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6 replies

Blood In Stool

S SimpleXMember
Hi all,

I had experienced blood in my stool (occasionally) over the past year which lead me to slowly be anemic. I was put on iron supplements and since then my hemoglobin has entered back into the normal range. For most of the time I have been on the supplements (2 months) I have notice blood in my stool very infrequently... only when I strain on the toilet or eat VERY large spicy meals.

In the past 2-3 days I have noticed blood in my stool most of the time I go to the bathroom. It's not always present when I wipe, but is obvious in the toilet as a medium (not dark not bright) red cloud "floating" around my stool.

First... Any ideas as to what could be causing this? It's been happening despite me being very careful to not strain and eat good foods.

Also, since I am freaking out.. It has been a little over 2 years since my takedown surgery. I've only had pouchitis once and it was very soon following surgery.

I've always been horrified about the possibility of being rediagnosed with chrones. Since I am two years out and have had no problems yet, is it less likely for me to be diagnosed with chrones? Is it true that the farther out you get from takedown with no complications, the less likely it is for you to have chrones, or does this not matter at all?

Thank you for all of your help; It is truly appreciated.

P.S... there have been no other changes besides the blood. No more frequency, no pain, etc.
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Jan DollarJan DollarModerator, RN, retired
First, I am sorry you are having this problem.

From what I've read, the further out from surgery you are, the more likely it is that you'll develop pouchitis. I have not seen anything to indicate that more time from colectomy improves your chances of avoiding a Crohn's diagnosis.

Are you sure you do not have cuffitis or a bleeding ulcer in or near the pouch? These would be the most likely culprit of the bleeding, not Crohn's.

Have you not been scoped while you are bleeding to find the source?

Jan Smiler
S SimpleXMember
Unfortunately I have not been scoped since takedown. I will likely have a scope in May once my school finishes up.

So you don't think its a random occurrence of crohns? That has me worried sick. If it is an ulcer, what is the treatment, cipro?

The blood is literally the only symptom I am having right now. Not sure what to make of it.
Last edited by SimpleX
Jan DollarJan DollarModerator, RN, retired
No, I don't think it is Crohn's. There's a saying that states, "if you hear hoofbeats, you should think horses, not zebras."

This means that cuffitis and pouchitis are by far the most likely cause of bleeding with a j-pouch (horses) not Crohn's (zebras). Ulcers are fairly common with pouchitis. I also wanted to point out that not everybody with pouchitis has the same symptoms, or even have symptoms. You can have mild pouchitis with severe symptoms or severe pouchitis with no symptoms.

So, until you KNOW otherwise, worrying that this is something other than a common complication gets you nothing but gray hair. Get examined and find out what is going on. It could even be a hemorrhoid, like Scott said. Again, Crohn's is the lesser likelihood. Just because it is possible, it does not mean it is likely.

Jan Smiler

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