Blood in Stool and Abdominal Distension Symptoms

Regarding blood in stool and bloating issues?

Hello doctor, I have been experiencing persistent pain in my lower left abdomen.
My bowel movements have been irregular, alternating between diarrhea and constipation, and there is blood on the surface of my stool.
I also notice blood when wiping.
Additionally, I have been feeling bloated and have had indigestion.
My last endoscopy was normal, but I am wondering why these symptoms have persisted for so long.
What could this indicate?

A He, 20~29 year old female. Ask Date: 2016/02/02

Dr. Ke Fangxu reply Surgery

Based on your description, it seems more like irritable bowel syndrome.
The bleeding could be caused by hemorrhoids.
It is recommended to start with a light diet and maintain a good lifestyle.
If the symptoms persist without improvement, you may ask a physician to prescribe medication.
If there is still no improvement or if you are very concerned, you can also arrange for a colonoscopy.

Reply Date: 2016/02/02

More Info

Understanding blood in stool and abdominal distension symptoms can be quite concerning and warrants a thorough evaluation. Based on your description, it seems you are experiencing a combination of symptoms including persistent left lower abdominal pain, alternating bowel habits (diarrhea and constipation), blood on the surface of your stool, and gastrointestinal discomfort such as bloating and indigestion.
The presence of blood in the stool, especially if it is bright red, can be indicative of several conditions. Common causes include hemorrhoids, anal fissures, diverticular disease, or inflammatory bowel disease (IBD) such as ulcerative colitis or Crohn's disease. Hemorrhoids and anal fissures are often associated with straining during bowel movements and can lead to bright red blood on the toilet paper or stool surface. On the other hand, IBD can cause more systemic symptoms, including abdominal pain, diarrhea, and weight loss, and may require more extensive investigation.

Your mention of alternating bowel habits—diarrhea followed by constipation—could suggest a condition known as irritable bowel syndrome (IBS), which is characterized by chronic abdominal pain and changes in bowel habits without any identifiable organic cause. IBS can often be triggered by stress, dietary factors, or gastrointestinal infections. However, it is essential to rule out any underlying organic pathology, especially given the presence of blood in your stool.

The fact that you have undergone a gastroscopy and it returned normal results is reassuring regarding upper gastrointestinal issues, but it does not entirely exclude the possibility of lower gastrointestinal problems. If your symptoms persist, further investigations may be warranted, such as a colonoscopy, which allows for direct visualization of the colon and rectum, and can help identify conditions like polyps, IBD, or colorectal cancer.

Additionally, the bloating and digestive discomfort you are experiencing could be related to dietary factors, such as lactose intolerance, gluten sensitivity, or simply the consumption of high-fiber foods that may not be well tolerated. Keeping a food diary to track your symptoms in relation to your diet may provide useful insights.

In summary, the combination of your symptoms suggests a need for further evaluation. It is crucial to consult with a gastroenterologist who can assess your condition comprehensively, possibly recommend additional tests, and provide a tailored treatment plan. If you experience any worsening of symptoms, such as increased pain, significant changes in bowel habits, or signs of anemia (like fatigue or paleness), seek medical attention promptly. Your health and well-being are paramount, and addressing these symptoms early can lead to better outcomes.

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