Brief Answer:
Infections and peptic ulcer need to be ruled out- stool tests and upper GI endoscopy are recommended

Detailed Answer:
Hello and welcome to 'Ask a doctor' service,

I carefully read your query.

Bloody diarrhea can be caused by infections, tumors and inflammatory bowel disease (Crohn or ulcerative colitis). Rarely, a bleeding peptic ulcer may cause blood with diarrhea if there is a lot of bleeding. Certain food allergies can be considered, even though these rarely cause blood with stools.

In your case, because colonoscopy is done and is found normal, ulcerative colitis and large bowel problems are ruled out.

You will need some stool tests to rule out infectious pathogens such as stools for ova and parasites, stool culture, stool for Clostridium Difficile (if you have used antibiotics recently). Tests for food allergy may be considered if all the rest of the tests come out normal.

Also, an upper endoscopy would be recommended to rule out a peptic ulcer.

To conclude:

- A normal colonoscopy only rules out problems with the large bowel as the cause of the bleeding and diarrhea (rules out ulcerative colitis and polyps or other tumors of the large bowel)

- Stool tests are needed to rule out infections (stool for ova and parasites, stool culture, tests for C. Difficile if you have been using antibiotics recently)

- An upper GI endoscopy is also recommended to examine the stomach mucosa and rule out a peptic ulcer. Rarely, food allergy tests may be needed.

I hope this is helpful.
I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj

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Brief Answer:
Upper endoscopy is examining your stomach with a camera from the throat

Detailed Answer:
Hello and welcome back,

If you have had a camera down your throat to the stomach, this is an upper GI endoscopy.

If this was normal then a peptic ulcer and other problems with the stomach are ruled out as well and the other tests mentioned should be done.

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Brief Answer:
The specialist has the expertise to evaluate you and decide on further steps such as blood tests, stool tests and probably scans

Detailed Answer:
Hello and welcome back,

I understand your concern with the bleeding and wondering what else the doctor is going to do as you have already had upper endoscopy and colonoscopy.

On the other hand, the GI doctor is the specialist on problems with bleeding from the GI, so he has the expertise to further evaluate you and decide on future steps and management.
I believe the GI specialist will do a thorough history, examine you, check the results of all the tests you had so far and will decide on further tests.

Very likely he will ask for blood tests, stool tests and possibly scans, but it is him that will better determine the needed tests and examinations for you.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj

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Brief Answer:
The biopsies can see things that the eye can not see and may lead to a diagnosis or rule out certain diagnosis

Detailed Answer:
Hello and welcome back,

I understand your concern. Colonoscopy is quite a good examination to see the structure of the large bowel but does not see microscopic changes or functional issues. A biopsy will tell if there are changes in the mucosa that the eye could not see.
The biopsy may rule out celiac disease, ulcerative colitis, and will also check the microscopic structure of the bowel. So, it is very good they have received the biopsy because it may lead to a diagnosis or at least rule out some other diagnosis.

I am pretty sure the doctor you are going to see tomorrow will give some more guidance on what has been ruled out so far and also what is expected with the tests and examinations to come.

It is normal to be anxious, especially because your symptoms are not subsiding but I believe the doctors are doing the right examinations.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj

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