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For about 12 hours now, every bowel movement (6-8 times now) has included a vast amount of blood. I had an episode like this years ago, post-J-pouch surgeries, and ended up in the ICU, where after upper and lower endoscopies, they couldn't determine the cause. But, that included intense cramping and blood incontinence. Today, the cramping isn't nearly as bad, and I can somewhat control the blood and BMs. Outside of today and the ICU thing, I've had bleeding before, but never even remotely as bad. I'm not normally on any medications, but recently have tried VSL#3 on and off.

I'm scared, but my gastro by phone said to do Cipro and Apriso, and come to the office on Monday morning. Here's why I'm scared:

-Possibly upper GI bleeding? I don't know what can cause that, nor how urgent it normally is.
-J-pouch failure or mechanical issues. I'd be beyond devastated to lose my J-pouch. I'm still trying to get in with a new colorectal surgeon, since my insurance excluded my old one this year.

Cost is an issue--otherwise, I'd already have gone to the ER. The blood is mostly watery, some dark, some light, but more of it kind of between the two. I occasionally have to push to expel what's there--almost like there's some sort of low-end blockage. I've had blockages in the past, but never with a lot of blood. I'd greatly appreciate any insight, thoughts, or advice!

VHDAN, it's very hard to estimate blood loss accurately in a toilet bowl. Nevertheless I understand your concern. The general rule is that lower bleeds (in or near the pouch) would be bright red, and upper bleeds (esophagus or stomach) would be dark or even black. Since you haven't described major pain, you might have something like a small ulcer over a small artery. Ordinary blockages don't usually bleed. Hopefully the Cipro will quickly reduce the inflammation and allow your bleeding source to begin to heal. Remember to stay hydrated - there is no fluid loss worse than blood loss. Good luck!

Scott F

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