Bleeding with formed stools?

I’ve been a pretty bad flare last two years and on pred 18months of that. Once I started remicade I managed to get off the oral steroids and onto the steroid enemas but because I got stuck on them instead, my gi switched me to Simponi.

After about 6 injections of the Simponi I have been doing great. Been off all steroids for about 6 weeks now and the loose stools haven’t returned and I ‘go’ like a normal person with formed stools about 3 times a day. I have been hopeful I’ve been heading into remission.

Anyway the last week I have suspected there’s been blood in my stool but it’s not been enough to be conclusive, however I went to the bathroom today and there was quite a bit of noticeable blood in my formed stool and when I wiped. I’ve always been a bum bleeder with this disease but this is the first time I’ve had such formed stools and noticed it.

I always thought if I was inflamed enough to bleed then I would also have diarrhoea, so I’m wondering if this bleeding could be from something else? Like hemorrhoids? I’ve never experienced this before so thought I’d ask if anyone has experienced a fair amount of blood with formed stools and it be from their disease? Perhaps this is part of the healing process or am I kidding myself?

I’ve got a colonoscopy next week so will find out exactly what’s going on then, but for now I would appreciate your input. If my stools are formed, can the bleeding be a result of inflammation?

Thanks for your reply. That’s what I’m hoping for.

Sorry if this is a silly question but I haven’t had hemorrhoids before, what do you have to do to treat them? Or do they go away on their own?

If you are 6-weeks post-pred and seeing blood then you cannot safely rule-out an UC flare (8 or more weeks post-pred to truly be safe). Yes, bleeding can happen from limited-extent inflammation (rectum-only as an example). I would ask your gasteroenteroligist for a stool test for inflammation to see if it is a flare (a calprotectin test).

It is possible to develop hemorrhoids at any time for us. As we sit on the toilet frequently, often for extended periods of time straining to poop. I had my first hemi about a year ago, it was an external-hemi that hurt but went away on it's own about a week after appearing. Often there is no treatment needed, you just see blood on tp and/or while pooping. External hemis that are painful can be removed by a colorectal surgeon (cut off, or banded).

It can be a challenge, is it a UC flare or a hemi. Just get a check for inflammation which should answer it. You can have a general practitioner doctor do a white finger and a glove check for hemis, as they are always shallow within an inch or two of the sphincter and hurt to the touch. You can also squat over a mirror to make sure there is nothing weird going on down there. Fissures (small paper cut like tears on or inside the sphincter) can bleed, as can abscesses (look like pimples within an inch outside of the sphincter) and other similar peri-anal complications can sometimes occur with us.

iPoop said...
If you are 6-weeks post-pred and seeing blood then you cannot safely rule-out an UC flare (8 or more weeks post-pred to truly be safe). Yes, bleeding can happen from limited-extent inflammation (rectum-only as an example). I would ask your gasteroenteroligist for a stool test for inflammation to see if it is a flare (a calprotectin test).

It is possible to develop hemorrhoids at any time for us. As we sit on the toilet frequently, often for extended periods of time straining to poop. I had my first hemi about a year ago, it was an external-hemi that hurt but went away on it's own about a week after appearing. Often there is no treatment needed, you just see blood on tp and/or while pooping. External hemis that are painful can be removed by a colorectal surgeon (cut off, or banded).

It can be a challenge, is it a UC flare or a hemi. Just get a check for inflammation which should answer it. You can have a general practitioner doctor do a white finger and a glove check for hemis, as they are always shallow within an inch or two of the sphincter and hurt to the touch. You can also squat over a mirror to make sure there is nothing weird going on down there. Fissures (small paper cut like tears on or inside the sphincter) can bleed, as can abscesses (look like pimples within an inch outside of the sphincter) and other similar peri-anal complications can sometimes occur with us.

Thanks for your reply, it has been really Informative.

It’s my rectum that’s been giving me problems for the last 6 months as I’ve been managing to keep off loose BMs with the steroid enemas, but as soon as I stopped them they have returned. This is the first time I’ve managed to get this long off steroids, so it’s quite possible this area is being stubborn and still causing me problems.

This fissure could also be a possibility, I thought that was more chrones related so didn’t think if that. I do have a painful area inside my bottom but put that down to irritation caused by the melasalazine suppositories I’ve been insterting, this does give me some hope.

Thanks for your reply, I haven’t heard of isatis cooking but I’ll give it a go if the bleeding doesn’t stop. For now I haven’t noticed any blood for 24 hours so I’m starting to feel more confident it’s from something else and not my disease. Usually for me when I start bleeding it’s a slippery slope to Diarrhea and a course of pred so for it to have stopped on it’s own is a great sign.

I hope your bleeding stops soon too, good luck!

thanks for the update, shame you are not in remission lets hope Simponi will kick in soon. I am having my colonoscopy next month and dreading the outcome as much as the prep