What Causes Excessive Rectal Bleeding After Bowel Movement?

Posted on Mon, 14 Dec 2015

Question: Hi... I am a nurse with a son who was diagnosed with Autism 30 years ago. As an infant he had Seborrheic Dermatitis/Eczema and after his MMR he ran a high fever and developed a measles rash. I told the M.D. I thought he had received a bad batch of the vaccine, He also developed Scarlet Fever after a Strep infection as a small child. some background re: immune deficiency problems. Now at 34 he developed bleeding with his bowel movements, sometimes a large amount. We had a Colonoscopy and they identified Hypertrophic Papillae...a "benign" condition. The bleeding continued so we saw a colorectal surgeon who found a rectal tear during surgery and sutured it but was concerned about an excessive amount of bleeding during surgery and mentioned von Willebrand's Disorder. Should we see a GP or a Hematologist to test for this. He was also anemic post surgery. Strmpriceeeong history of autoimmue disorders in my family...RA, MS...the bleeding has continued but not to such an extent...Hgb. was 10.9 post surgery and after surgery for Empyema he had to get 2 units of PRBCs and his WBC was uppronounced, and down alot. He has always been underweight. He has gingivitis and his knuckle joints are

Answered by Dr. Shailja Puri (2 hours later)

Brief Answer:
Excessive bleeding could be due to coagulation disorder, inv required.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Anemia is expected after a heavy bleeding from the rectal tear.
However, an excessive bleeding out of proportion to the injury requires a hematological work up.
Excessive bleeding after any injury can occur due to disorders of coagulation or clotting system.
von Willebrands disease is one of the coagulation disorder which is also one of the commonest.
As you have mentioned that 2 units of PRBCs have been administered, it should increase the hemoglobin by two units.
However, if the hemoglobin is not improving, a cause for it needs to be found out.
In this situation you need to consult a hematologist to investigate for any coagulation disorder and persistence of low hemoglobin despite PRBC transfusion.
Rest of the XXXXXXX issues need to managed symptomatically - gingivities and joint problem.
You need to consult a dentist for gingivitis.
For the joint problem, you need to consult an orthopedician for clinical assessment.
For weight issue, you need first get anemia corrected and thereafter the cause for low weight can be looked for and thus treated.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Shailja Puri (21 hours later)

The blood transfusion was not after Colorectal surgery...it was after surgery for Empyema when he had to have the Pulmonologist strip the pleural space on his left lung due to Aspiration Pneumonia per the Surgeon. His CBC from day to day was all over the place....WBC and RBC's and a strange LE edema. None of the specialists could explain the edema. If we go to a Hematologist what labs would you suggest????

Answered by Dr. Shailja Puri (5 hours later)

Brief Answer:
Please post the blood reports for evaluation.

Detailed Answer:
Hello and welcome again,

It would be more informative if you could post the blood reports that has been done yet.

Thanks
Dr Shailja Puri

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Prasad