[18F] Experiencing gastrointestinal symptoms with blood in stool

Patient Description

An 18-year-old female is experiencing bloating, diarrhea, and bright red blood coating the stool, which started today. The diarrhea, described as tan-colored and runny with a strong smell, has been occurring 2-3 times daily for the past three days. The patient reports increased bloating in the lower abdomen, which is relieved by defecation, and an urgency to defecate without severe abdominal pain or signs of dehydration. Additionally, the patient has been feeling unusually tired, has a decreased appetite for about a week, and has been more irritable, especially when tired during the middle of the day. There is no recent travel history or identified food triggers. The patient's mother had colon cancer last year, but there has been no genetic screening for hereditary cancer syndromes. The patient had shingles last year but has no other chronic conditions. Allergies include clindamycin and penicillin. The patient has been on Sprintec birth control pills since last September and is not taking any other medications, supplements, or herbal remedies.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Hemorrhoids: These are swollen blood vessels in the rectum or anus that can be the source of bright red blood coating the stool. They can be associated with diarrhea and a feeling of bloating or fullness in the lower abdomen. Hemorrhoids are common and can be caused by straining during bowel movements, constipation, sitting for long periods of time, and certain diseases like liver disease.
- Treatment usually involves over-the-counter creams or suppositories, eating a high-fiber diet, and drinking plenty of fluids. In some cases, a doctor may need to perform a procedure to shrink or remove the hemorrhoids.
Anal fissure: This is a small tear in the thin, moist tissue (mucosa) that lines the anus, which can cause bright red blood to appear on the surface of the stool. Anal fissures can be caused by passing large or hard stools, constipation, or chronic diarrhea.
- Treatment usually involves dietary changes to soften the stool, over-the-counter creams or ointments, and in some cases, surgery.
Colorectal cancer: Given your family history of colon cancer, this is a possibility that should be considered, although it is less likely given your age. Colorectal cancer can cause blood in the stool, changes in bowel habits (like diarrhea), and abdominal discomfort.
- Treatment usually involves surgery to remove the cancer, followed by chemotherapy or radiation therapy if necessary.

What you can do

It would be best to consult a doctor about your symptoms as soon as possible. In the meantime, you can try the following to alleviate your symptoms:

Drink plenty of fluids to avoid dehydration from diarrhea.
Eat a high-fiber diet to help soften your stool and reduce straining during bowel movements.
Try over-the-counter creams or ointments to relieve discomfort from hemorrhoids or anal fissures.

What you should look out for

Reasons to seek immediate medical attention:

If you notice a significant increase in the amount of blood in your stool.
If you develop severe abdominal pain.
If you experience symptoms of dehydration, such as dizziness, dry mouth, or infrequent urination.
If your symptoms worsen or do not improve after a few days.

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare professional who can evaluate your symptoms in person.

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11 mo ago

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