Question: Hello - I am a 37yr old Asian male. I consider myself to be in good athletic shape with my only health issues being I take 50mg of zoloft for GAD daily and I have high cholesterol. I usually go to the gym 2-3 times per week and I mix my time between weights and cardio.

Here is my concern: Last Monday (05Oct) I came down with the flu. Sore throat, congestion, fever, body aches, fatigue...the usual mess. I immediately started taking mucinex cold every 4 hrs to hopefully combat any congestion and break up my phlegm. In addition, I took cherry tussin to help combat my cough. Throughout, I continued to take mucinex and some Advil. I finally went to the doc on Wed and he gave me a ZPACK and stated I could continue with the mucinex, cherry tussin, and Advil. The following Friday I switched up to the 12hr Mucinex D hoping the pseudoephedrine would help better with my congestion. Anyway, that Sunday, I woke up, started my day and sometime mid-morning, I developed a bad bloody nose. I attributed it to the mucinex and thinning out the membranes in my nasal passages. What concerned me most was that on the same day I had a bowel movement and I noticed blood in the water of the toilet bowl. Not so much in the stool, but more in the water and in the toilet paper. It was a bright red. It looked as if it had dripped from my rectum. I have had 4 bowel movements since then, but no more blood in the water and/or stool.

-The nose bleed lasted approximately 10mins and then ceased. No further bloody noses since and it was the first and only incident. It was a decent amount of blood, but nothing crazy.

-The doctor knew I was on the Zoloft (been using it for 9 yrs. now)

-No rashes, vomiting, diarrhea, stomach ache. Just fatigue and headache from flu.

-Bowel movements seemed normal. No extreme pushing or any weird pains, etc.

*I immediately stopped taking any cold/flu medication (Mucinex) or Advil since the blood in my stool. I continue to take my zoloft.

*No incidents of bloody stool water since the initial incident.

All meds taken last week: Mucinex day/night; Mucinex D (2 TIMES); Advil; Zoloft 50mg; daily multi vitamin; immune booster (herbal); cherry tussin (2 TIMES); ZPACK (2PILLS FIRST DAY 1 PAY FOR 4 DAYS AFTER);

My last CBC was conducted approx. 5 months ago and aside from my cholesterol, all numbers were within range. I just ultimately want to know if the blood I saw in my stool and in the water, on the one occasion, is something I should immediately see my doctor for and something I should genuinely be concerned about or is it something that I can just monitor for now.

UPDATE: No further issues with the bloody nose or blood in stool, but I continued to feel under the weather, specifically, cough, phlegm, and fatigue. On 16Oct, I followed up with a urgent care physician and they completed both a chest X-ray and cbc. the CBC showed the following with abnormalities:

LOINC Code     Test     Result     Normal Range     Abnormal Flag Date Performed
6690-2 CBC/Diff-m-WBC     16.6     4.4-11.0 K/mm3     abnormal     10/16/2015
789-8      CBC/Diff-m-RBC     4.57     4.5-5.9 M/mm3     normal     10/16/2015
718-7      CBC/Diff-m-Hgb     14.7     14.0-17.5 g/dL     normal     10/16/2015
4544-3 CBC/Diff-m-Hct     41.9     41.5-50.4 %      normal     10/16/2015
787-2     CBC/Diff-m-MCV     92     80-96 fL     normal     10/16/2015
785-6     CBC/Diff-m-MCH     32.3     27.5-33.2 pg     normal     10/16/2015
786-4     CBC/Diff-m-MCHC     35.2     33.4-35.5 g/dL     normal     10/16/2015
777-3     CBC/Diff-m-Plat     344     150-450 K/mm3     normal     10/16/2015
770-8     CBC/Diff-m-Seg     81.5     40.9-70.9 %     abnormal     10/16/2015
736-9     CBC/Diff-m-Lymph     14.7     22.7-43.6 %     abnormal     10/16/2015
5905-5 CBC/Diff-m-Mono     3.8     0.0-7.3 %     normal     10/16/2015

Chest X-RAY revealed: There is a poorly defined fibronodular density in the right upper lung zone, most likely representing an acute infiltrate.

I was prescribed:ALBUTEROL HFA INHALER, GUAIFEN & CODEINE ORAL SOL'N, LEVOFLOXACIN and a MEDROL DOSEPACK

Diagnosis: Acute Bronchitis; the doc was not too concerned with the blood in my stool or nosebleed.

My question to you is, at what point should I start to feel better. I started taking all medication on Saturday 10/17/14. Although I do not have much phlegm I am still coughing somewhat. Are there any other more serious medical conditions I should be worried about and when should I recontact my primary care physician if I feel my condition has not improved.