Persistent Mucous and Blood in Stool: Seeking Solutions for Gastrointestinal Issues

I have been continuously passing mucus with blood for nearly a month, sometimes having bowel movements 5-6 times a day, and medication has not improved the condition?

Hello Dr.
Yang: At the beginning of August this year, I noticed a change in my bowel habits, experiencing alternating constipation and diarrhea, along with persistent urgency to defecate and blood in my stool.
After visiting the hospital for examination, a colonoscopy was scheduled on August 24, during which polyps measuring 0.3 mm and 0.5 mm were removed.
The doctor indicated that they were benign and advised me to pay attention to my diet, allowing for a normal diet only after one month.
However, starting in early September, my bowel movements became very frequent, with up to six times from morning to afternoon and once at night, often accompanied by bloody mucus.
Later in early September, I consulted a doctor who diagnosed me with intestinal inflammation and prescribed "A-Chang-Ke 400 mg" for me to take.
However, my condition would improve for a day or two before returning to frequent bowel movements with bloody mucus.
A week later, during a follow-up visit, the doctor performed a digital rectal examination and found a sizable lump at the anus.
A flexible sigmoidoscopy revealed ongoing intestinal inflammation, and the frequent bowel movements had caused internal hemorrhoids to enlarge.
The doctor prescribed another week of "A-Chang-Ke," but my condition did not improve, and I continued to experience frequent bowel movements and mucus, sometimes only passing mucus.
My mother was very worried, so in mid-September, I went to another hospital for a check-up.
The doctor also confirmed intestinal inflammation, but since the previous medication was ineffective, this doctor prescribed "2 Amoxicillin capsules, 1 Loperamide 40 mg tablet, and 1 Hemorrhoid Relief capsule" for a week.
My condition improved slightly, with less frequent bowel movements, but I still had mucus, although the blood in the mucus decreased.
In early October, during a follow-up visit, the doctor advised me to continue taking the medication for another two weeks until October 21.
During this period, I still had 2-3 bowel movements every 1-2 days, but on some days, it would spike to six times (causing significant anal pain and bleeding).
I continued to pass mucus daily (sometimes mixed with gas), and there were days when I only passed mucus, occasionally with blood and sometimes without.
After nearly a month of medication with persistent mucus, my mother became very distressed, fearing that the intestinal wall might thin out from the continuous mucus discharge.
I am truly at a loss, as I have been controlling my diet and taking my medication regularly, yet I am terrified of the ongoing mucus discharge.
I visited a traditional Chinese medicine practitioner two days ago, so now I am taking both Chinese and Western medicine.
From October 13 to 14, my condition improved, with no mucus, but tonight I passed a large amount of mucus again (without blood).
What should I do or what medication should I take to achieve complete recovery? Seeing my mother so worried about me makes me feel very sad...
I don't understand why I cannot fully recover.

Abei, 30~39 year old female. Ask Date: 2015/10/15

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Ms.
Abai, based on your detailed description, your symptoms are more indicative of ulcerative colitis.
The symptoms may fluctuate, but it is essential to consult a professional physician.
Therefore, please seek an appointment with a gastroenterologist.
Changhua Hospital cares about your health.

Reply Date: 2015/10/15

More Info

It sounds like you are experiencing a challenging and distressing situation with your gastrointestinal health. Based on your description, you have been dealing with persistent changes in your bowel habits, including alternating constipation and diarrhea, the presence of mucus and blood in your stool, and inflammation in your intestines. You have undergone several medical evaluations, including a colonoscopy, which revealed benign polyps, and have been prescribed various medications, but your symptoms have not fully resolved.

Understanding Your Symptoms
The presence of mucus and blood in your stool can be indicative of several gastrointestinal conditions, including inflammatory bowel disease (IBD), infections, or even functional gastrointestinal disorders. Given that you have been diagnosed with intestinal inflammation, it is essential to consider that conditions like ulcerative colitis or Crohn's disease could be at play, especially since these conditions can cause similar symptoms.

Importance of Follow-Up Care
You mentioned that you have seen multiple doctors and have been prescribed different medications, including antibiotics and anti-inflammatory drugs. It is crucial to maintain open communication with your healthcare providers about your ongoing symptoms. If your current treatment plan is not providing relief, it may be necessary to revisit your doctor for further evaluation. This could include additional tests, such as imaging studies or repeat endoscopic evaluations, to assess the state of your intestines more thoroughly.

Dietary Considerations
Diet plays a significant role in managing gastrointestinal symptoms. While you are already controlling your diet, consider keeping a food diary to identify any potential triggers that may exacerbate your symptoms. Common irritants include dairy products, high-fiber foods, spicy foods, and caffeine. A low-residue diet may be beneficial during flare-ups, as it can help reduce the frequency of bowel movements and the amount of stool produced.

Medication Management
You mentioned taking a combination of Western and traditional Chinese medicine. While integrating different treatment modalities can be helpful, it is essential to ensure that they do not interact negatively with each other. Always inform your healthcare providers about all the medications and supplements you are taking. If your symptoms persist despite medication, your doctor may consider adjusting your treatment plan or exploring other therapeutic options, such as corticosteroids or immunosuppressive agents, which are often used in cases of significant inflammation.

Psychological Support
Chronic gastrointestinal issues can take a toll on mental health, leading to anxiety and stress, which can further exacerbate symptoms. It may be beneficial to seek support from a mental health professional or join a support group for individuals with similar conditions. This can provide you with coping strategies and emotional support during this challenging time.

Conclusion
In summary, your situation requires careful monitoring and possibly a reevaluation of your treatment plan. Persistent mucus and blood in the stool warrant thorough investigation to rule out serious conditions. Maintain a close relationship with your healthcare providers, keep track of your symptoms and dietary habits, and consider seeking psychological support to help manage the emotional aspects of your condition. Remember, you are not alone in this, and with the right approach, improvement is possible.

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