Puzzling rheumy question

[Agavegirl]

I had one of my regular telephone consultations with my rheumy today. My CRP is 6.3 and ESR is 22. I am symptom-free apart from hip stiffness when climbing stairs. He asked all the usual questions and recommended I stay on 3 mgs. The puzzling question was “do I have any bleeding anywhere including in my stools”. I don’t so we just moved on but now I wished I had asked him why this new question. Anyone got any idea?

[Seacat30]

Did he find signs of reduced iron levels in your tests?

[Agavegirl in reply to Seacat30]

He didn’t mention iron levels.

[Seacat30 in reply to Agavegirl]

How about hemoglobin? Did you tell him about any symptoms that might suggest anaemia?

[Agavegirl in reply to Seacat30]

Not as far as I am aware. Apart from this one question the discussion was virtually identical to others I have had with him in the past year. The blood tests cover CRP, ESR and he always tells me these results. Apparently they also cover a white cell count and Neutophil but he only gave me results on these in August 2021 and they haven’t been mentioned since.

[PMRpro Ambassador]

Pred can be associated with a tendency to bleed - and has a not entirely deserved reputation for irritating the stomach which can lead to bleeding there. That is why a lot of doctors in the UK automatically hand out a PPI for stomach protection. Do you take one? (Omeprazole or something else whose name ends in -prazole). If not, maybe he was concerned.

Not that asking about "blood" is much use, if it were originating in the stomach it would be seen as dark, even black, stools not the bright red that most people think of!

[Agavegirl in reply to PMRpro]

I’m prescribed omeprazole but have not taken it once I got down to 5 mgs. I still have fragile skin and bruise easily but I only bleed when the cat gets me.

[Nominem]

I sometimes get small purple spots on skin on 5mg prednisoolone. Just started on statin .I have just lansoprazole prescription instead of omeprazole which caused distentionand burping see how it goes.