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Have GERD. Found blood in stools. Took Zolpidem. Suggest

Apr 2013
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General Surgeon
Practicing since : 2008
Answered : 9351 Questions
Hi- I have had moss-to dark green stoll ab 3 mos- mixed with what I call IBS 6mos ago and again last month.
I say IBS because I had in late 90's this is more like loose bowels till noon
I was on statins for 4 yrs till 4/2012- kept me very regular.
Off them now because of side effec.ts
Pretty sure I have GERD take Prilosec-2x year until 02 now every few weeks.
Here it comes-today 2nd day I found blood in stool. First time ever-def pink/red blood swirling.
Now what? I am 58 -finished menopause 2007-am adopted-going thru alot of non-intestinal things- eg arthritis, tinnitus. Take Dicofenac Sod 75 for pain and zolpidem tart er 12.5 for a new muscle/bone issue just since
yet to be diagnosed. ist time ever pain/sleep pills.
Theblood scares me.

Thank you.
Posted Tue, 4 Jun 2013 in Digestion and Bowels
Answered by Dr. Ivan R. Rommstein 5 hours later

Thank you for your query.

Blood in stool scares everyone who notices this and people always think of the worst which is wrong. Fortunately, the most causes (more than 95%) of blood in stool are benign, treatable and don’t cause serious difficulties. So you don’t have to be concerned, just need to watch for some signs I will mention and do some tests.

First, this green stool can be sign that transit time of stool is too fast, not sufficiently exposure to bile during digestion. Also can be caused by certain vegetables. So if this happens again you should check your biliary and hepatic system by doing liver enzymes and liver and gallbladder ultrasound.
Also eat 25-30 grams of fiber/day, reduce aspirin/Ibuprofen and reduce alcohol use. IBD is a diagnosis I don’t like very much. This is used when no specific bowel pathology is found. But it can lead to faster stool transit and greenish stool, but it can’t cause blood in stool...

Secondly, long-term use of diclofenac and similar NSAIDs predisposes for peptic ulcer which can cause upper GI bleeding. In this case stool wouldn’t be red, it would be coffee ground black called XXXXXXX However, if you feel stomach difficulties, bloating and heartburn you should switch to another painkiller.

When talking about those causes of fresh blood in stool; in your age most common causes re angiodysplasia, fissures, hemorrhoids and polyps. These 4 are those 95% I have mentioned. Angiodysplasia is actually broken bowel wall vessel which bleeds for a while and then stops. It can’t cause serious bleeding or anaemia and no treatment is necessary.

Hemorrhoids usually bleed when defecating and are associated with burning pain. It can be easily diagnosed by proctologist examination and there are various methods of treatment.
Polyps can bleed periodically and always must be considered in such conditions. It can be verified only by colonoscopy which is also curative method for such lesions. Also polyps can transform to maligancices sometimes.

Some countries recommend to do colonoscopy for every women aged >55 as a preventional program. So you don’t need to hurry but I suggest that if you notice this again and there is no hemorrhoids or fissure, you should do colonoscopy to rule polyps and tumours out.

If you don’t notice this again then do occult stool blood test and check your red blood count. If there is anaemia or positive stool test, do colonoscopy.

Wish you good health. If you have any question I will be glad to help.
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