What Causes Pain Abdomen With Blood In Stool?

Posted on Thu, 3 Apr 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 3 Apr 2014 Answered on

Tue, 22 Apr 2014 Last reviewed on

Question : My spouse is having pain in lower abdomen and her legs hurt. She is 46 years old. She has also had small amounts of blood in stool, also has small amounts of blood when wiping after trying to have bowel movement. She says that pain in abdomen gets a little better after having bowel movement. She smokes a pack and a half a day of cigs. Blood pressure is 128/89 pulse of 79. 5 foot 6 inch 118 pounds. The pain in legs just started. She has been diagnosed with endometriosis and emphysema. She has had a little blood in stool for a while now. he also says she is real tired feeling. I am worried about this!

Answered by Dr. Ashish Verma (5 hours later)

Brief Answer: can be anal fissure with early burgers disease Detailed Answer: Hi, Thanks for writing to HCM. The pain abdomen with blood in stools point towards a possible anal fissure. I guess she is also having constipation and passing hard stools. Regarding pain in legs, with a smoking history, goes more in favour of a peripheral vascular disease (PVD) like Burger's disease. Both these require a clinical examination for confirmation. I would suggest that you show her to a surgeon for a physical examination to see for the fissure and to rule out haemorrhoids, and feel the peripheral pulsations of her leg. An arterial colour doppler scan of her leg may be required if he also suspects a PVD. If there is indeed anal fissure, he will surely start on a laxative and Sitz's bath (sitting in XXXXXXX warm water for 15 mins) and an analgesic ointment to help heal the fissure. The treatment of leg pain will depend upon the doppler report. But she has to completely stop the smoking else it will be of no use. Hope i have been helpful. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ashish Verma (3 hours later)

I forgot to say she takes Metamucil 2 times daily. This was recommended by doctor after episode when she could not stop vomiting roughly 5 years ago. She does take warm to hot bath that seems to help. Without Metamucil she is always constipated. Does this change your diagnosis?

Answered by Dr. Ashish Verma (18 minutes later)

Brief Answer: no it does not. Detailed Answer: Hi, Metamucil is a fiber supplement. I guess she is not taking that enough, as her constipation has come back. The longer we are constipated, the harder the stool inside becomes, as water is continuously being absorbed from it by the rectum. This hardened stool when comes out of the anal opening under pressure, tears the anal mucosal lining by stretching it excessively. This tear causes pain and bleeding. And due to this pain and trauma, the anal sphincter goes into spams leading to constipation and the cycle continues. So this cycle needs to be broken. Thats why laxatives and Sitz bath was recommend along with an anasthetic cream. Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj