Stumped & GI can't give a straight answer...Need you guy's/gals to put your thinking caps on please.

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Veteran Member

Date Joined Mar 2008
Total Posts : 1580
   Posted 6/13/2008 10:16 PM (GMT -6)   
I have been passing nice formed stools for the most part and have had no D, but about 3 weeks ago I switched from Asacol to Lialda and I started getting a mini flair w/ stomach pain, still no D, no mucous but some bright red blood at the end, and only at the end, of a BM.  I asked my GI doc what it means that I'm only getting blood at the very end of a BM and he said it could be from the lower end of the colon or higher above. He upped the Lialda to 4 per day which equates to 12 asacol (I was only taking 8 asaocl before with rowasas every other night) and he also upped the rowasas to every night for a week...the bleeding stopped and I started feeling better after a week or so and no blood.
I still feel fine with little or no pain and I cut the Lialda back to 3 perday and the rowasa to every other night but this morning I passed a VERY large wide stool and I could feel  pain in the rectum/anus as the stool passed, and once again I got a bit of blood but ONLY at the very end of the BM. Tonight whem I had a BM I also passed so very large stool and still felt pain my rectum/anus as it passed and there was no blood on the stool except for the very end of the BM again...the blood was bright red and it seemed to be on the surface and a bit mixed in. I do have an old fissure but if it opened up why blood only at the tail end?
It's funny I normally pass smoother more solid stool at the beginning of a BM (provided I'm not in a flair) but at the end it always softer and fluffier...I asked my GI doc about that a few times and he always mumbles something about electrolyte levels etc.
So after reading the facts above, what do you guys think is causing the blood and only at the tail end (no pun intended) of my BM's?

Post Edited (bbc) : 6/13/2008 9:32:04 PM (GMT-6)

Elite Member

Date Joined Mar 2003
Total Posts : 10407
   Posted 6/13/2008 10:37 PM (GMT -6)   
bbc, sounds like it could be hemorrhoids or possibly a fissure. Sometimes if they're starting to open up, they'll only bleed when stretched a lot - as in passing a large stool. Have you taken a look in the mirror? If there's no fissure, you might try an over the counter like Preparation H of ask your GI if he'll give you a script for some cortifoam to use for a bit to help it heal up.

I'd say the beginning of your stool has been sitting in the rectum compacting, and the end just arrived and isn't as compacted yet. That's pretty common, even for people who don't have IBD.
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
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Regular Member

Date Joined Apr 2008
Total Posts : 499
   Posted 6/13/2008 10:43 PM (GMT -6)   
My first thought was maybe hemmoroids but I am no expert. Hope it gets better soon.
Lori (Bellski)-age 43 from Illinois
Diagnosed February 2008 with Ulcerative Proctitis,
Currently: symptoms have subsided for the most part
Medications:  Asacol 400mg X 6, Cymbalta 20 mg X 1, Canasa (sometimes) Vitamins:  Calcium 600 + D X 2, One a Day Women's X 1, Citrucel, Probiotics
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Veteran Member

Date Joined Mar 2008
Total Posts : 1580
   Posted 6/13/2008 10:44 PM (GMT -6)   
Thanks Judy.

I edited my post above mentioning that I have an old anal fissure so I'm hoping that's whats causing the bleeding. My question is if the large stool opened up the fissure then why was there no blood on the large stool pieces and just on the soft stuff at the end.

Veteran Member

Date Joined Mar 2008
Total Posts : 1580
   Posted 6/13/2008 10:45 PM (GMT -6)   
Thanks Bellski.
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