Blood in Stool After Norovirus: Causes and Concerns

Diarrhea that turns into bloody stools?

Hello Doctor, I was diagnosed with norovirus three days ago.
On the first day, I had a fever and experienced vomiting and diarrhea.
On the second day, I stopped vomiting, and the frequency of watery stools decreased.
By the third day, I had neither vomiting nor diarrhea, so I ate a little rice porridge for dinner.
However, later when I had a bowel movement, there was a large amount of blood along with a small amount of stool.
I felt slight discomfort in both sides of my lower abdomen.
Now, during my second bowel movement, there is again a large amount of blood and a little stool.
The toilet is too murky to see the stool color clearly, but the tissue shows a deep brown color with yellow liquid, and the blood appears somewhat mucous and bright red.
I have been taking medication and replenishing fluids and electrolytes.
I would like to ask the doctor if this is also related to an exacerbation of enteritis.
Thank you for your help.

Xiao Hei, 20~29 year old female. Ask Date: 2020/03/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

Please have the gastroenterology outpatient clinic perform a flexible sigmoidoscopy or colonoscopy as needed.

Reply Date: 2020/03/09

More Info

Experiencing blood in your stool after a bout of norovirus can be concerning, and it’s important to understand the potential causes and implications of this symptom. Norovirus typically causes gastroenteritis, which is characterized by symptoms such as vomiting, diarrhea, abdominal pain, and fever. While most individuals recover from norovirus without complications, the presence of blood in the stool is not a typical symptom of norovirus infection and warrants further investigation.

Possible Causes of Blood in Stool After Norovirus
1. Intestinal Inflammation: The gastrointestinal tract can become inflamed during a norovirus infection, leading to irritation and damage to the intestinal lining. This inflammation can cause bleeding, which may present as blood in the stool.

2. Hemorrhoids or Anal Fissures: The severe diarrhea associated with norovirus can lead to straining during bowel movements, which may cause hemorrhoids or anal fissures. These conditions can result in bright red blood on the stool or toilet paper.

3. Secondary Infections: After a viral infection, the gut may be more susceptible to bacterial infections, which can lead to conditions such as bacterial gastroenteritis or colitis. These infections can cause inflammation and bleeding.

4. Other Gastrointestinal Conditions: Conditions such as inflammatory bowel disease (IBD), diverticulitis, or even colorectal cancer can cause blood in the stool. While these are less likely to be directly related to norovirus, they should be considered, especially if the bleeding persists.

Symptoms to Monitor
Given your symptoms of abdominal pain and the presence of blood in your stool, it is crucial to monitor for additional symptoms that may indicate a more serious condition, such as:
- Increased Abdominal Pain: If the pain becomes severe or localized, it may indicate a more serious issue.

- Fever: A high fever may suggest an infection that requires medical attention.

- Persistent or Worsening Symptoms: If diarrhea returns or if you continue to see blood in your stool, it is essential to seek medical care.

When to Seek Medical Attention
You should seek medical attention promptly if you experience any of the following:
- Continued Blood in Stool: If the blood persists or increases in volume.

- Severe Abdominal Pain: If the pain becomes unbearable or localized.

- Signs of Dehydration: Such as dizziness, dry mouth, or decreased urination.

- Fever: Especially if it is high or persistent.

Conclusion
While norovirus can lead to gastrointestinal symptoms, the presence of blood in your stool is not typical and should be evaluated by a healthcare professional. It is essential to rule out other potential causes of gastrointestinal bleeding and to ensure that you receive appropriate treatment. Given your recent illness and current symptoms, I recommend contacting your healthcare provider as soon as possible for a thorough evaluation and possibly further testing, such as stool tests or imaging studies, to determine the underlying cause of the bleeding.

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