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What Causes Frequent Bowel Movements Along With Blood In Stool? D

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Posted on Sat, 19 Nov 2016
Question: I have moderate to severe crohns and UC. I have been in a serious flare for the past month, prior to this I had been able to largely manage my sx through diet. I am now having 5+ bowel movements/ day with a very significant amount of bright red blood. I also have several bowel movements with no stool at all, just blood clots. I did a prednisone taper, which didn't help at all. Got blood work results back yesterday and liver enzymes are elevated. Alanine aminotransferase at 116 and aspartate aminotransferase at 109. I'm 36 years old. I had pre-cancerous polyps removed when I was 30. I had my last colonoscopy 2 months ago and signs has improved. I also had a abdominal US just before that, which was negative. I don't know if this is all IBD, or of something else is going on, but it's scary. My husband and I are hoping to get pregnant next year and the last thing I want is to be on some of these serious drugs. Not sure what to do.
doctor
Answered by Dr. Tayyab Malik (10 hours later)
Brief Answer:
kindly read detailed answer below

Detailed Answer:
hi.
thanks for posting query at HCM.

i read your question thoroughly and understood your concern.
i would try to answer in the best of my capacity.

1. Increased bowel movements with bright red blood

Since you recently underwent colonoscopic examination and it did not display a significant finding, so infectious causes of bloody diarrhea may also be ruled out. ( diarrhea is also a term for increased bowel movements) .
therefore, i recommend you to have "stool culture and leukocyte stool test". If these tests are negative for infectious cause then you may need immunomodulators / biological drugs to combat the current symptoms. it maybe a flare of IBD. the aforementioned drugs are used to treat refractory cases of IBD. another option is Salicylate ( Sulfasalazine ) if you did not take this drug previously.

2. Increased liver enzymes

your liver enzyme values are NOT worrisome. However your advised to rule out viral causes. therefore, Blood test for viral serology are recommended -
HBsAg, anti HBs and anti HCV.
If your obese or overweight, lipid profile test may also be done.
avoid alcohol altogether and avoid junk food as well as oil-rich food.
2 tsp pure edible olive oil maybe ingested on empty stomach to restore colon architecture and improve digestion function.

hope to answer your concern.

further questions are welcomed.
regards

Dr Tayyab Malik

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Tayyab Malik (24 minutes later)
If it is all related to my IBD, again I usually try to avoid drugs. We plan to get pregnant in the next several months and would prefer not to be on a long term medicaion.

Which medications may help me for the short term if this has no viral causes? Also, I am not overweight, but previously I worked out and trained for triathlon 6 days a week. I have no longer been able to do this and have gained about 15lbs. I don't want to gain weight in this process. Which drugs may help me avoid this?

Thanks, XXXXXXX
doctor
Answered by Dr. Tayyab Malik (10 hours later)
Brief Answer:
Kindly read detailed amswer below

Detailed Answer:
hi.
thanks for getting back to me.

Salicylates against IBD are relatively safe medicine with minimum side effects. if currently, if its just a flare of IBD, long term treatment may not be necessary. only few weeks treatment with any drug maybe sufficient and you may get pregnant as per planing.furthermore, avoid food that might precipitate IBD symptoms.
you may discuss starting slaicylates after discussing with treating physician.

secondly, if viral causes are excluded for hepatitis ; then avoiding alcohol, oil rich food and junk food will be sufficient. no drugs for treatment needed. recheck liver enzymes after 6 to 8 weeks.

any further questions are welcomed
regards

Dr Tayyab Malik
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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What Causes Frequent Bowel Movements Along With Blood In Stool? D

Brief Answer: kindly read detailed answer below Detailed Answer: hi. thanks for posting query at HCM. i read your question thoroughly and understood your concern. i would try to answer in the best of my capacity. 1. Increased bowel movements with bright red blood Since you recently underwent colonoscopic examination and it did not display a significant finding, so infectious causes of bloody diarrhea may also be ruled out. ( diarrhea is also a term for increased bowel movements) . therefore, i recommend you to have "stool culture and leukocyte stool test". If these tests are negative for infectious cause then you may need immunomodulators / biological drugs to combat the current symptoms. it maybe a flare of IBD. the aforementioned drugs are used to treat refractory cases of IBD. another option is Salicylate ( Sulfasalazine ) if you did not take this drug previously. 2. Increased liver enzymes your liver enzyme values are NOT worrisome. However your advised to rule out viral causes. therefore, Blood test for viral serology are recommended - HBsAg, anti HBs and anti HCV. If your obese or overweight, lipid profile test may also be done. avoid alcohol altogether and avoid junk food as well as oil-rich food. 2 tsp pure edible olive oil maybe ingested on empty stomach to restore colon architecture and improve digestion function. hope to answer your concern. further questions are welcomed. regards Dr Tayyab Malik