Bleeding

Some of you may have seen some of my recent posts however today for the first time since my total colectomy ( December 2017)  I am bleeding. This is not blood from wiping, I came home and got in the shower. Thinking I could let a small bowel movement out, I looked down and was surprised to see somewhat bright red blood between my feet. Since I was showering, I did not get to see how much blood actually came out and I would say it was between 50-100mL if not more. I have not had any bleeding since my colectomy, nor with my ileostomy, and I had my takedown to a j pouch this past June. The doctors are convinced that I do not have Chrons as I was originally diagnosed with UC. I cannot think of any foods that I ate that would have caused this. I started with a small cup of coffee this morning (I drink coffee nearly every day with no issues). Today I ate grilled teriyaki chicken (no veggies or seeds)  white rice, and miso soup for lunch, followed by another small coffee.  I had an Avacado & Rice sushi roll with soy sauce (Seaweed peeled off before consuming) & lastly a Grilled Chicken Breast with a slight amount of barbecue sauce, which I can always handle. Lastly I consumed a decent amount of water (around 1500ml/1.5 lifers) Ever since take down it feels like my pouch is “attacking itself”. I also have been waking up feeling very fatigued and drained, and have expertised a new slight pain near one of my old stoma scars. Could this be a possible adhesion? I have gone through courses of antibiotics to treat what they thought was pouchits with no relief, and found slight relief with Probiotic VSL #3, although it causes me to have extreme gas. The only change to my diet, is that I stopped taking the VSL#3 yesterday. Should I be worried? Should I go to the ER? Fortunately I am able to get ahold of my doctor via an online portal and I am about to request a course of Prednisone. I have been taking Mesalamine 1000mg Suppositories daily. Again I have endured severe “rumbling” pains, along with severe gas ever since takedown. I really appreciate any advice as I have not seen blood like this since my last flare up which led to an emergency colectomy due to toxic megacolon paired with a c diff infection. Any help is greatly appreciated, I would like to avoid going to the ER if possible. Also, I would like to add that I have been feeling a somewhat new pain near my Anus (My rectum was also removed) and the pain near my anus is becoming more frequent, it comes in frequent short waves that do not last long. Again, it feels as if something down there is being “attacked”. Please help, I am on a strict diet avoiding sugars, dairy, carbs, and gluten and keeping them all to a minimum. It is 5am currently and this occurred just about an hour ago, again the primary question is if I should be concerned enough to go to the ER, or wait until my next GI appointment which is in roughly 1 week. My urine this morning was very yellow as if I was dehydrated, Bieber I have been drinking an ample amount of water. Does this sound this like cuffitis? I know there is a  lot of information here, I want to provide all details to get the best responses possible. I just need help from the community as a doctor will likely overlook this and prescribe antibiotics again. 

Original Post

My best guess would be cuffitis, but anything that erodes into a small blood vessel can do this. Have you had a pouchoscopy? Once treatments aren’t working then it’s especially important to reconsider the diagnosis.

There’s a good chance that you’ll be fine until your GI appointment. If the bleeding recurs in quantity then that changes, of course. The ER is likely to be a very disappointing experience unless you’re experiencing life-threatening bleeding.

Why do you think your doctor will overlook this? Do you need a better doctor?

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