What leads to passing bloody stools for two months?

Question

Hello doctor,

I have been experiencing bowel changes for the past year, including an urgent need to have a bowel movement two to three times every morning. There have also been noticeable changes in the shape, pattern, and color of my stool. For the past three to four years, I have had a lot of mucus in and around the stool. However, in the last two months, I have started noticing bloody mucus in my stool, along with mild pain in the lower left side of my back and abdominal discomfort. The blood in the stool is visible, and the color of the stool has also changed.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand that you have been experiencing this issue for the past three to four years, and for the last six months, you have had blood in your stools. Based on the information you have provided so far, it is difficult to determine the exact cause, but one possibility could be inflammatory bowel disease (IBD).

To help me better understand the underlying cause, I would appreciate it if you could answer the following questions:

Have you noticed any weight loss recently?
Have you undergone any stool tests or a colonoscopy in the past? If yes, please share the reports.
Is there any family history of similar symptoms?
Is there any family history of colon or rectal cancers?
Have you taken any medications for this issue? If so, please provide the names, doses, and duration of treatment.
Did you experience any relief with the medications you used in the past?
What is your occupation?
Are you married?
Do you have children?
Do you have any known allergies to medications?

Once I have these details, I will be in a better position to guide you further. Given your age, the duration of symptoms, and the presence of blood in the stool, there are several possible causes. However, inflammatory bowel disease remains one of the more common causes of rectal bleeding in young to middle-aged females.

Please provide the above information at your convenience, and I will be happy to assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

The report you shared (attachment removed to protect the patient's identity), which is a CT scan without contrast, seems to be normal except that there is a large stone inside the right side of the kidney with obstruction. I believe you should consult a urologist to confirm the plan in the future. I do not think that with the current CT scan (computed tomography scan), it is possible to comment on the large bowel as well as the other abdominal structures, such as the colon, stomach, and pancreas, since the CT scan is done without intravenous contrast injection. I also believe that with the CT scan findings, I could not tell you the reason for the bleeding in the stools. Considering your current symptoms, I suggest that you undergo a colonoscopy and gastroscopy.

Formerly, it was performed to see inside your large bowel, and later it was performed to see the stomach and part of the small bowel. I believe this would further help us to determine the cause of altered bowel habits as well as per rectal bleeding. Furthermore, you must remember that the seriousness of the problem could not be explained by symptoms only; for me to rule out the exact cause of your symptoms, I need to have further testing. I am unable to comment on whether you have cancer or not. Should have data, including a contrast-enhanced CT scan of the abdomen, plus a colonoscopy and biopsy before being able to diagnose the cancer.

I hope you are satisfied with my answer.

For further queries, you can consult me at iCliniq.