Post-Colonoscopy Bleeding: What You Need to Know - Gastroenterology and Hepatology

Post-colonoscopy bleeding

Hello Doctor, I am currently on a business trip abroad.
For the past six months, I have been experiencing frequent diarrhea and persistent bowel urgency.
I consulted a physician here and underwent a colonoscopy today at 2:30 PM on December 23, 2015.
The nurse informed me that there were no polyps, but the doctor performed two biopsies.
After being discharged at 4 PM, I went to the restroom and experienced a significant amount of fresh blood in the toilet.
At 4:30 PM, during my next visit to the restroom, there was again a large amount of blood.
I called the hospital to consult the doctor, who advised me to return to the emergency room.
I entered the emergency room at 4:40 PM, where they drew blood and checked my blood pressure, but no other tests were conducted.
At 5:30 PM, I went to the restroom again in the emergency room, and this time there were blood clots, but the bleeding had decreased significantly.
By 7 PM, during my next restroom visit, there were only a few drops of blood in the toilet, although the toilet paper was still stained red.
At 7:30 PM, the doctor stated that my red blood cell count was normal.
After a physical examination, he said everything was fine, and I could leave.
I had a small amount of congee and tofu at 8:30 PM, but by 10 PM, I noticed more blood and blood clots during another restroom visit.
At 3 AM on the 26th, I woke up with diarrhea.
I had a small amount of bread at 4 AM and experienced another bout of diarrhea at 6 AM.
Currently, I feel discomfort in my abdomen, but it is not painful.
Light pressure causes a feeling of nausea, and I cannot lie on my stomach.
There is a mild, dull pain on the lower left side of my abdomen.
Is this considered normal? The hospitals here do not provide immediate testing like in Taiwan, and even in the emergency room, the earliest I can return home is early next year.
I would like to hear your opinion, thank you.

Ethan, 30~39 year old female. Ask Date: 2015/12/23

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, it is suspected that the bleeding was caused by the biopsy.
Generally, the wounds from biopsies are minimal and do not typically lead to bleeding.
However, patients with bleeding tendencies may have a higher risk of noticeable bleeding.
Bleeding tendencies can include coagulation disorders or the use of anticoagulants or antiplatelet agents.
Even in the absence of these factors, bleeding can still occur, but the likelihood is very low.
Dr.
Chi-Feng Chen, Attending Physician, Department of Hepatobiliary and Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/23

More Info

Post-colonoscopy bleeding can be a concerning issue, especially when it presents as fresh blood in the stool. It is important to understand the potential causes, what to monitor, and when to seek further medical attention.

Firstly, it is not uncommon to experience some bleeding after a colonoscopy, particularly if biopsies were taken or polyps were removed. The bleeding can range from minor spotting to more significant blood loss. In your case, the fact that you experienced significant bleeding shortly after the procedure is concerning and warrants careful monitoring.

Given that you have already been evaluated in the emergency department and your vital signs, including red blood cell count, were reported as normal, it suggests that you are not in immediate danger. However, the presence of fresh blood and blood clots in your stool indicates that there may still be some irritation or minor bleeding occurring in the colon, possibly from the biopsy sites or from the colon's lining due to the procedure.

Here are some important points to consider:
1. Monitor Symptoms: Keep a close eye on your symptoms. If the bleeding persists, increases, or if you experience additional symptoms such as severe abdominal pain, dizziness, or fainting, you should seek immediate medical attention. These could be signs of a more serious complication, such as perforation or significant hemorrhage.

2. Diet and Hydration: Since you are experiencing diarrhea and discomfort, it is crucial to stay hydrated. Drink plenty of fluids, and consider a bland diet to help ease your gastrointestinal symptoms. Foods like rice, bananas, applesauce, and toast (the BRAT diet) can be gentle on your stomach.

3. Rest and Recovery: Your body needs time to heal after a colonoscopy. Avoid strenuous activities and give yourself time to recover. If you feel discomfort in your abdomen, try to rest in a position that is comfortable for you.

4. Follow-Up Care: Since you mentioned that you cannot return to your home country for follow-up care until early next year, it is advisable to keep in touch with the medical facility where you had the procedure. If your symptoms worsen or do not improve, ask if there are any alternative facilities nearby where you can receive care.

5. Understanding the Risks: While most post-colonoscopy bleeding resolves on its own, it is essential to be aware of the risks. Complications can occur, though they are rare. If you have any underlying conditions that affect blood clotting or if you are on anticoagulant medications, this could increase your risk for complications.

In conclusion, while some bleeding after a colonoscopy can be normal, the amount and persistence of your symptoms should not be taken lightly. Continue to monitor your condition closely, maintain communication with healthcare providers, and do not hesitate to seek further evaluation if your symptoms change or worsen. Your health and safety are paramount, and it is always better to err on the side of caution when it comes to post-procedural complications.

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