Is Blood in Stool After Medication a Cause for Concern?

Rectal bleeding

Hello Doctor: I recently had mumps complicated by epididymitis, and I have been taking anti-inflammatory medication.
After recently stopping the medication, I started experiencing pellet-like stools (which has lasted for almost two weeks), and there is a small amount of blood in the stool, although there is none on the toilet paper.
Is it necessary to do a stool test?

Nìmíng, 10~19 year old female. Ask Date: 2020/11/06

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, it is likely that the bleeding from the intestinal mucosa is caused by hard stools or hemorrhoidal bleeding.
If blood is visible to the naked eye, performing a fecal occult blood test may not be very meaningful.
I recommend consulting a colorectal surgeon if the bleeding persists.
As for the most common pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs) can indeed cause gastrointestinal bleeding as a side effect.
If the pain is not severe, it may be advisable to stop taking the pain medication.
Thank you for your inquiry.

Reply Date: 2020/11/06

More Info

Blood in the stool can be a concerning symptom, especially when it appears after a course of medication. In your case, you mentioned that you were taking anti-inflammatory medication due to complications from mumps and epididymitis, and now you are experiencing changes in your bowel movements, including the presence of blood in your stool.

First and foremost, it is essential to understand that the presence of blood in the stool can arise from various causes, some of which may be benign, while others could indicate a more serious condition. The fact that you have been experiencing hard, pellet-like stools for two weeks suggests that you may be dealing with constipation, which can lead to anal fissures or hemorrhoids, both of which can cause minor bleeding. However, the presence of blood, even if it is minimal, should not be ignored.

Given your recent medication history, it is also important to consider the potential side effects of the anti-inflammatory drugs you were taking. Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, can sometimes lead to gastrointestinal issues, including ulcers or bleeding, particularly if taken over an extended period or without adequate food intake. If you have been taking NSAIDs, this could be a contributing factor to your symptoms.

In light of these considerations, it is advisable to take the following steps:
1. Consult Your Healthcare Provider: It is crucial to discuss your symptoms with your doctor, especially since you have noticed blood in your stool. They may recommend a physical examination and possibly a referral to a gastroenterologist for further evaluation.

2. Stool Examination: A stool test can help identify the presence of blood and other abnormalities. This test can also check for infections, parasites, or other gastrointestinal issues that may be causing your symptoms.

3. Dietary Adjustments: Since you mentioned that your stools are hard and pellet-like, it may be beneficial to increase your dietary fiber intake and ensure you are drinking enough fluids. This can help alleviate constipation and may reduce the likelihood of anal fissures or hemorrhoids.

4. Monitor Symptoms: Keep track of any additional symptoms you may experience, such as abdominal pain, changes in appetite, weight loss, or any other unusual changes. This information can be valuable for your healthcare provider in determining the cause of your symptoms.

5. Avoid Self-Medication: While it may be tempting to self-diagnose or treat your symptoms with over-the-counter medications, it is best to avoid this until you have consulted with a healthcare professional.

In conclusion, while the presence of blood in your stool may not always indicate a severe condition, it is essential to take it seriously, especially given your recent medication history. A thorough evaluation by a healthcare provider will help determine the underlying cause and appropriate treatment. Remember, early intervention is key to addressing any potential health issues effectively.

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