Wednesday, November 30, 2022

Bloody Stools

Dear doctor,

I am 49 years old. I have been concerned about my health for a long time. I have been noticing blood in my stools since 2010. I have been silent about it and thought it would go. It still persists and I think it is worsening. Sometimes I pass frank red blood. I am always dizzy and have a splitting headache that won’t go away with pain killers.

Martin, Gaborone

DR NTWAAGAE ANSWERS

A number of things could cause that. Your problem should be taken serious because it seems you are losing more blood than you can imagine. The dizziness and headache are a result of blood loss.

These complaints, in the presence of blood loss are linked to a condition called anemia, which in your case would be caused by blood loss.

Blood in stools could be caused by conditions affecting the anal region, the rectum and the colon.

Sometimes it could be from higher up in stomach as in the case of a seriously bleeding ulcer of the stomach or the small intestine. Hemorrhoids, often presenting as masses hanging out in the anal opening are known to commonly cause a significant bleeding. Uncomplicated hemorrhoids are not painful and thus one could just notice bleeding after passing stools. Sometimes they complicate and cause pain, but in this case the dominant complaint will be pain. It would be difficult to differentiate it from an injury that occurs from overstretching of the anal opening as would be done by constipation. This is called fissure (crack), very painful and in most cases would cause recurrent constipation since pain would induce a fear to pass stools.

Sometimes ulcers or growths develop in the rectum and the colon. These can present with various pictures. You need to see a surgeon or a gastroenterologist for possible investigations such as colonoscopy. Get well.

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