Persistent Abdominal Pain and Bleeding After Diarrhea: What to Do?

Diarrhea with persistent abdominal cramps?

If you are experiencing persistent cramping pain in your stomach and abdomen after having diarrhea, along with pain in the anal area, there may be a possibility of developing hemorrhoids.
If the pain has not decreased after taking the medication prescribed at the clinic, it is important to seek further medical evaluation.
The presence of bleeding when wiping could indicate a more serious condition, and it is advisable to consult a healthcare professional as soon as possible for a thorough examination and appropriate treatment.

Chen, 20~29 year old female. Ask Date: 2004/03/15

Dr. Chen Fuquan reply Internal Medicine

1.
This situation is likely due to the formation of internal hemorrhoids (external hemorrhoids can be felt and are usually more painful when sitting).
When there is gastrointestinal bleeding, the contractions of the small and large intestines can intensify, leading most patients to experience abdominal pain.
When internal hemorrhoids bleed, patients often feel a cramping sensation in the lower abdomen and have a constant urge to have a bowel movement, resulting in bright red blood on the toilet paper after wiping.
2.
Young individuals, especially males, who sit for prolonged periods are more prone to developing hemorrhoids.
They can start by taking medication (anti-inflammatory drugs), such as Bromelain available at our hospital, and applying ointments like Posterisan to the affected area.
Of course, it is important to avoid sitting or standing for too long, eat plenty of fruits and vegetables, and engage in regular exercise to prevent the formation of hemorrhoids.
3.
For older individuals (over 50 years old) who experience frequent bleeding, it is advisable to undergo a colonoscopy at our hospital, as the risk of colorectal cancer increases with age.

Reply Date: 2004/03/15

More Info

Persistent abdominal pain and bleeding after experiencing diarrhea can be concerning and may indicate several underlying issues. Given your symptoms of continuous cramping pain in the abdomen, anal pain, and the presence of bleeding, it is crucial to approach this situation with caution.

Firstly, the abdominal pain you are experiencing could be a result of several factors, including inflammation of the intestinal lining due to diarrhea, which can lead to conditions such as gastroenteritis or colitis. The pain may also be exacerbated by the strain of frequent bowel movements, which can cause irritation and inflammation in the anal region. This irritation can lead to conditions such as anal fissures or hemorrhoids, which can cause bleeding during bowel movements.

The presence of blood when wiping can be alarming, and while it may not always indicate a severe condition, it is essential to take it seriously. If the bleeding is bright red, it typically suggests that the source is from the lower gastrointestinal tract, such as the rectum or anus, rather than from higher up in the digestive system. However, any significant bleeding or persistent symptoms should prompt immediate medical attention.

Here are some steps you can take to manage your symptoms and seek appropriate care:
1. Hydration: Ensure you are staying well-hydrated, especially if you have experienced diarrhea. Electrolyte solutions can help replenish lost fluids and minerals.

2. Diet: Stick to a bland diet that is easy on the stomach. Foods like bananas, rice, applesauce, and toast (the BRAT diet) can help. Avoid spicy, fatty, or heavy foods that may exacerbate your symptoms.

3. Pain Management: Over-the-counter pain relievers like acetaminophen can help alleviate discomfort. However, avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, as they can irritate the gastrointestinal tract further.

4. Monitor Symptoms: Keep track of your symptoms, including the frequency and nature of your bowel movements, the amount of bleeding, and any other associated symptoms like fever or nausea.

5. Seek Medical Attention: If your symptoms persist or worsen, or if you experience significant bleeding, fever, or severe pain, it is crucial to seek medical attention. A healthcare provider may perform a physical examination, order blood tests, or conduct imaging studies to determine the underlying cause of your symptoms.

6. Consider Gastroenterology Referral: If your symptoms do not improve with initial treatment, a referral to a gastroenterologist may be necessary. They can conduct further evaluations, such as a colonoscopy, to assess for conditions like inflammatory bowel disease, infections, or other gastrointestinal disorders.

In conclusion, while some abdominal pain and bleeding can be attributed to minor issues, the persistence of your symptoms warrants a thorough evaluation. It is essential to prioritize your health and seek medical advice to address your concerns effectively.

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