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Burning sensation while passing stool, RBC count low. Had motion and culture test. Findings?

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General & Family Physician
Practicing since : 2006
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Hi Doctor I am a 24 years old male. I had some problems while passing stools like burning sensation and the presence of black spots over the stool. Hence, I had a couple of motion tests done during March 1st week 2013.
The first result showed me he following:
Occult Blood - Absent
RBC 02-05 hpf
OVA - Hook worm ova seen ( 01-02 hpf)
Cyst - Entamoeba histolytica cyst 02-03 seen/hpf.
Micro organism - plenty of bacteria seen(Bacilli/hpf)
Pus cells seen (01-03/hpf).

The next motion test result showed the following:
Occult Blood - Absent
Bacteria Seen.
Then I followed the Somprez tablet and Gavisvon Syrup as per the prescription for the next 30 days.Then I took the below test after 30 days during which I did not take any medication.
Then I followed the Somprez tablet and Gavisvon Syrup as per the prescription for the next 30 days.
I had a motion test on 4th May 2013 which was a complete+culture test. The result showed the following.
Occult Blood - Absent
RBC 0-1 hpf.
Bacteria Seen.

From the last 3 test reports I infer that presence of RBC's has been intermittent in my body. Though the Occult Blood is not present, I am getting worried if my RBC count as well indicates the passage of blood. Do i need to worry about it? I have a few questions kindly help me.

1. Why is the presence of bacteria intermittent and what does the presence of RBC's indicate? Is it the real blood which is getting discharged ?
2. I have given only a small quantity of my stool to test and it shows me 0-1 hpf of RBC's. Do they mean that there are so many RBCs in my total discharge ?
3. Those black spots were present as traces in my discharge. But the sample which i gave for test did not have those black spots? Are the black spots blood? If so it is blood, will my motion test indicate presence of blood though the sample which did not have black spots?
Do i need to follow any medication to be free from bacteria presence throughout. Kindly advise..
Posted Tue, 28 May 2013 in General Health
Answered by Dr. Jay Patel 1 hour later

Welcome to XXXXXXX
I am Dr. XXXXXXX And I will try my level best to help you.

Let me answer the question one by one in same order as they are asked.

1) Presence of bacteria is mostly seen in stool as human gut is heavily loaded with the bacteria so it’s quite normal to see bacteria in stool sample. Now the presence of RBC indicates that there may be some minor bleeding due to hard stool passage in the gut or may be a very minor XXXXXXX abrasion. Nothing to worry as the presence of RBC is very low and the occult blood is not seen in your report.

2) Now HPF - Stands for HIGH POWER FIELD, means in order to see those RBC high power field was used and still using high power field on very few that is 0-1 are seen hence its very,very low and there is nothing to worry about

3) The black spots seen in you stool, might be a bleeding from the stomach ulcer. The blood when reacts with acid in stomach turns black and appears tarry black in stool. Now, you were treated with two different drugs and both of them are used to treat stomach ulcer, which may have healed by the medication you took and so no black spot are seen in the subsequent stool sample and no occult blood was detected on stool test.

4) Now about "being free from bacteria forever" is impossible, as we do need bacteria in gut as some of them release chemicals, which do help us in breaking our food and making it easily digestible and absorbable. It is like mutual relationship going on between bacteria and the gut, they both help each other, and gut provides shelter and food to bacteria while bacteria help to make food easily digestible and absorbable for body.

Hope I was able to answer all of your questions satisfactorily.

Please feel free to contact me in case of any further questions or concern.

Above answer was peer-reviewed by
Follow-up: Burning sensation while passing stool, RBC count low. Had motion and culture test. Findings? 1 hour later
Thank you Doctor !!!

I did an endoscopy and sigmoidoscopy during Feb'2013 and the result was Gastricitis. You have mentioned like RBC count is very very low and nothing to worry out. Is it something very common among all and is that why are you saying me nothing to worry about? Do the presence of bacteria too contribute to RBC count ?

I pass my stool very relaxed and smoothly and its not a hard passage. You have told me RBC may be due to minor XXXXXXX abrasion. Where will this XXXXXXX abrasion take place? Will it be in my anal area ?Should i take any other tests to confirm it?

Last time my RBC count was 2- 5hpf and now its 0-1 hpf. I gave only a very little sample for test. How will the lab people calculate RBC count? Is that 0-1 hpf specific to the little sample i gave or is it for the entire stool discharge ?

Moreover i did not take the black spots area of my stool to give for test. I took the rest of the portion and gave it for test. If those black spots are blood then my sample too should indicate presence of blood rite ? But i got a result showing occult blood absent. Should have i given sample which had black spots ?

Am confused doctor. Kindly help me.

Answered by Dr. Jay Patel 8 hours later
Hello again,

Let me explain why I told you there is nothing to worry. The gut is about 6 foot long and the such a long organ will have a little bit scratch, like we have on our skin as a part of normal wear tear. The scratch may be from some friction caused by passing stool or a hard product which we ate. It may ooze some very very small amount of blood and may show up in microscope with "HIGH POWER FIELD". The real bleeding can be visualized even with naked eyes or with "LOW POWER FIELD". But, in your case RBC are only seen in HIGH MAGNIFICATION which means they are very very low in stool. It can even be present in anybody's stool sample. Its with in normal range. Please stop worrying about 0-1 RBC HPF.

Presence of bacterial infection may contribute to RBC. But there are two types of bacteria. One of them are called (1)helping kind {which are described in previous answer #4} and (2) pathological/ harmful type, the presence of harmful kind of bacteria, which can cause infections. This can cause some RBC in stool, but it will show more rise in "WBC" count and that is a point to check in case of infection. RBC seen in stool at very low number as in your case is not to be worried for.

Hard stool will be felt while your are going to bathroom, its not all the time it occurs. It only occurs if you do eat some less fibrous food for long time. The gut being very long like 6 feet. Its hard to figure out the location of very minor scratch. Its like trying to find needle in haystacks. There is no need to do any test for very small finding like "0-1 RBC HPF" results. Sometimes, it can be a stool particle seen in microscope and can be mistaken as RBC.

About the gut, the inner lining of gut is sloughed off every now and then, and new layer is formed constantly. Its like snake scaling off its external skin, if you have seen it. The 2-5 RBC hpf may have coincided with such sloughing off event, still its very normal. Please stop worrying about very low RBC in stool.

Black spots may be some times from the food ingested like "whole MUSTARD SEED". But its mostly from blood coming out from stomach reacted with acid. But even if you did not have the black portion in the stool, the stool will test positive for occult blood in case of blood. But in your case the occult blood came out to be negative. So there is no major bleeding in your gut. Everything looks fine as per your stool test report.

Hope this will help you clear your confusion. If still in any doubts, feel free to contact me as many times you feel like.

Thanks again.
Above answer was peer-reviewed by
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