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Gastroenterology  (Expert Forum)
 | 
IBS?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

IBS?

by Bethlynn, Jul 19, 2005 12:00AM
I am 29 years old and I am in excellent health, I exercise and eat right.  I am under stress and I had a 4 episodes of bright red blood on my toilet paper after bowel mvmt over the past 4.5 months.  I went to the doctor and explained my symptoms.  Symptoms consisted of diaharri (blood is never present with diaharri) (sp?) and then after my first hard bowel mvmt, blood would be present on the toilet paper.  She examined me and told me my rectum looked irritated and she said that I have the first symptoms of IBS.  She gave me some hyrdrocortisome and told me to come back if symptoms reoccured.  About two weeks later, I had another episode of heavy diaharri and another tough bowel mvmt, with blood on toilet paper.  Now, after a hard bowel mvmt I have very little blood on the toilet paper and my rectum stings a little bit during and after bowel mvmt. This small amount of blood only occurs during the first bowel mvmt of the day, never on the second. Furthermore, it is not everyday that blood is present.  I called the nurse and she said that is normal and not to worry.  She told me to soak in a bath with baking soda and use tucks pads for soothing.  
FACTS/SYMPTOMS:
MAR: Stressful life changing event
Starting MARCH two incidents with blood on toilet paper after heavy diaharri
MAY:  Another stressful life changing event
MAY two incidents w/ blood on toilet paper after heavy diaharri
PRESENT:  a very small amount (much smaller amount of blood than the past) after heavy bowel mvmt, but not every bowel mvmt and only on the first bowel mvmt of the day.
FACTS:  I lift weights; under a great deal of stress (just moved to another state, changed jobs and geographically separted from husband);blood is not present on a daily basis; I am very regular, I have a bowel mvmt every morning after I wake up and possibly a second in the morning.  I am on fiber and I drink a ton of water.

by Kevin Pho, MD, Jul 20, 2005 12:00AM
Irritable bowel can certainly be considered.  There are other possibilities as well, including the hard stool you describe (which can irritate the rectum and lead to bleading.  Other considerations would be inflammatory bowel disease, hemorrhoids, or diverticulitis.  Diseases like cancer or polyps would be less likely in someone your age.

If the symptoms continue, you can consider a flexible sigmoidoscopy for further evaluation.

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.
http://www.straightfromthedoc.com
Member Comments (5)

by Bethlynn, Jul 19, 2005 12:00AM
I forgot to add, I am feeling great, energy level is good.

by astros18, Jul 19, 2005 12:00AM
To: Bethlynn
Bethlynn, you are under a huge amount of stress. If the flare ups come after a particularly stressful event, then you may have your answer. If your bowel movements change often between diarreah, hard, to firm then you may have a digestion issue. Have you been on antibiotics lately or been out of the country. Yeast and parasites are often culprits in a bowel change, and parasites can cause some blood. If no, then I encourage you to try to relax using massage, writing in journal, or whatever it is that works for you. Women have a tendency to heap more and more on our shoulders.Just remember that you can't do it all and be all things to everybody. Take care of YOU!

by Bethlynn, Jul 19, 2005 12:00AM
thank you for the reply.  I find that this is putting more stress on me too.  I have done reflexology and my holistic doctor has me on some other vitamins/herbs as well.  No, I have not been out of the country, the doctor asked the same thing as well.  Again, thank you for your kind words.

by wassupwassabi, Jul 19, 2005 12:00AM
To: Bethlynn
I think it's good that you are into holistic medicine.  Often times the solution involves a lot more than (or an alternative to) drugs!

by Inanga, Jul 20, 2005 12:00AM
hi had something similar but less frequent - occasional bleeding of bright fresh blood into the toilet - always occurred after hard large stools - i guess they did some damage on the way through - had it checked and i have some minor internal haemaroids - these were getting damaged and bled. Had a colonoscopy for peace of mind mainly (pushing 40 so good to us the insurance for a cecnt checkup). Anyway the best way to manage the situation is to be stingent on diet to avoid constipation and the damaging stools - drink more, eat more dietry fibre and Kiwifruit are excellent.

I also had recurring cosntipation and diarrhea - now I attribute that to food sensitivites to gluten and allergies to certain fruit - bananas and melons. Dietry change has sorted it all out for me.

good luck
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