Blood in Stool During COVID: When to Seek Gastroenterology Care

Blood streaks during the COVID-19 period?

Hello, Doctor: I would like to ask you two questions.

1.
I recently had COVID-19 and my fever has subsided, but I am now experiencing intermittent abdominal pain.
During my first bowel movement, I had difficulty passing stool and noticed blood streaks after passing gas.
The second time, I began to have diarrhea.
Could you please explain what might be causing this and whether I need to see a gastroenterologist? The medication prescribed by the doctor is not for COVID-19, as I was unaware of my COVID status when I visited the hospital.
2.
Three years ago, I had an upper endoscopy at a small clinic and was found to have two polyps.
I have not had them addressed since then.
Is it necessary for me to have a follow-up examination and possible removal at a larger hospital? Thank you for your response, Doctor!

Xiao Xin, 40~49 year old female. Ask Date: 2023/05/05

Dr. Chen Bingze reply Surgery

If you do not meet the criteria for antiviral medication, the doctor cannot prescribe COVID-19 antiviral drugs to you, and you will only receive symptomatic treatment.
After diagnosis, some individuals may experience lingering symptoms.
I recommend that you consider undergoing a self-paid anesthesia-assisted gastrointestinal endoscopy in the future.

Reply Date: 2023/05/05

More Info

Experiencing blood in the stool during a COVID-19 infection can be concerning and warrants careful consideration. The symptoms you describe—abdominal pain, the passage of blood-streaked stool, and diarrhea—can be indicative of several gastrointestinal issues, especially in the context of a viral infection like COVID-19.

Firstly, it's important to understand that gastrointestinal symptoms, including abdominal pain and diarrhea, have been reported in COVID-19 patients. These symptoms can arise due to the direct effects of the virus on the gastrointestinal tract or as a result of the body's inflammatory response to the infection. The presence of blood in the stool, however, is not typical for COVID-19 and should be evaluated further.

Blood in the stool can arise from various causes, including:
1. Hemorrhoids or Anal Fissures: Straining during bowel movements, especially if you are experiencing diarrhea, can lead to hemorrhoids or fissures that may bleed. This is often the most benign cause of blood in the stool.

2. Gastrointestinal Infections: Viral or bacterial infections can cause inflammation of the intestines, leading to bloody diarrhea. This can occur alongside other gastrointestinal symptoms.

3. Inflammatory Bowel Disease (IBD): Conditions such as ulcerative colitis or Crohn's disease can cause bloody stools and abdominal pain. If you have a history of gastrointestinal issues, this could be a consideration.

4. Polyps or Tumors: Given your history of polyps found during a previous endoscopy, there is a possibility that they could be causing bleeding, especially if they have changed in size or nature.

Given these possibilities, it is advisable to seek care from a gastroenterologist, especially since you are experiencing blood in your stool. A gastroenterologist can perform a thorough evaluation, which may include a colonoscopy or other imaging studies to determine the source of the bleeding and to assess the health of your gastrointestinal tract.

Regarding your second question about the polyps found three years ago, it is crucial to follow up on any findings from previous endoscopies, especially if they were not removed. Polyps can sometimes develop into cancer, and regular surveillance is recommended based on their size, type, and number. A gastroenterologist can provide guidance on whether you need another endoscopy for evaluation and potential removal of these polyps.

In summary, while some gastrointestinal symptoms may be related to COVID-19, the presence of blood in the stool is a red flag that should not be ignored. It is essential to consult with a healthcare professional, preferably a gastroenterologist, to ensure a proper diagnosis and treatment plan. Early intervention can help prevent complications and address any underlying issues effectively.

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