When I saw it, I screamed.
I tossed my jacket on the back of a chair on a warm afternoon in March and headed for the bathroom. The familiar abdominal cramping from Crohn’s disease hit a few steps later.
When I finished in the powder room, I was shocked to spot patches of bright red blood on a piece of bathroom tissue. I just sat there for maybe 30 seconds, already convinced I was dying of cancer.
Blood in the stool is actually pretty common for Crohn’s patients. While the most frequent signs of the disease patients first notice include abdominal pain, cramping and diarrhea, loss of appetite and rectal bleeding are also high on the list, according to LivingwithCrohn’sDisease (LWCD).
Information from the Mayo Clinic suggests that one of the problems in determining whether a patient has Crohn’s or ulcerative colitis is that both diseases can cause intestinal bleeding. Other conditions that are culprits are colon polyps, peptic ulcers, colorectal cancer, constipation, diverticular bleeding, infection and lack of blood supply to the bowel.
The initial question at every visit I’ve made to the best gastroenterologist for treatment is the same: Have you experienced any bleeding? My usual answer has been that I had isolated episodes. Being able to provide the dates only reinforces the need for all Crohn’s patients to record their symptoms on a calendar they bring with them to all medical appointments.
Every physician who has laid eyes on me since I was finally diagnosed with Crohn’s after 20 years of suffering has reiterated that those with the disease are at higher risk for intestinal cancer than individuals in the general U.S. population. However, just because you have rectal bleeding doesn’t mean you have cancer.
What causes blood in stool for Crohn’s patients? There are several possibilities, according to the Mayo Clinic.
Foods and supplements: You might see blood if you’ve ingested beets, licorice or blueberries. Other potential causes include medications such as bismuth subsalicylate, which is sold over the counter as Pepto-Bismol. Any of these can temporarily change the color of solid waste to red, maroon or even black.
Crohn’s disease: Either inflammatory bowel disease – Crohn’s or its first-cousin, ulcerative colitis – can result in intestinal bleeding. Crohn’s disease itself causes tissue in the digestive tract to inflame, ulcerate and bleed on occasion. Food passing through your gut can also aggravate the inflamed areas, causing them to bleed. The blood in stool you notice could be either bright red, meaning it’s from a lower part of the gut, or darker, indicating it probably originated higher in the digestive tract.
Hemorrhoids: Let’s just say they’re not rare among Crohn’s patients, especially those who have had surgery for anal fistulas or fissures. You might notice small drops or smears or bright red blood in your stool, in the toilet bowl, or on the tissue.
Other than scaring you half out of your mind, what are the effects of blood in the stool? The National Digestive Diseases Information Clearinghouse (NDDIC) states that rectal bleeding can indeed be serious and might not stop without medical intervention.
The most common side effect from prolonged bleeding is anemia, which makes the patient feel tired. Anemic individuals have lost too many blood cells and can also experience weight loss, issues with their skin and fever.
Not all blood in stool is visible to the naked eye. Your medical practitioner might conduct repeated lab tests to reveal minute quantities that you can’t see, according to NDDIC. Finding microscopic quantities is often a diagnosis indicator for Crohn’s.
The Clearinghouse suggests the first mode of treatment if the bleeding is actually tied to Crohn’s is to bring the disease under control with medication. The typical drugs used include anti-inflammatories, steroids and immune system suppressors. However, some patients might need surgery to treat blockages, fistulas, infections and bleeding if medication cannot resolve them. Most commonly, this involves removal of the smallest part of the affected areas of the bowel.
What should you do if you have Crohn’s disease and see or suspect blood in your stool? First and foremost, don’t panic and head to the nearest emergency room unless you’re bleeding profusely. Under most circumstances, isolated episodes warrant a call to your physician’s office within 24 hours for advice on how to proceed.