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Bright red blood in stools with CROHNS. Treatment?

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Age 56 female with well managd crohns (only mild discomfort with too much dairy or nuts; no problem with salad, apples etc), 4-5 times a week there is a small amount of blood on tp after urinating, which I do a lot because i have to drink a lot to stay hydrated with no large intestine. (Colostamy age 37) Not bright red blood, usually light...sometimes looks like very minimal residual menstruation. Normal cervix (slight thickening) after baseline exam and sonogram 7-8 months ago. Overweight 5'7" 215 ...weight shot up while on Tomoxifen 2004-2009 (Lcis) never been able to get it off again. Seems like a lot of people have blood on tp. Primary said blood can signal a prob. But how much? How often? I feel fine. About to start a new job.

Go to clinic at Teaching hospital. Great GI doc retired (well known large practice); doc who took over his practice refused to see me after I failed to schedule yrly appt (i was crazy busy AND felt fine). Now stuck with revolving door of GI residents who don't really know me. Plus my primary/internist had serious/tragic prolonged medical issues with own children so have been seeing a variety of people in that practice. Not sure if this is anything I should go back to have evaluated.

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thanks for posting your query at DoctorSpring.com
Any kind of post menopausal spotting needs evaluation.
First off, there is nothing to panic.
The most common cause is - Atrophic Vaginitis.
This is dryness of the tissues of the vagina / vulva due to lack of local hormones, leading to friability, breakage and spotting.
More sinister causes such as cervical growths, lesions, infection - need to be ruled out.
Please have an internal evaluation by an OB / GYN, a Pap smear and a pelvic ultrasound scan.
That is essential.
All the best.
Please feel free to discuss further.

Patient replied :

Thank you. I always confuse sonogram and ultrasound. Had ultrasound within last 7 months. All was normal. Sounds like internal exam still adviseable. How often do people with these issues have ultra sounds?

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

A sonogram and an ultrasound scan are synonymous, the same essentially.
6 monthly scanning is preferable.

Patient replied :

Many thanks.

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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