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Hi everyone.

I had my takedown at the end of March, so I'm almost 3.5 months out. For the past 2-3 weeks or so I have been noticing small amounts of bleeding occasionally after a BM that have gotten slightly worse in the last few days. Other than this I'm feeling pretty good; no pain, going to the toilet 5-6 times in a 24 hour period, stool is somewhat formed.

I'm worried that the blood is a sign of pouchitis or cuffitis, but since I am not having any other symptoms I'm a bit stumped. Could it be an internal hemorrhoid?

Some things I have noticed:

  • The blood is bright to medium red
  • The blood is always at the end of a BM, not mixed with the stool. It is literally a few drops of blood running out of my anus (don't ask me how I know this)
  • Usually only visible on TP, sometimes a little bit in the toilet
  • It seems to get worse (more blood) if I prolong going to the bathroom, almost as if the stool keeps irritating something in there
  • It doesn't happen every time I go to the toilet. Maybe 2 times per day
  • I do take psyllium in order to bulk up my stool. Perhaps I'm overdoing it?


In short: Small amount of bleeding with no other symptoms. Anyone got any ideas?

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Hemorrhoids can run the gamut from going way by themselves to (in extreme cases) requiring surgery. The key recommendation is to not strain on the toilet, which is good advice for J-pouchers in general, and to make sure your stool stays soft (but not liquid). You probably want your doc to take a look, to verify the diagnosis.

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