New Onset Crohn’s Disease
Crohn’s disease is an inflammation of the bowel. It is caused by a faulty immune system response which makes the body attack the lining of the intestines.
The disease usually appears before age thirty and can affect anyone. Those with a family history may be most susceptible. Smoking is a known risk factor.
Aggravating factors include stress, poor diet, and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin.
Early symptoms usually develop gradually, but can appear suddenly. These include fatigue, loss of appetite, fever, mouth sores, diarrhea, abdominal pain, and blood in stool.
Untreated Crohn’s disease can cause ulcers throughout the digestive tract as well as bowel obstruction, malnutrition, and deteriorating general health.
Diagnosis is made through blood test and stool sample test. Colonoscopy, CT scan, MRI, endoscopy, and/or enteroscopy may also be used.
Crohn’s disease cannot be cured, but can be managed through reducing the inflammation. Antibiotics, corticosteroids, and immune system suppressors may be tried. Excellent nutrition, vitamin supplements, smoking cessation, and reduction in stress can be helpful.
Top Symptoms: fatigue, stomach bloating, loss of appetite, constipation, abdominal cramps
Urgency: Primary care doctor
When To See A Healthcare Provider
Rectal bleeding is always a reason to have a touchpoint with a healthcare provider. For chronic conditions that cause bleeding during a flare-up, it is still important to get advice from a provider.
Bleeding from the rectum isnt normal, and it is a sign that something is wrong. It could mean needing a diagnosis to find the cause of the bleeding or it could mean that a change is needed to better manage an already diagnosed condition.
Seek emergency medical attention if rectal bleeding is accompanied by severe abdominal pain, vomiting, dizziness, or fainting,
Whats The Difference Between A Flexible Sigmoidoscopy And A Colonoscopy
Both procedures are screening tools for colon cancer. A sigmoidoscopy is less invasive. It allows your healthcare provider to see only the lower part of the colon. With a colonoscopy, your healthcare provider can examine all of the large intestine. If the flexible sigmoidoscopy procedure reveals polyps in your lower colon, your healthcare provider can remove them. Youll need a colonoscopy next. During a colonoscopy, your healthcare provider can remove additional polyps before they turn cancerous.
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How Is A Flexible Sigmoidoscopy Performed
A flexible sigmoidoscopy takes place as an outpatient procedure at your healthcare providers office or medical center. You can go home the same day. Because flexible sigmoidoscopy isnt as involved as a colonoscopy, you shouldnt need medicine that puts you to sleep . The procedure may feel a bit uncomfortable, but its usually done in less than 30 minutes.
Youll lie on your left side on an exam table. During the procedure, your healthcare provider:
- Slides a thin, lubricated sigmoidoscope through the rectum into the lower intestine.
- Pumps air through the scope into the large intestine for a better view. If you have cramps, try taking a few deep breaths.
- Examines the inside of the rectum and lower intestine using video images sent from the scopes camera.
- Inserts small instruments through the scope to remove tissue samples or polyps to biopsy, if needed.
- Gently removes the scope.
What Your Doctor Will Check
If you notice any unusual bleeding, make an appointment to see your doctor. They’ll ask you questions and give you a physical examination. Symptoms such as changes in bowel habits, stool color , consistency, and whether you have pain or tenderness may tell your doctor which area of the GI tract is affected.
They’ll test your stool for blood. You’ll also take a blood test to check to see if you’re anemic. The results will give your doctor an idea of the extent of the bleeding and how chronic it may be.
If you have bleeding in your digestive tract, you’ll likely get an endoscopy. This common procedure lets your doctor see exactly where the symptom is happening. In many cases, the doctor can use the endoscope to treat the cause of bleeding, too. It’s a thin, flexible tool that they can insert through your mouth or rectum to see the areas of concern and take a tissue sample, or biopsy, if needed.
Several other procedures can be used to find the source of bleeding, including:
X-rays. During these tests you either drink or have barium-containing fluid placed through your rectum. Then an X-ray is used to look for any unusual signs. Barium lights up on this imaging test.
Angiography. Doctors inject a dye into a vein before you get a CT scan or MRI. The dye helps to show where the trouble is. In some cases, doctors use angiography to inject medicine that may stop the bleeding.
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Are There Any Foods That Can Change The Color Of My Stool In A Similar Way To Rectal Bleeding
There are certain foods that can make your poop an unusual color. You can have green, yellow and even black stool. This can happen for a variety of reasons having too much bile during digestion, having a medical condition like inflammatory bowel disease or celiac disease, being on antibiotics, or even just eating foods with strong color pigments.
Often, blood can make your stool look very dark and almost black. Foods like black licorice, beets, dark berries and red gelatin can all make your poop look very dark. This can easily be confused for blood in your stool. If you notice very dark poop during a bowel movement, think back to what you ate recently. Theres a chance that what you ate could be the cause for the usually dark stool.
