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What causes flatulence with bleeding during a bowel movement?

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Gastroenterologist
Practicing since : 1986
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I am 88, diagnosed with prostate cancer, 2010, took Lupron for a year and 42 doses of IMRT. Since then my PSA has been between .2 and .3, so in remission I presume. Several times in the past year, I experienced a lengthy bout of intestinal gas, for several minutes, ending in much gas, heavy traces of red blood, no fecal material, but some bloody particles. A normal BM occasionally shows a trace but sometimes not. Is the gas causing the bleeding or is the bleeding source causing the gas? What is going on? XXXXXXX
Sat, 9 Jun 2018 in Digestion and Bowels
 
 
Answered by Dr. Ramesh Kumar 3 hours later
Brief Answer:
please see details.

Detailed Answer:
Hello,
Thank you for choosing HealthcareMagic for your query.
I've gone through your details.
I am Dr Kumar and would be addressing your concerns.

There are a few things to consider when a person says he has blood in the stool.

The first thing is if it is really blood. There are some food and industrial chemicals that might be in stool and give the impression it is blood and in fact, it is not. Unless it bright red blood (which is clear that it is blood). Other times the way to know if you are bleeding or not is having a stool occult blood test or a stool microscopy that will confirm the presence of blood with the stools.

Generally, blood coming from higher levels (stomach and small bowel) converts into a dark coal black colour due to the changes the blood has in the bowel. It is the bleeding from lower parts (colon) that will show as bright red blood.

Have you ever had a colonoscopy done? After the age of 50, it is recommended that all people should have a colonoscopy every 5-10 years. Even if you have had this test in the last 5 years it might be recommended to repeat it as you are having this bleeding if the stool tests confirm you are really bleeding.

A CBC would be a good test to be done if you suspect bleeding to see if you are developing anaemia as a complication of bleeding and need treatment for it or not.

So to conclude:
1. we need to be sure you are bleeding or not- a stool test like faecal occult blood test and or stool microscopy for blood will help in this.

2. if it is confirmed that you are bleeding then you will need a colonoscopy to find the cause of it.

3. if you have bright red blood while defecating (passing stools) this might also be due to haemorrhoids which are mostly due to constipation so in meantime please make sure you take extra fibre with diet and drink plenty of water.

4. if you had any massive rectal bleeding than an urgent visit to a doctor is needed.


Gas is not related to blood
The pathophysiology of gas and flatulence is complicated.
The term gut microflora or microbiota means hundeds of species of bacteria which lives in our intestinal tractintestinal tract.These bacterias and yeast are responsible for proper digestion and fermentation of food. Hundereds of species of bacteria and yeast re found in colon of human intestine.In the same way thousands of these species florishes in our gut these bacteria play a vital role in digestuio and absorption of food.Even minor disturbances in gut microflora can lead to significant changes in gut function, including gas production.
There are various mechanism that can be related to increased flatulence

If this microbiota is disturbed food is improperly fermented causing production of large amount of gases in gut leading to severe flatulence.Hence most commmon cause in most of the cases is disturbed microbiota.In old patient mobility of intestines is severly compromised leading to accumulation of large amount of gases in intestines.As persitaltic moments are week gas accumulates in intestines.Severe constipation or incomplete evacuation can also hinder the passage of gases.


-Small Intestinal Bacterial Overgrowth can be a reason of gas

Tests suggested-
Small bowel imaging and a gastric-emptying scan.


Hope i answered your query with relevent details.I have included pathophysiological details also so that you can understand things better as you have asked the same question twice before, therefore i have tried to include all details you could be looking for.

In case you need any other professional advice feel free to ask.
Thank you.
.
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