Lots of Bleeding 2 years out

pamela_preib

Hi ya'll, It's been a while.  I've been doing pretty well and I consider myself lucky.  I've had constant issues with diarhea but mostly in the morning, as most of us have and wasn't experiencing too many problems other than that up until my last visit.  I had one issue back in October of heavy bleeding during a bowel movement that scared me, but hadn't had a repeat until recently.  I went in for my follow up (now every six months).  I spoke with my doctor about my issues, and she suggested Metamucil for the diarhhea problem..  Well, since that appointment, every time I have a bowel movement I bleed quite a bit.  Like completely red toilet water.  The only thing I've changed is the Metamucil intake.  I do a glass in the morning, and it has done wonders for my regularity and I'm not constipated, but the blood part is alarmiing.  I'm wondering if anyone else is experiencing this.  I'm going to email my doc and ask her what she thinks. But she told me when I was there that bleeding is normal and that some people deal with it every time they have a bowell movement.  Well, that's me now out of the blue.  Could it be something that happened during my anascopy.  I haven't been the same since, and I certainly don't want to go back and have another one if it's not necessary.  I'm not in pain at all, just bleeding.  Hands off for six months.  I always do the happy dance once I get thru one.  Thanks for any input. 

mp327

Pam

I have never had bleeding to that extent, but I can certainly understand your concern.  It is true that many of us deal with bleeding after treatment.  Radiation enteritis can rear its ugly head at any time post treatment.  It can be aggravated by large or hard stools.  Have you had issues with either of those things?  If it continues, I would definitely contact your doctor again.  Hopefully, things will improve!

Ouch_Ouch_Ouch

If only we had x-ray vision......

Hello, pamela_preib:

I am a little confused. You wrote about diarrhea then mentioned constipation. Are you experiencing both alternately? If so, it could be a symptom of irritable bowel syndrome, the type called IBS-A. (You're right that psyllium can sometimes act like a jell for loose stools.) Are you passing loose stool around constipated stool? That would indicate a fecal impaction and can end up becoming serious, not just uncomfortable.

About the bleeding, bear in mind that it doesn't really take much blood to stain the toilet bowl water pink or even red. But I don't blame you for being a bit feaked out - blood is supposed to stay put, not go out for walks!

Do you have a gastroenterologist you could speak to about controling your stools, someone who can take a good history and examine you? Maybe the oncologist could refer you to one?

All the best.

nicotianna

bleeding

Pam - I have a couple thoughts about the bleeding.  Do you take aspirin or blood thinners?  Also, how are your hemoglobin & hematocrit?

Nic

pamela_preib

Ouch_Ouch_Ouch said:

If only we had x-ray vision......

Hello, pamela_preib:

I am a little confused. You wrote about diarrhea then mentioned constipation. Are you experiencing both alternately? If so, it could be a symptom of irritable bowel syndrome, the type called IBS-A. (You're right that psyllium can sometimes act like a jell for loose stools.) Are you passing loose stool around constipated stool? That would indicate a fecal impaction and can end up becoming serious, not just uncomfortable.

About the bleeding, bear in mind that it doesn't really take much blood to stain the toilet bowl water pink or even red. But I don't blame you for being a bit feaked out - blood is supposed to stay put, not go out for walks!

Do you have a gastroenterologist you could speak to about controling your stools, someone who can take a good history and examine you? Maybe the oncologist could refer you to one?

All the best.

I've never been constipated. 

I've never been constipated.  Just diarrhea.  That was the reason for my doctor suggesting Metamucil.  I've always had strange stomach issues and have suspected I had some form of IBS going on, but have attributed most of my recent trouble to cancer treatment.  Someone posted info regarding the Fodmap diet recently and I have tried to follow that somewhat and it seems to help some.  Onions seem to be a big culprit for me.  I haven't been too concerned about the blood and it doesn't hurt.  It seems to be letting up now.  I also got diagnosed with Hemachromotosis during my chemo so I figure a little blood letting can't hurt haha but I was concerned it was going on for so long. 

pamela_preib

Things seem to be improving

Things seem to be improving the last couple of days.  Just when I start to get concerned and ask questions my symptoms started letting up.  Always nice to have the support here to work thru it.  Thank you all.

Ouch_Ouch_Ouch

pamela_preib said:

I've never been constipated. 

I've never been constipated.  Just diarrhea.  That was the reason for my doctor suggesting Metamucil.  I've always had strange stomach issues and have suspected I had some form of IBS going on, but have attributed most of my recent trouble to cancer treatment.  Someone posted info regarding the Fodmap diet recently and I have tried to follow that somewhat and it seems to help some.  Onions seem to be a big culprit for me.  I haven't been too concerned about the blood and it doesn't hurt.  It seems to be letting up now.  I also got diagnosed with Hemachromotosis during my chemo so I figure a little blood letting can't hurt haha but I was concerned it was going on for so long. 

Sisters in IBS-hood.