When Will I Know The Results Of The Colonoscopy
Usually, your doctor will speak with you after the procedure to explain what was done. The doctor will tell you if you did have polyps and if any tissue was removed. They will also go over when you are able to start taking your medications again if you had to stop taking something before the colonoscopy.
Also, usually you will get a formal report either mailed to you or sent to you and your primary care provider in your electronic medical record. Your healthcare team will let you know if any follow-up is needed based on the results of your colonoscopy.
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Enhancing Healthcare Team Outcomes
Rectal bleeding frequently poses a diagnostic dilemma and is best managed with an interprofessional team approach. These patients may exhibit non-specific signs and symptoms. Interprofessional team communication and patient care coordination between primary care clinicians, gastroenterologists, and colorectal surgeons play a critical role to optimize management strategies.
When To See Your Doctor
Occasional rectal pain is rarely a cause for immediate concern. But if youre experiencing rectal pain with regularity, its always a good idea to make an appointment to see your doctor.
You should see your doctor right away if youre experiencing rectal pain that worsens or spreads into the lower half of your body. You should also see your doctor if you have:
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What Are The Symptoms
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- “Coffee-grounds” appearance of vomit
Other signs, which also need a doctorâs attention, include:
The location of the bleeding may affect what you notice.
If it comes from the rectum or the lower colon, bright red blood will coat or mix with your stool. The stool may be mixed with darker blood if the bleeding is higher up in the colon or at the far end of the small intestine.
When there’s bleeding in the esophagus, stomach, or duodenum , the stool is usually black, tarry, and very foul smelling. Vomit may be bright red or have a “coffee-grounds” appearance when bleeding is from the esophagus, stomach, or duodenum.
If bleeding is hidden, you might not notice any changes in stool color.
Symptoms also vary depending on how quickly you bleed.
If sudden, massive bleeding happens, you may feel weak, dizzy, faint, short of breath, or have cramp-like belly pain or diarrhea. You could go into shock, with a rapid pulse and drop in blood pressure. You may become pale.
How Are Hemorrhoids Treated
Medical treatment of hemorrhoids includes treatment of any underlying constipation, taking warm baths and applying an over-the-counter cream or suppository that may contain hydrocortisone. If medical treatment fails there are a number of ways to reduce the size or eliminate internal hemorrhoids. Each method varies in its success rate, risks and recovery time. Your doctor will discuss these options with you. Rubber band ligation is the most common outpatient procedure for hemorrhoids in the United States. It involves placing rubber bands around the base of an internal hemorrhoid to cut off its blood supply. This causes the hemorrhoid to shrink, and in a few days both the hemorrhoid and the rubber band fall off during a bowel movement. Possible complications include pain, bleeding and infection. After band ligation, your doctor may prescribe medications, including pain medication and stool softeners, before sending you home. Contact your doctor immediately if you notice severe pain, fever or significant rectal bleeding. Laser or infrared coagulation and sclerotherapy are also office-based treatment procedures, although they are less common. Surgery to remove hemorrhoids may be required in severe cases or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy.
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What Can You Do To Make A Colonoscopy Preparation Easier
There are things that might help you to drink the solution more easily. These include using a straw to drink the liquid and cooling the solution in the refrigerator before drinking it. You can add lemon drops or chew ginger candy. You will need to stay close to the bathroom during bowel preparation period. A split-dose might make the preparation easier. You will know you have done a good job when your diarrhea looks clear and yellowish, like urine.
- Wipe the skin after each bowel movement with disposable wet wipes instead of toilet paper. These are found in the toilet paper area of the store.
What You Should Do
For non-severe cases of constipation, the best action you can take is to start eating plenty of fiber-rich foods such as leafy greens, fresh fruit, whole-grain breads, and nuts and drink plenty of water to avoid dehydration. Also, try to maintain regular bowel habits.
To treat non-severe hemorrhoids, get up and walk around every so often if you sit a lot. Fiber-rich foods are also important when you have hemorrhoids, and avoid heavy lifting as much as possible. Also, when going to the bathroom, dont push too strenuously or for to long during a bowel movement.
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What Happens On The Day Of A Colonoscopy
Take a shower in the morning if you like, but do not use lotions, perfumes, or deodorants. Leave your jewelry, other valuables and contact lenses at home.
During the procedure itself:
- You are asked to wear a hospital gown and an IV will be started.
- The procedure can be done with conscious sedation, often referred to as twilight, or deeper sedation referred to as general anesthesia. You are given a pain reliever and a sedative intravenously . You will feel relaxed and somewhat drowsy. This step means that the colonoscopy will not hurt.
- You will lie on your left side, with your knees drawn up towards your chest.
- A small amount of air is used to expand the colon so the doctor can see the colon walls.
- You may feel mild cramping during the procedure. Cramping can be reduced by taking slow, deep breaths.
- The colonoscope is slowly withdrawn while the lining of your bowel is carefully examined.
