[25F] With umbilical hernia and bloody stool

Patient Description

A 25-year-old female presents with an umbilical hernia and has been experiencing bloody stools for over a week. The blood in the stool varies from a few drops to slightly more, occurring about once every other day. This is the first occurrence of bloody stools, which started suddenly. The patient also has hemorrhoids but reports no abdominal or rectal pain, nausea, vomiting, or changes in stool color or consistency. She has lost 6 pounds in a week and feels fatigued and dizzy. There have been no changes in appetite, urine color, or diet. The patient has no history of gastrointestinal diseases or surgeries. She smokes cigarettes daily. Family history includes heart disease, stroke, diabetes, cancer, and psychiatric illnesses. Recent blood tests showed a high white blood cell count. She has not had a period for 2 years due to birth control (Nexplanon). Current medications include Zyprexa 20mg and Vistaril 50mg, taken every night. The patient is allergic to Bactrim and is not taking any other medications, supplements, or herbal remedies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few potential concerns that need immediate attention:

  1. Gastrointestinal Bleeding: The presence of blood in your stool, even in small amounts, can indicate gastrointestinal bleeding. This could be due to hemorrhoids, but given the sudden onset and your other symptoms, it could also be from other sources such as ulcers, diverticulosis, or more serious conditions like colorectal cancer.

  2. Infection or Inflammation: A high white blood cell count suggests that your body might be fighting an infection or inflammation. This could be related to your gastrointestinal symptoms or another underlying condition.

  3. Weight Loss and Fatigue: Unintentional weight loss and fatigue are concerning symptoms that could be related to a variety of conditions, including infections, chronic diseases, or even malignancies.

  4. Hemorrhoids: While hemorrhoids can cause blood in the stool, they usually do not cause significant weight loss or a high white blood cell count. However, they could be contributing to your symptoms.

What you can do

  1. Seek Immediate Medical Attention: Given the combination of bloody stools, significant weight loss, fatigue, and a high white blood cell count, it is crucial to seek medical attention immediately. These symptoms could indicate a serious condition that requires prompt evaluation and treatment. Please go to the nearest emergency room or urgent care center as soon as possible.

  2. Call 911 if Necessary: If you feel light-headed, dizzy, or if your symptoms worsen, do not hesitate to call 911. It is important to get to a medical facility quickly to ensure you receive the necessary care.

  3. Avoid Straining: If you have hemorrhoids, try to avoid straining during bowel movements. Drink plenty of water, eat a high-fiber diet, and consider using over-the-counter stool softeners if needed.

  4. Follow Up with Your Doctor: After receiving emergency care, make sure to follow up with your primary care physician or a specialist to discuss your symptoms and any necessary further testing or treatment.

Remember, while I can provide information based on your symptoms, I am not a doctor. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your health and safety are the top priority.

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People Also Ask


What could cause bloody stools in a young adult?

Bloody stools in a young adult can be caused by a variety of conditions, including hemorrhoids, gastrointestinal infections, ulcers, diverticulosis, or more serious conditions like colorectal cancer. It's important to seek medical evaluation to determine the exact cause.


How does smoking affect gastrointestinal health?

Smoking can negatively affect gastrointestinal health by increasing the risk of conditions such as peptic ulcers, Crohn's disease, and colorectal cancer. It can also exacerbate symptoms of existing gastrointestinal issues.


What are the potential side effects of Nexplanon related to menstruation?

Nexplanon, a hormonal birth control implant, can cause changes in menstrual bleeding patterns, including amenorrhea (absence of menstruation), which is a common side effect. This is generally not harmful, but any concerns should be discussed with a healthcare provider.


Why is a high white blood cell count concerning?

A high white blood cell count is concerning because it often indicates that the body is responding to an infection, inflammation, stress, or more serious conditions like leukemia. It requires further investigation to determine the underlying cause.


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