Blood in Stool: Causes and Concerns After Gastrointestinal Issues

I have an unusual feeling in my abdomen, and there is blood in my stool?

Hello Doctor: I just had a colonoscopy and gastroscopy in July of this year.
The colonoscopy results were normal, except for the presence of hemorrhoids.
However, the gastroscopy revealed a gastric ulcer and a duodenal ulcer.
They also performed a test for Helicobacter pylori, which came back negative.
Additionally, some gastric biopsies were taken, and those results were normal.
At that time, I was experiencing diarrhea and unformed stools, which led to weight loss, but I did not have any abdominal pain.
After the colonoscopy and gastroscopy, the doctor found the ulcers in my stomach and mentioned that my symptoms should improve in about a month.
After taking the prescribed medication, my bowel movements returned to normal.
However, recently, my stools have become softer again, and I have noticed a few drops of fresh blood in my stool or splattered around the toilet.
Is this normal? I have been feeling more fatigued at work and lifting heavy objects; could this lead to a recurrence of the ulcers?

Hsuān, 20~29 year old female. Ask Date: 2023/08/31

Dr. Lin Minghui reply Gastroenterology and Hepatology

Loose stools and diarrhea with blood in the stool may indicate gastroenteritis, irritable bowel syndrome, or bleeding hemorrhoids.
Increased stress from work can lead to higher gastric acid secretion, and poor dietary habits may contribute to acid-related conditions such as gastritis, gastric ulcers, or duodenal ulcers, which should not be taken lightly.
It is advisable to follow up on these symptoms.
Wishing you good health!

Reply Date: 2023/08/31

More Info

Experiencing blood in your stool can be alarming, especially after having undergone previous gastrointestinal issues such as ulcers and hemorrhoids. Based on your history of having a colonoscopy and endoscopy, where you were diagnosed with hemorrhoids and ulcers, it is crucial to understand the potential causes of your current symptoms and the necessary steps to take.

Firstly, the presence of fresh blood in your stool can indicate several conditions. Given your history, the most likely causes could be related to your hemorrhoids, especially if you have been experiencing softer stools or diarrhea. Hemorrhoids can bleed when there is increased straining during bowel movements, which may occur if you are experiencing diarrhea or softer stools. The blood you see could be a result of irritation or trauma to the hemorrhoids, particularly if you have been lifting heavy objects, which could increase abdominal pressure and exacerbate the condition.

Another possibility is that the blood could be related to the ulcers you previously had. While you mentioned that tests for Helicobacter pylori were negative and that your biopsies were normal, it is still possible for ulcers to cause gastrointestinal bleeding, especially if they have not fully healed or if there has been a recurrence. However, this is less likely to present as blood in the stool unless there is significant bleeding.

It is also important to consider other gastrointestinal conditions that could cause blood in the stool, such as diverticulosis, inflammatory bowel disease (IBD), or even colorectal cancer, especially if you have a family history of such conditions. However, given your recent colonoscopy showed no abnormalities, these are less likely but should not be completely ruled out.

Regarding your concern about whether lifting heavy objects could lead to a recurrence of your ulcers, stress and physical strain can indeed exacerbate gastrointestinal symptoms, including those related to ulcers. However, it is essential to note that while physical strain can lead to increased abdominal pressure, it is not a direct cause of ulcer formation. Ulcers are primarily caused by factors such as H. pylori infection, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), or excessive alcohol consumption.

Given your symptoms of fresh blood in the stool and the recent changes in your bowel habits, it is advisable to consult with your healthcare provider as soon as possible. They may recommend further evaluation, which could include repeat endoscopy or imaging studies to assess for any complications related to your previous ulcers or to evaluate the hemorrhoids more closely.

In the meantime, it is crucial to maintain a diet that is gentle on your gastrointestinal tract. Focus on high-fiber foods to help regulate your bowel movements and avoid straining. Staying hydrated and avoiding heavy lifting or strenuous activities can also help reduce the risk of exacerbating your symptoms.

In summary, while the presence of blood in your stool can be related to your existing conditions, it is essential to seek medical advice to rule out any serious complications and to receive appropriate treatment. Keeping track of your symptoms, including any changes in bowel habits, pain, or weight loss, will be beneficial for your healthcare provider in making an accurate diagnosis.

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