Abdominal Noises and Blood in Stool: When to Seek Help

Supine position with bowel sounds + blood in stool?

Hello, since early November, whenever I lie down, I experience loud gurgling sounds (similar to croaking), which I have never experienced before.
I have tried taking probiotics and yogurt, but there has been no improvement.
I have had rectal bleeding since high school, which is always bright red.
Sometimes my stools are loose, while other times they are normal.
I typically have a bowel movement every 2 to 3 days.
I experienced fresh blood again at the beginning and end of last year.
At the end of last year, I went to the hospital for a fecal occult blood test and blood tests, both of which came back normal.
Additionally, my maternal grandfather had rectal cancer, my paternal grandfather had colon cancer, and my father has polyps and hemorrhoids.
I am very concerned that I may have a problem.
Should I seek further evaluation? I usually go to bed around 1-2 AM and wake up at 8-9 AM.
I work at night, so on Tuesdays and Thursdays, I usually eat around 9 PM; at other times, my eating schedule is normal.
I often skip breakfast or sometimes only drink soy milk or milk.

M, 20~29 year old female. Ask Date: 2023/01/17

Dr. Chen Shidian reply Gastroenterology and Hepatology

Borborygmi is simply the sound of intestinal peristalsis being more pronounced, which can be more easily stimulated by fruits and vegetables; it is harmless.
Additionally, for bleeding, it is advisable to consult a gastroenterologist to confirm whether it is due to hemorrhoids or anal fissures.

Reply Date: 2023/01/17

More Info

Based on the information provided, it seems that you are experiencing significant gastrointestinal symptoms, including loud abdominal noises and blood in your stool. Given your family history of colorectal cancer and polyps, it is essential to take your symptoms seriously and seek further medical evaluation.

Understanding Your Symptoms
1. Abdominal Noises: The loud gurgling sounds you hear when lying down could be related to increased intestinal activity or gas. This can happen for various reasons, including dietary changes, stress, or gastrointestinal disorders. While occasional abdominal noises are normal, persistent or loud sounds, especially when accompanied by other symptoms, warrant further investigation.

2. Blood in Stool: The presence of fresh blood in your stool is concerning, particularly given your family history of colorectal issues. Blood can originate from various sources in the gastrointestinal tract, including hemorrhoids, diverticular disease, or more serious conditions like polyps or cancer. The fact that you have experienced this symptom intermittently since high school and have a family history increases the urgency for further evaluation.

3. Bowel Habits: You mentioned having bowel movements every 2-3 days, which could indicate constipation. This, combined with your dietary habits (skipping breakfast and irregular eating patterns), may contribute to your gastrointestinal discomfort. A diet low in fiber can lead to harder stools and increased straining, which can exacerbate issues like hemorrhoids and bleeding.

Recommendations for Further Evaluation
Given your symptoms and family history, I recommend the following steps:
1. Consult a Gastroenterologist: It is crucial to see a specialist who can perform a thorough evaluation of your gastrointestinal health. They may recommend a colonoscopy, which is the gold standard for diagnosing conditions like polyps, diverticulitis, or colorectal cancer. Given your family history, this may be especially important.

2. Dietary Changes: Consider improving your diet by incorporating more fiber-rich foods, such as fruits, vegetables, whole grains, and legumes. This can help regulate your bowel movements and reduce straining. Staying hydrated is also essential.

3. Regular Check-ups: Given your family history, it may be advisable to begin regular screenings earlier than the typical recommended age. Discuss this with your healthcare provider to determine the best plan for you.

4. Monitor Symptoms: Keep a detailed record of your symptoms, including the frequency and appearance of blood in your stool, any changes in bowel habits, and any associated symptoms like abdominal pain or weight loss. This information will be valuable for your healthcare provider.

When to Seek Immediate Help
You should seek immediate medical attention if you experience any of the following:
- Significant or worsening abdominal pain
- Large amounts of blood in your stool
- Symptoms of anemia (such as fatigue, weakness, or dizziness)
- Changes in your bowel habits that are sudden or severe

Conclusion
Your symptoms, combined with your family history, indicate that further evaluation is necessary. Do not hesitate to seek medical advice, as early detection and intervention can significantly improve outcomes for gastrointestinal issues. Remember, it is always better to err on the side of caution when it comes to your health.

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