[55F] Experiencing constipation and blood in stool

Patient Description

A 55-year-old female reports a six-month history of constipation and noticing blood mixed within her stool. She describes the blood as dark and the stool as difficult to pass, a condition she has experienced her whole life. However, the recent change includes the blood being mixed within the stool and a change in the caliber of her stool. The patient has no associated symptoms such as abdominal pain, fatigue, or unintentional weight loss. She has a known diagnosis of Hashimoto’s since 2018 and is currently taking venlafaxine, Synthroid, Lamictal, and estradiol on a daily basis. She reports allergies to hydrocodone, codeine, and sulfa but no side effects from her current medications. There is no family history of colorectal or gastrointestinal cancers, and she does not use tobacco or alcohol.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Hemorrhoids: These are swollen veins in your lower rectum. Internal hemorrhoids can cause blood in the stool, which is usually bright red. However, you mentioned dark blood, which suggests a source higher up in the digestive tract.

    • Treatment typically includes over-the-counter creams or suppositories, a high-fiber diet, and drinking plenty of fluids. More severe cases may require medical procedures.

  • Anal fissures: These are small tears in the thin, moist tissue that lines the anus, which can cause bleeding during bowel movements.

    • Treatment typically includes increasing your fiber intake to soften stools, which allows the fissure to heal. If this doesn't help, other treatments are available.

  • Diverticular disease: This condition involves small pouches (diverticula) that can form in the walls of the colon and bleed. However, this usually causes bright red or maroon stools, not dark blood.

    • Treatment typically involves a high-fiber diet, pain relievers, and in some cases, antibiotics. Severe cases may require hospitalization or surgery.

  • Gastrointestinal bleeding: This is bleeding that occurs in the digestive tract, which can cause dark blood in the stool (melena). This is a serious condition that requires immediate medical attention.

    • Treatment depends on the cause of the bleeding, but may include medications, endoscopic therapy, angiography, or surgery.

  • Colorectal cancer: This is a type of cancer that starts in the colon or rectum. It can cause changes in bowel habits and blood in the stool. Given your age and the duration of your symptoms, this is a possibility that should be ruled out.

    • Treatment typically involves surgery, radiation therapy, and/or chemotherapy.

What you can do

You should seek immediate medical attention due to the presence of blood in your stool. This is a symptom that should always be evaluated by a healthcare professional. They can provide a formal assessment and order relevant tests if necessary, such as a colonoscopy or stool test.

In the meantime, try to keep a record of your symptoms, including the frequency and consistency of your bowel movements, the appearance of the blood in your stool, and any other symptoms you may be experiencing. This information can be helpful for your healthcare provider.

What you should look out for

Reasons to seek emergency medical attention include:

  • Severe abdominal pain
  • Vomiting blood or black material
  • Black, tarry stools
  • Dizziness or fainting
  • Shortness of breath
  • Chest pain

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for accurate information.

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9 mo ago

People Also Ask

What could cause dark blood in the stool?

Dark blood in the stool, known as melena, can be caused by bleeding in the upper gastrointestinal tract, such as from a peptic ulcer, gastritis, or esophageal varices. It can also be a sign of more serious conditions like gastrointestinal bleeding or colorectal cancer.

How is gastrointestinal bleeding treated?

Treatment for gastrointestinal bleeding depends on the cause and location of the bleeding. It may include medications to reduce stomach acid, endoscopic procedures to stop the bleeding, angiography to locate and treat the bleeding, or surgery in severe cases.

What are the symptoms of colorectal cancer?

Symptoms of colorectal cancer can include changes in bowel habits, such as diarrhea or constipation, blood in the stool, abdominal discomfort, unexplained weight loss, and fatigue. However, symptoms can vary, and some people may not experience any symptoms in the early stages.

How can constipation be managed in patients with Hashimoto's disease?

Constipation in patients with Hashimoto's disease can be managed by ensuring adequate thyroid hormone replacement, increasing dietary fiber intake, staying hydrated, and engaging in regular physical activity. It's important to work with a healthcare provider to adjust thyroid medication as needed and address any other contributing factors.

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