Blood in stool & Lower back pain

[Jetsetter123]

Hi,

Quick overview.

Had a work/sport injury, resulting in a bulge disc in my lower back in start of Aug. I was on strong anti inflammatory pills and then got better but had to start doing regular Physiotherapy as I had leg pain with the back pain. I have not been to the physio again as I'm managing with no pain and doing stretches frequently, maybe only a little pain when sitting long. End of Aug I saw a small amount of blood on toilet paper. It reoccurred every 1 or 2 weeks. then disappeared for Nov. Dec one more occurrence after flying a 14 hour flight. All occurrences were fairly small amounts (less than a quarter teaspoon), painless, and only happened when I was straining, but straining was at a minimum. Now I eat more fruit, drink a lot of water and take a natural fibre supplement twice a day. Bowl movements changed to twice a day, very consistent, morning and early afternoon, but I feel bloated some times, still get back pain but lower than previous more on the bone near rectum. I haven't seen any blood in my stool that I can confirm or on toilet paper but if I do look closely too stool in the toilet it looks like there might be some red stuff, but I can't be 100% sure. My recent stool has a shape and consistency of something like type 5 or 6 stool on the Bristol Stool Scale.

My most recent occurrence of blood was when we went kayaking for 3 hours which made my lower back quite stiff and that night caused some blood in toilet and on toilet paper. Bright red blood. After that bowl movement I had one more bowl movement with a little maroon colour on the toilet paper but nothing in the toilet. I assumed the worst had passed in the first bowl movement.

My doctor keeps giving me Presto Gel Rectal repositories to take before I go to sleep and insist I drink more water and up my fibre which I have already done. I am fairly fit. I jog 2 kilometres a day and go to the gym twice working out doing weight lifting for 1.5 Hour in the afternoon and 2 hours after work. I do drink pre workout that consist of Beta-alanine, betaine anhydrous, taurine, potassium nitrate, N-Acetyl L-Tyrosine, Caffeine Anhydrous, Juglans Regia (Root Extract). When I exercise I tend to avoid exercises that put strain on my bowl like stomach and lower back exercises.

A week ago I woke up at 4am with extreme stomach cramps and bloating. Not like its never happened in my life before but never before with above symptoms. Something else to note is my weight is consistent and im not losing any weight or gaining. Maybe losing some fat with all my exercising lately. But normally I stay between 84kg and 86kg.

Also something to note, I don't have a stressful job so I'm not thinking its stress related.

I'm very concerned it might be something that could be prevented if caught early but it feels like my doctor is just delaying until symptoms get worse before referring me to get other tests done.

Any advise would be greatly appreciated. After reading up so much I would just want to put my mind at ease for once. I might have over read and researched my symptoms.

Thanks to who ever is taking the time to read my question.

[Hidden]

Hey bud, out of interest has dr done any stool sample checks, rectal exams or prostate examinations?

[Jetsetter123 in reply to Hidden]

Hey. He actually did perform a rectal check(with his fiñger) but said he found nothing and all seemed normal

[Hidden in reply to Jetsetter123]

Ah good news there, surely gp should do stool sample if blood in it & bleeding?

[Jetsetter123 in reply to Hidden]

Nope. Thats the frustrating part of it. You think I should request a stool test?

[Hidden in reply to Jetsetter123]

Yeah defo, that was one of the other things doc did when I was bleeding, I think some of these tests are age related, how old are you?

[Jetsetter123 in reply to Hidden]

Ah that makes sense. He obviously thinks because of my age the likelihood of something serious is small. But nonetheless I've read of plenty of cases where a younger person was diagnosed with one of more serious diseases. I don't feel the same lately, don't know if it's because I am over thinking things or if how I am feeling really is different from normally. I'm turning 28 in January now.

[Hidden in reply to Jetsetter123]

Yup possibly, I know my doc dismissed things because of my age but I pushed him for tests due to family illnesses, some of it’s probably overthinking but I would defo push him because as you say there maybe few younger cases but they do exist and if you don’t feel right you know your mind and body bud

[Jetsetter123 in reply to Hidden]

Ah i see, if you don't mind me asking what was your problem and what test did you end up doing? I think at the least I will clear my head of this stuff for the next week or so and just focus on everything the doc has advised and if something happens or if i still don't feel as i "normally" would I will maybe start pressing for tests.

[Jetsetter123 in reply to Jetsetter123]

By the way. Thanks for the advice. Strangely helps discussing this stuff and reading about other people with similar issues.

[Hidden]

Good plan, yup agreed reading and talking with others does help, I was diagnosed with a anal fissure & internal haemorrhoids so nothing to serious thankfully

[Jetsetter123 in reply to Hidden]

That is good news. I'm reallt hoping it just is a not to serious case of internal haemorrhoids. Mind if I ask how the haemorrhoids issue got resolved? And is it completely resolved?

[Hidden in reply to Jetsetter123]

Dr prescribed some suppositories & cream to apply, meds resolved but they come back now n then, i presume I have a case of them now as I have blood again but just small amount, dr did rectal examination with the finger to check prostate as well but also used some form of equipment to allow him to see inside

[Hidden]

Weightlifting can also cause them

[Jetsetter123 in reply to Hidden]

Thanks that is good to know.

Unfortunate about the weight lifting though. I'm really enjoying it. Being one of my few hobbies I guess I'll have to take it easy but not quit completely and see how it affects me.

[jonblane]

Under no circumstances should you delay further getting this symptom investigated.

Request specifically that you be referred to a gastro enterologist with a view to having a colonoscopy. If the GP refuses ~ request to see a different GP at the same surgery for a second opinion.

