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Dr. Andrew Rynne

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Ulcerative colitis, regular bowel movement, blood on the paper, flaky stool, no pain. Is it a fissure and constipation?

My daughter has ulcerative colitis and has been off prednisone for 3 weeks. She has been having one regular bowel movement per day until a few days ago. She skipped a day, then had a bowel movement and had blood on the paper. This has remained for the past few days. She has now skipped 2 days of having a bowel movement and went today, having a little more blood and some flaky stool . Her GI doctor thinks she probably has a fissure and is constipated. Do you agree with this. She is having no pain at all.
Fri, 12 Apr 2019
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General Surgeon 's  Response

* As per my surgical experience, the issue of fissure usually present with moderate to severe pain in and around the anal opening.
* So, the possible cause of blood in stool is more likely related to internal bleeding from the colon, rather than surface bleed.

However, the condition must be evaluated with per rectal examination by a consultant for confirmation.

* Till that time, sitz bath and high fiber diet with bulk-forming laxative as Ispaghula husk will serve best relieving agents for her.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Dr Bhagyesh V. Patel, General Surgeon
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