Consistent digestive Issues

Straight to the point. Over the last five years I have had many digestive problems and cannot seem to find the issue.

3 years ago - Colonoscopy - Negative
1.5 years ago - Colonoscopy - negative with the exception of a hemmoroid (Internal)

Then about 3 months ago had a BM and noticed blood in the bowl and on the paper. Went to a Gastro (the same one that has done the colonoscopies) and he said it was the hemmoroid he indicated from the scope and then did a digital rectal exam. He said he did not feel anything abnormal. He also said it would not be the last time.
Well he was right, about 2 months ago had it again but this time much more blood. Being constipated, lots of straining and I think that may have caused this repeat.
Then one month ago I decided to try an intestinal cleanser...I won't provide the name but you take pills to help excreet parasites, drink a psyllium husk mixture in the morning and drink a herbal tea mixture at night.
I stopped the tea mixture because it made me anxious. Everything seemed to be going great for three weeks...3-4 BM's a day, soft, felt empty..then after three weeks on it, I had an explosive BM and about an hour later another BM, but nothing but mucous mixed with blood. The next morning another mucous and blood..Stopped taking the intestinal cleaner. Now back to constipation and my stools look like ribbons (this is not new but now getting consistent)
Since I have had 2 colonoscopies in three years, what could be causing this and what should my next step be in trying fix this distressing problem.

[Kevin Pho, MD]

The negative colonoscopies would rule out many of the major GI disorders.  However, if the symptoms worsen, a repeat colonoscopy or flexible sigmoidoscopy can be repeated to ensure there are no new growths or the presence of inflammatory bowel disease.

The stool can also be tested for various forms of fat malabsorption, as well as lower GI infections.  Blood tests can also be done to rule out celiac disease.  

If the tests are negative, irritable bowel syndrome can be considered, and treatment optimized with antispasmodic agents or the antibiotic Rifaximin.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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