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Q. I have blood and mucus in stool with pancreatitis. How to treat my condition?

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 01, 2020 and last reviewed on: Sep 05, 2020

Hello doctor,

I am having mucus and bloody stools. The mucus has been occurring for about 10 months, and the bleeding began about one month ago. I have issues with my pancreas for which I am taking Creon, and I had my gallbladder removed due to gallstones seven months ago. I am a 24-year-old female with a healthy diet and not overweight or underweight. I am passing stools normally three times a day. There is no pain associated with passing stools but occasionally pain associated with eating.

#

Hello,

Welcome to icliniq.com.

I can imagine that you must be very upset about your bleeding issue, on the background of pancreatitis problem. You are through pretty tough time, I can imagine that.

Well, the post-meal pain seem to be due to pancreatic related. With recurrent pancreatitis, the calcification and stones can form in the main pancreatic duct, which can cause pain just after meals. Vitamin B deficiency seems to be malabsorption which simply accompanies with recurrent acute pancreatitis.

Now, the bleeding with mucus is suggestive of rectum inflammation. The rectum is the reservoir of large bowel which stores stools before they are passed out. The inflammation of the rectum can cause, urgency, feeling of incomplete evacuation, mucus with some blood. Since the problem is going on for pretty long time, I am afraid that you might have ulcerative proctitis which is form of ulcerative colitis limited to rectum only.

The ulcerative colitis is an autoimmune condition of inflammation of the large bowel, which can accompany type II autoimmune pancreatitis. Since the cause of your pancreatitis is still in doubt (microlithiasis of gall bladder is one cause which was very well taken care off, but no one can justify the recurrent episodes even after removal of the gall bladder). So I want you to ask some blood and stool testing, as I can be in better to confirm the findings what I just said.

Once the cause of your ongoing bleeding and mucus is establish, I can start you on treatment right away.

I hope this helps.


The Probable causes:

Recurrent pancreatitis. Ulcerative proctitis/colitis.

Investigations to be done:

Do upload all investigations which you have for the work up of pancreatitis, and for this bleeding in stools. Get the following tests if not done previously.
ANA (antinuclear antibody). Profile including ANA, AMA, ASMA. Liver function testing. Serum IgG4 level. Serum IgG level. Stool for detailed report. Stool for fecal calprotectin. Stool for ova and parasites. Stool for C difficle antigen. Blood IHA titer for the Entamaeba histolytica.

Probable diagnosis:

Autoimmune pancreatitis type II. Idiopathic recurrent acute pancreatitis (genetic-related). Ulcerative procitits/colitis.

Treatment plan:

Will discuss once the investigations are available.

Regarding follow up:

Follow up after investigations.


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