever, or dehydration.

- A significant change in bowel habits, such as prolonged diarrhea or constipation.

- Symptoms of dehydration, such as excessive thirst, dry mouth, or decreased urination.

Your Specific Situation
In your case, the presence of blood mixed with mucus in your stool after consuming avocado milk raises some concerns. While it is possible that the blood is related to an underlying condition, it is also important to consider the possibility of food intolerances or allergies, especially if you have had similar reactions in the past after consuming dairy products.

The two doctors you consulted provided different perspectives. One suggested testing for occult blood in the stool, which is a reasonable approach to determine if there is hidden blood that may not be visible. The other indicated that inflammation of the intestines could be the cause, which aligns with the symptoms you described.

Given your history of hemorrhoids and diverticula, it is essential to monitor your symptoms closely. If you experience further episodes of blood in your stool or worsening symptoms, it would be prudent to undergo further evaluation, such as a stool test or even a colonoscopy, to rule out any serious conditions.

Conclusion
While it is understandable to feel anxious about the possibility of serious conditions like ulcerative colitis or Crohn's disease, it is important to remember that many causes of blood in diarrhea are treatable. If you have concerns about your symptoms or if they persist, consider seeking a second opinion or consulting a gastroenterologist who specializes in digestive disorders. They can provide a more comprehensive evaluation and guide you through the necessary tests and treatments.

In summary, blood in diarrhea can stem from various causes, and while some may be benign, others require prompt medical attention. Monitoring your symptoms and seeking appropriate medical care is crucial for your health and peace of mind.

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