- The procedure lasts about 30 minutes. It takes about 12 minutes to move the scope five or six feet and another 12 minutes to take it out. If there are polyps to remove, the procedure will take longer.
What Medications Can Cause Rectal Bleeding
Some of them can include:
- Alpha agonists such as Catapres-TTS
- Anticholinergic agents like Atropen and trihexyphenidyl
- Antihistamines such as Benadryl , Claritin , and
- Calcium channel blockers such as Cardizem , Norvasc , and Verelan
- Calcium and iron supplements, including antacids that contain calcium
- Histamine-2 receptor antagonists such as Pepcid and Tagamet HB
- Opioid pain relievers such as Anexsia
- Overactive bladder medications such as Detrol and Ditropan XL
- Parkinson’s disease medications such as Sinemet
- Tricyclic antidepressants such as amitriptyline and Norpramin
Nonsteroidal anti-inflammatory drugs such as Advil or Motrin and Aleve can cause intestinal ulcers that can lead to rectal bleeding.
There are other medications that can increase the risk of bleeding in the body. If theres an ulcer or another issue going on in the digestive system, a medication that increases bleeding could cause it to bleed more than it normally would.
Some of these medications are:
- Anticoagulants such as vitamin K antagonists, Coumadin , or heparin
- Corticosteroids, such as prednisone
- Direct oral anticoagulants such as Pradaxa , Eliquis , Savaysa , and Bevyxxa
- Platelet inhibitors such as Plavix or Effient
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The Center For Advanced Gastroenterology
At the Center for Advanced Gastroenterology, we have dedicated our practice to providing effective diagnostic and treatment solutions for issues of the upper and lower gastrointestinal tract and liver for our patients. These issues include such conditions as:
- Viral hepatitis
- Acid reflux/GERD
- Gastritis/abdominal pain
- Banding of internal hemorrhoids
Will Rectal Bleeding Go Away On Its Own
Depending on the cause of the bleeding, your rectal bleeding can actually stop on its own. However, you need to pay attention to your body and keep track of the bleeding. If it happens one time and then stops, take note of it, but it most likely isnt an emergency. If you have heavy rectal bleeding or are regularly seeing blood, reach out to your healthcare provider to get immediate care. Its always a good idea to let your healthcare provider know about any rectal bleeding you have experienced.
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How Should I Prepare For A Flexible Sigmoidoscopy
Your bowels must be completely empty before this examination. Your healthcare provider might have you use an enema in the office just before the procedure, or theyll have you do the following at home:
- Stick to a clear liquid diet for up to 24 hours before the procedure.
- Use a prescribed bowel preparation, a laxative or an enema to soften stool and empty the bowels.
Note that your own healthcare providers office might have different instructions for you to follow.
What Will A Doctor Do About The Blood In My Stool
Rectal bleeding is commonly evaluated and treated by gastroenterologists. The first priority upon receiving a patient with rectal bleeding is always to correct any low blood volume or anemia, with fluids or a blood transfusion. They will then determine the site and cause of the bleeding, stop the bleeding, and prevent bleeding in the future if possible.
The doctor may order repeated blood tests to monitor changes, and will often initiate a colonoscopy or an endoscopy, depending on where they suspect the bleeding is happening .
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Rectal Bleeding Tumors Colon Polyps And Other Causes
Polyps: Lumps of tissue or polyps bulge out from the lining of the colon. Bleeding occurs when large polyps develop, which can be hereditary. Usually harmless, some types can be precancerous.
- Few people with tumor or polyps will have rectal bleeding. When bleeding does occur, it is usually slow, chronic, and minimal.
- If cancerous lesions are advanced, additional symptoms such as weight loss, a change in the caliber of stools, a sense of rectal fullness, or constipation may be experienced.
- Diagnosis requires evaluation with colonoscopy.
Trauma: Rectal bleeding from a traumatic cause is always a critical concern. Rectal damage from a gunshot wound or foreign body insertion can result in extensive infection or rapid and fatal blood loss. Prompt emergency evaluation is necessary.
Upper gastrointestinal source: A common source of rectal bleeding is bleeding from the upper gut, usually the stomach or duodenum. This can occur after someone has swallowed a foreign object that causes injury to the stomach lining, bleeding stomach ulcers, or Mallory-Weiss tears.
- Long-term, chronic alcohol consumption can also cause ulcers, esophageal varices, and gastritis. All of these upper GI tract problems can bleed so briskly that people may note blood in the stool or in the rectum.
Unexplained Weight Loss Loss Of Appetite And Feeling Weak
Losing weight, losing your appetite or feeling weak are all possible signs of colon or rectal cancer along with many other unrelated conditions. In patients with colon or rectal cancer, these symptoms are usually related. Persistent diarrhea can cause weight loss. Stomach pain and nausea can reduce your appetite so that you dont consume enough food to maintain your weight. All these issues, as well as anemia, can lead to weakness.
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