Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Hi, Back In Early December Of 2018 I Had An
Question: Hi,
Back in early December of 2018 I had an upper scope done due to having real bad burning in the middle of my chest and waking up choking when I was eating later at night. I had the scope done and the gastro doctor said there was no damage at all. My family doctor put me on a protonix script 40mg which I took once daily up until 6-24-19. In early May of this year I was getting joint cracking and severe pain and could barely sit down at work. When I talked to the pharmacist on 6-24-19 I told her what was going on and she said joint and bone fractures can occur with long term use of PPI's. I was on the 40mg Protonix since December along with chewable Pepcid Complete daily. The pharmacist said I did not need to wean off of Protonix and could just stop taking it. I have a history of hemorrhoids, but normally they are itchy and flare up on the outside and burn more so. Since about 6-14-19 I have lost about 12-15 lbs without changing my diet at all and ince the last 2 months I found light red coloring on my tissue paper and once night had a loose stool with about 4 tablespoons of crimson colored blood. Last night on 6-28-19 I was at work and went to the bathroom and it was solid and brown to dark brown and I had pain what seemed to be very high up in my rectum, but then also felt pain when I wiped each time. I went to the ER last night and they stated it could be internal hemorrhoids and gave me two prescribed laxatives. I took one laxative at 230pm today which was a powder mix with water and did not have a stool at all. I took the other laxative pill at 8pm tonight (6-29-19) and still have not had a stool. I had a few pieces of pizza today, noodles, and a piece of cake at 530pm and still nothing. Should I be concerned about cancer here, could it be linked to getting off the PPI cold turkey on 6-24-19 or linked to an internal ulcer? In ER they checked my hemoglobin levels, WBC count, RBC counts, and a CT scan with contrast on my lower abdomen since I was having cutting sensations and everything passed just fine.
Back in early December of 2018 I had an upper scope done due to having real bad burning in the middle of my chest and waking up choking when I was eating later at night. I had the scope done and the gastro doctor said there was no damage at all. My family doctor put me on a protonix script 40mg which I took once daily up until 6-24-19. In early May of this year I was getting joint cracking and severe pain and could barely sit down at work. When I talked to the pharmacist on 6-24-19 I told her what was going on and she said joint and bone fractures can occur with long term use of PPI's. I was on the 40mg Protonix since December along with chewable Pepcid Complete daily. The pharmacist said I did not need to wean off of Protonix and could just stop taking it. I have a history of hemorrhoids, but normally they are itchy and flare up on the outside and burn more so. Since about 6-14-19 I have lost about 12-15 lbs without changing my diet at all and ince the last 2 months I found light red coloring on my tissue paper and once night had a loose stool with about 4 tablespoons of crimson colored blood. Last night on 6-28-19 I was at work and went to the bathroom and it was solid and brown to dark brown and I had pain what seemed to be very high up in my rectum, but then also felt pain when I wiped each time. I went to the ER last night and they stated it could be internal hemorrhoids and gave me two prescribed laxatives. I took one laxative at 230pm today which was a powder mix with water and did not have a stool at all. I took the other laxative pill at 8pm tonight (6-29-19) and still have not had a stool. I had a few pieces of pizza today, noodles, and a piece of cake at 530pm and still nothing. Should I be concerned about cancer here, could it be linked to getting off the PPI cold turkey on 6-24-19 or linked to an internal ulcer? In ER they checked my hemoglobin levels, WBC count, RBC counts, and a CT scan with contrast on my lower abdomen since I was having cutting sensations and everything passed just fine.
Brief Answer:
Years of intake of Protonix might cause such problems.
Detailed Answer:
Hello and thanks for choosing 'Ask A Doctor' service for your query,
I've read your details.
Firstly any proton pump inhibitor tablet would take years to develop osteoporosis of that level. So not to worry. You should get serum calcium, vitamin D3, and uric acid level checked.
2) There are a few things to consider when a person says he has blood in the stool.
As you are a known case of hemorrhoids get yourself checked by an MD to rule out internal hemorrhoids and it's stage.
Medicines like Calcium dobesilate, Preparation H, etc would be used to provide relief to you.
The first thing is if it is real blood. There is some food that might be in stool and give the impression it is blood and in fact, it is not.
Unless it bright red blood (which is clear that it is blood). Other times the way to know if you are bleeding or not is having a stool occult blood test or stool microscopy that will confirm the presence of blood with the stools.
Generally, blood coming from higher levels (stomach and small bowel) converts into a dark coal black color due to the changes the blood has in the bowel. It is the bleeding from lower parts (colon) that will show as bright red blood.
