Hi, * The severe abdomen pain with blood in stool indicates possible issue of bowel infection, inflammation, colitis, diverticulitis or other pathology. In my clinic, I do recommend a basic evaluation with - per abdomen and per rectal, anoscopy examination on OPD basis - stool microscopy, complete blood cell counts to look particularly, leucocytosis, changes in lymphocytes, erythrocyte sedimentation rate, occult or fresh blood with vegetable or epithelial cells in stool and others. Depending upon the symptoms, I request to take anti spasmodic and supportive medications after clinical assessment and depending upon the data of lab , I decide further line of action. As the symptoms progress or regress and reports guide, one may or may not need colonoscopy examination. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Bhagyesh V. Patel, General Surgeon