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I am a chronic pain patient and have battled constipation for years. This past week In started noticing that old blood odor, along with mucus and blood when I wipe and also on my stool. I am really nervous at this point as to what to do. Any suggestions from anyone?

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  • Dr. Chris January 21, 2011

    Usually “old blood” causes the stool to be black and tarry in appearance. This is known as melena. It also has a distinctive odor that is somewhat foul. Melena is usually indicative of a bleed in the upper gut, as the blood degrades along its route through the gut. However, in constipation, even bleeding from lower down in the gut can also result in melena.

    Brighter or “fresh” blood in the stool, or noticed upon wiping is known as hematochezia. This is most likely from bleeding in the lower gut. A common cause of hematochezia, especially the way you are describing it, is hemorrhoids. This may also account for the mucus.

    However, given your history, it would be prudent to investigate for other causes. Inflammatory bowel disease is one of the more common causes of your symptoms – constipation, mucus and blood in the stool. It has to be investigated carefully and any polyps need to be sent for histological examination. This is depending on whether the causative condition is inflammatory bowel disease.

    Ideally you should see a gastroenterologist, a medical specialist in gut conditions. A colonoscopy, stool test and other investigations would be necessary to try to find a cause for these stool abnormalities. Speak to your doctor as soon as possible.

    You may find other causes of dark and fresh blood in the stool as well as mucus in the stool in these articles :


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