Hello, pamela_preib:

I've had IBS since I was young. I have never had the constipation component, either. The only time I had formed poo with any regularity was when I was on an anti-depressant called Cymbalta. Since the aftermath of post-chemo and post-radiation, my GI tract has functioned differently; poos are not as loose and watery as before, but still are problematic: 2-4 x day, long long streams passed each time, pasty - difficult to clear, irritating to the Angry Fissures.

I saw a gastroenterologust on Thursday to see if he had any recommendations on reducing the amount of stuff I pass. He said to continue with the reduced residue diet (it has helped some), prescribed Levsin 0.125 mg under the tongue when needed for cramping, and an over-the-counter daily probiotic called Align (it has different bacteria than the others on the shelf). If these measures aren't effective enough, he might add a low-dose anti-depressant called Pamelor, but is concerned with pushing me over to the too-formed side while I still have Angry Fissures.

I asked about the FODMAP diet. He said the patients he had tried it on didn't have much success, but thought it might have been a compliance issue. Maybe a combination of the low-residue and FODMAP diets.....???

Do you have heditary hemachromotosis or secondary hemachromotosis? If secondary, did the cancer treatment bring it on?

jcruz

Ouch_Ouch_Ouch said:

Sisters in IBS-hood.

Hello, pamela_preib:

I've had IBS since I was young. I have never had the constipation component, either. The only time I had formed poo with any regularity was when I was on an anti-depressant called Cymbalta. Since the aftermath of post-chemo and post-radiation, my GI tract has functioned differently; poos are not as loose and watery as before, but still are problematic: 2-4 x day, long long streams passed each time, pasty - difficult to clear, irritating to the Angry Fissures.

I saw a gastroenterologust on Thursday to see if he had any recommendations on reducing the amount of stuff I pass. He said to continue with the reduced residue diet (it has helped some), prescribed Levsin 0.125 mg under the tongue when needed for cramping, and an over-the-counter daily probiotic called Align (it has different bacteria than the others on the shelf). If these measures aren't effective enough, he might add a low-dose anti-depressant called Pamelor, but is concerned with pushing me over to the too-formed side while I still have Angry Fissures.

I asked about the FODMAP diet. He said the patients he had tried it on didn't have much success, but thought it might have been a compliance issue. Maybe a combination of the low-residue and FODMAP diets.....???

Do you have heditary hemachromotosis or secondary hemachromotosis? If secondary, did the cancer treatment bring it on?

anti-depressants

I've been taking 2 anti-depressants since April when I fell into a deep black hole of depression.  Following my treatment I had become accustomed to 3-4 or more urgent BMs every morning.  Urgency had improved slightly over that time but not much.  But when I started taking the anti-depressants I had the very positive side effect of slowing down the passage of stool, a lot.  I now usually have one (yes, only one) formed by not hard BM in the morning.  It's a rare day when I have any more.  I was talking with old friends from work about our guts.  One who has IBS takes an anti-depressant as part of treatment for that and the other has some other kind of digestive problem, also successfully treated with an anti-depressant.

When the anti-depressants began to have their effect I did have to take a stool softener for a few weeks but I guess my body has adjusted.  It's an incredible feeling to go into my day without that huge anxiety about my bathroom needs.

Interesting?

eihtak

pamela_preib said:

Things seem to be improving

Things seem to be improving the last couple of days.  Just when I start to get concerned and ask questions my symptoms started letting up.  Always nice to have the support here to work thru it.  Thank you all.

Off topic but......

This is way off topic but firstly I'm glad your symptoms are letting up, this reminded me of this though....

I've been saying I don't like my hair for a couple months and I NEED a hair cut, so today I finally have time and guess what......great hair day!  (I still plan to go as I don't think it will last)

katheryn

0626june

eihtak said:

Off topic but......

This is way off topic but firstly I'm glad your symptoms are letting up, this reminded me of this though....

I've been saying I don't like my hair for a couple months and I NEED a hair cut, so today I finally have time and guess what......great hair day!  (I still plan to go as I don't think it will last)

katheryn

aint it the way??

never fails...the day I call and make an appointment for a hair cut, someone will compliment me and tell me my hair looks nice this length.....

 

Ouch_Ouch_Ouch

jcruz said:

anti-depressants

I've been taking 2 anti-depressants since April when I fell into a deep black hole of depression.  Following my treatment I had become accustomed to 3-4 or more urgent BMs every morning.  Urgency had improved slightly over that time but not much.  But when I started taking the anti-depressants I had the very positive side effect of slowing down the passage of stool, a lot.  I now usually have one (yes, only one) formed by not hard BM in the morning.  It's a rare day when I have any more.  I was talking with old friends from work about our guts.  One who has IBS takes an anti-depressant as part of treatment for that and the other has some other kind of digestive problem, also successfully treated with an anti-depressant.

When the anti-depressants began to have their effect I did have to take a stool softener for a few weeks but I guess my body has adjusted.  It's an incredible feeling to go into my day without that huge anxiety about my bathroom needs.

Interesting?

Here's the scoop.......

Neurons (nerve cells) send along impulses from cell to cell in order to accomplish a goal - excitation or calming of the end target cells in the line. But do the cells actually touch one another in order to pass on those impules? NO! They do NOT! There is a teeny-weeny-microscopically small gap, called a synapse, between each cell.

In order to send the signals along the neurons, chemicals called neuro-transmitters are sent across the synaptic gap to stimulate the next neuron in line. This turns out to be a very flexible way to send messages because a number of chemicals, each with a different function, can be the transmitter of choice to suit the situation at hand. Then after the transmitters arrive at the other side of the synapse, like a good recycler, the body breaks it down into its component parts and sends them back upstream in order to be re-used for the next signal. This process is called "reuptaking".

The neuro-transmitter called serotonin causes a calming effect on brain cells. Anti-depressants that act as serotonin reuptake inhibitors (SSRI) in the brain can relieve such conditions as depressions and anxieties. By interferring with that aforementioned reuptake process, SSRIs make sure that the chemical is not immediately broken down into its component parts, but will stick around longer, multiplying that calming effect. Moreover, the nerves that ennervate the intestinal muscles also utilize serotonin to calm the gut. Lower serotonin levels = higher muscle tone with faster bowel motility, looser stools, and cramping; higher serotonin levels = lower muscle tone with a more relaxed gut, slower motility, more formed stools, and little to no cramping.

So, that's why SSRI anti-depressants help with bowel issues, too. Aren't you glad you didn't ask?

mp327

Ouch_Ouch_Ouch said:

Here's the scoop.......

Neurons (nerve cells) send along impulses from cell to cell in order to accomplish a goal - excitation or calming of the end target cells in the line. But do the cells actually touch one another in order to pass on those impules? NO! They do NOT! There is a teeny-weeny-microscopically small gap, called a synapse, between each cell.

In order to send the signals along the neurons, chemicals called neuro-transmitters are sent across the synaptic gap to stimulate the next neuron in line. This turns out to be a very flexible way to send messages because a number of chemicals, each with a different function, can be the transmitter of choice to suit the situation at hand. Then after the transmitters arrive at the other side of the synapse, like a good recycler, the body breaks it down into its component parts and sends them back upstream in order to be re-used for the next signal. This process is called "reuptaking".

The neuro-transmitter called serotonin causes a calming effect on brain cells. Anti-depressants that act as serotonin reuptake inhibitors (SSRI) in the brain can relieve such conditions as depressions and anxieties. By interferring with that aforementioned reuptake process, SSRIs make sure that the chemical is not immediately broken down into its component parts, but will stick around longer, multiplying that calming effect. Moreover, the nerves that ennervate the intestinal muscles also utilize serotonin to calm the gut. Lower serotonin levels = higher muscle tone with faster bowel motility, looser stools, and cramping; higher serotonin levels = lower muscle tone with a more relaxed gut, slower motility, more formed stools, and little to no cramping.

So, that's why SSRI anti-depressants help with bowel issues, too. Aren't you glad you didn't ask?

Ouch

Thanks for the informative post!  I learned a lot from reading it!

jcruz

Ouch_Ouch_Ouch said:

Here's the scoop.......

Neurons (nerve cells) send along impulses from cell to cell in order to accomplish a goal - excitation or calming of the end target cells in the line. But do the cells actually touch one another in order to pass on those impules? NO! They do NOT! There is a teeny-weeny-microscopically small gap, called a synapse, between each cell.

In order to send the signals along the neurons, chemicals called neuro-transmitters are sent across the synaptic gap to stimulate the next neuron in line. This turns out to be a very flexible way to send messages because a number of chemicals, each with a different function, can be the transmitter of choice to suit the situation at hand. Then after the transmitters arrive at the other side of the synapse, like a good recycler, the body breaks it down into its component parts and sends them back upstream in order to be re-used for the next signal. This process is called "reuptaking".

The neuro-transmitter called serotonin causes a calming effect on brain cells. Anti-depressants that act as serotonin reuptake inhibitors (SSRI) in the brain can relieve such conditions as depressions and anxieties. By interferring with that aforementioned reuptake process, SSRIs make sure that the chemical is not immediately broken down into its component parts, but will stick around longer, multiplying that calming effect. Moreover, the nerves that ennervate the intestinal muscles also utilize serotonin to calm the gut. Lower serotonin levels = higher muscle tone with faster bowel motility, looser stools, and cramping; higher serotonin levels = lower muscle tone with a more relaxed gut, slower motility, more formed stools, and little to no cramping.

So, that's why SSRI anti-depressants help with bowel issues, too. Aren't you glad you didn't ask?

thanks

Nice clear summary of how SSRIs work in the brain.  I read as much as I could understand when I first starting taking both an SSRI and an SNRI but this kind of stuff doesn't stick in my head very well.

And I am super-glad they help with bowel issues.  I may never go off of them for several reasons including a deep family history of depression but also it means I can poop like a normal person.  I eat anything I want, even kale salad which was about as far away from my diet as I could think of anything being.  Unless something changes I'm over the plain foods and overcooked veg.

I wonder if this might be offered as something to try for those of us who are dealing with radiation proctitis.