Have you ever had a colonoscopy done? It is recommended that all people should have a colonoscopy every 5-10 years. Even if you have had this test in the last 5 years it might be recommended to repeat it as you are having this bleeding if the stool tests confirm you are really bleeding.
A CBC would be a good test to be done if you suspect bleeding to see if you are developing anemia as a complication of bleeding and need treatment for it or not.
So to conclude:
1. We need to be sure you are bleeding or not- a stool test like fecal occult blood test and or stool microscopy for blood will help in this.
2. If it is confirmed that you are bleeding then you will need a colonoscopy to find the cause of it.
3. if you have bright red blood while defecating (passing stools) this might also be due to hemorrhoids which are mostly due to constipation so in meantime please make sure you take extra fiber with diet and drink plenty of water.
4. if you had any massive rectal bleeding than an urgent visit to a doctor is needed.
I hope this is helpful and answers your questions.
Please feel free to reply in case any more clarification is needed on this.
Kind regards
Years of intake of Protonix might cause such problems.
Detailed Answer:
Hello and thanks for choosing 'Ask A Doctor' service for your query,
I've read your details.
Firstly any proton pump inhibitor tablet would take years to develop osteoporosis of that level. So not to worry. You should get serum calcium, vitamin D3, and uric acid level checked.
2) There are a few things to consider when a person says he has blood in the stool.
As you are a known case of hemorrhoids get yourself checked by an MD to rule out internal hemorrhoids and it's stage.
Medicines like Calcium dobesilate, Preparation H, etc would be used to provide relief to you.
The first thing is if it is real blood. There is some food that might be in stool and give the impression it is blood and in fact, it is not.
Unless it bright red blood (which is clear that it is blood). Other times the way to know if you are bleeding or not is having a stool occult blood test or stool microscopy that will confirm the presence of blood with the stools.
Generally, blood coming from higher levels (stomach and small bowel) converts into a dark coal black color due to the changes the blood has in the bowel. It is the bleeding from lower parts (colon) that will show as bright red blood.
Have you ever had a colonoscopy done? It is recommended that all people should have a colonoscopy every 5-10 years. Even if you have had this test in the last 5 years it might be recommended to repeat it as you are having this bleeding if the stool tests confirm you are really bleeding.
A CBC would be a good test to be done if you suspect bleeding to see if you are developing anemia as a complication of bleeding and need treatment for it or not.
So to conclude:
1. We need to be sure you are bleeding or not- a stool test like fecal occult blood test and or stool microscopy for blood will help in this.
2. If it is confirmed that you are bleeding then you will need a colonoscopy to find the cause of it.
3. if you have bright red blood while defecating (passing stools) this might also be due to hemorrhoids which are mostly due to constipation so in meantime please make sure you take extra fiber with diet and drink plenty of water.
4. if you had any massive rectal bleeding than an urgent visit to a doctor is needed.
I hope this is helpful and answers your questions.
Please feel free to reply in case any more clarification is needed on this.
Kind regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
An ER doctor took a sample and sent it to the lab and did say it was blood about a month ago, but I rarely have this happen and there have been times where it was lighter colored blood on the toilet paper. The night the ER doctor took the sample I had about 3 or 4 tablespoons worth of crimson colored blood in my stool. I did end up having a stool finally about an hour ago that was lighter brown in color and it passed slowly, but was solid. Can those laxatives still cause a solid stool? I always assumed they would be loose. Can stopping PPI's cold turkey after 8 months or so cause issues at all in the digestive system or cause lower cutting sensations in the very low abdomen?
Brief Answer:
Follow up.
Detailed Answer:
Hello and thanks for follow up,
As per your history proper colonoscopy has to be done to look for the source of bleed for e.g a small fissure, hemorrhoid or polyp.
Stool softener and laxative would loosen up the stool and won't make i hard.
But my recommendation is to get a p|operation colonoscopy done to rule out culprit.
P. S internal hemorrhoids never bleed.
Hope I was clear and easy to understand.
Follow up with reports.
Follow up.
Detailed Answer:
Hello and thanks for follow up,
As per your history proper colonoscopy has to be done to look for the source of bleed for e.g a small fissure, hemorrhoid or polyp.
Stool softener and laxative would loosen up the stool and won't make i hard.
But my recommendation is to get a p|operation colonoscopy done to rule out culprit.
P. S internal hemorrhoids never bleed.
Hope I was clear and easy to understand.
Follow up with reports.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