If this request is refused then change medical practice and start again.

It is true that at your age the symptom is more likely to be caused by piles ( haemorroids ) than digestive tract cancer. However the latter cannot be ruled out without further investigation. There ARE cases of colon cancer in younger men ~uncommon but it does happen, and of course the prognosis is much better with early detection.

Even if , on investigation, it is only piles then A] your mind will be put at rest which is itself an important benefit to health; and B] the instrument used for colonoscopy has not only a camera but also a cutting tool which can be used to clip the piles ~which should end the symptom of blood in stool.

Also the specialist gastro ~entero specialist may well have other ideas as to diagnosis etc. if piles are also absent. SOMEthing is causing it ~it is not remotely normal or something you should expect to just have on a regular basis.

[Jetsetter123 in reply to jonblane]

Hi Jonblane.

Thanks for your reply. It helps to hear that I'm not over reacting to the situation. I really feel like my gp isn't taking this as serious as I would want him too. My reasoning was the same as your even if they find the piles at least i would know. But one thing that I'm confused about is the severity of piles and what kind of symptoms they cause in the early stage.

Also I can't seem to understand how my lower back is related.

Luckily i wouldn't need my go to really refer my to a gastroenterologist. I can just read up and make a booking myself. Or well thats how I understand it. (From New Zealand. Haven't been here long so don't know all the rules yet)

[Phiden18]

Hi, I agree with the comments left by jonblane. It is very likely to be haemorrhoids or an anal fissure - however, because you have been experiencing abdominal pain and bloating, it is imperative to rule out other causes; this would not necessarily be indicative of bowel or anal cancer, but could possibly be Crohn's or Colitis (as I have, though thankfully quiescent!) or IBS, or a combination of conditions, all of which are treatable. Please do not waste any more time with your GP, most of them lack specialist knowledge and some of them... it really beggars belief that they made it through medical school at all! Ask for a referral to a gastroenterologist straight away. I can make a recommendation if you live in or near Cambridgeshire? If not, demand that referral and research which gastroenterologist in your area has the most expertise in IBD - they will be the most able to provide you with an accurate diagnosis and arrange the most appropriate investigate path. Good luck, and please let me know if I can be of any further help? I have suffered from haemorrhoids (internal and external), anal fissures, Crohn's and IBS, so am very well informed in this area!

[Jetsetter123 in reply to Phiden18]

Hi phiden18.

I would have really appreciated a referral but sadly I'm in New Zealand 😅 i do however have a question regarding anal fisure. Does it occur outside the anal region or inside?

Im not sure how severe my situation is yet but I am most certainly not going to waste time any more. The not knowing is ruining my well being. I've heard people with crohns and IBS can manage it fairly well. But im curious how does it affect your life style? Can you do sport activities? Do you have to take supplements for your bowl movements. Diet changes?

Thanks so much for all your advice guys.

[Phiden18 in reply to Jetsetter123]

Hi Jetsetter123 and apologies for my belated reply - have been crazy busy over the weekend!

So without further ado, to answer your questions - anal fissures usually affect the anal opening and tend to occur when passing large stools or because there's a stricture around the anal sphincter.

Your other question regarding Crohn's and IBS is far more complex and would take an essay length answer in order to do it justice! However, in a nutshell, Crohn's and Colitis are inflammatory disorders in which the sufferer's immune system oversensitises, causing an inflammatory response the same as when the body is fighting a foreign body or injury. Because 60% of our immune system resides in the intestines, this is usually where IBD tends to hit most commonly. It can though, affect other areas of the body, including joints (rheumatoid arthritis, for example). Treatment is very varied and a bit hit-and-miss at the outset, with a tiered methodology for administering medications and dependent on if the patient has an immediate, acute flare-up or needs preventative/prophylactic drugs. In my personal experience, I had a very severe form of Crohn's that quickly escalated, requiring years of surgeries and aggressive drug therapies. Do not let this scare you! I had absolutely pathetic medical care for the first few years after diagnosis, which is why I am impressing on you, the urgency to get this checked. Reassuringly, the symptoms you describe, do not sound like those caused by IBD. I have now been in remission for almost a decade and can live a fairly normal life, but I do suffer from Chronic Fatigue Syndrome, Fibromyalgia and a weak immune system, the latter being the result of immunosuppressive drugs. I do take various supplements, such as probiotics, starflower oil and turmeric. I do tend to suffer from diarrhoea or loose bowel movements, which can be fairly frequent - this is kept in check with the occasional loperamide, but I also find Merbeverine, Hyoscine Hydrochloride (Buscopan) and Odansetron helpful. Dietary restrictions are nearly always an issue with IBD, usually involving a low fibre diet - tricky if you're vegetarian like me!

IBS is very different to IBD (Crohn's and Colitis), though it can occur concurrently with IBD! Such is the case for me! IBS can be helped by drugs such as Merbeverine and Hyoscine Hydrochloride. However, the best weapon in your arsenal (excuse the pun!😉), is stress management, plenty of rest, and noting what your triggers are.

Sorry this is so wordy, but I wanted to make sure you were armed with all the facts from someone who's been there! You might find the following website useful:

crohnsandcolitis.org.uk

Good luck and please do get in touch if you need further advice or support; you are welcome to message privately if preferred.

[Hidden]

Anal fissure can be both bud, I have IBS it’s just learning your trigger foods, lifestyle takes a bit to get used to re eating out, sports fine with IBS, my specialist gave me the FOD MAP diet, basically cuts ya foods back to basics n u gradually add foods back to help you find your triggers, for example beetroot in vinegar is a trigger & mango is, google the diet it originated in Australia, Crohns is a lot worse than IBS