How to manage green stools that result from taking Lactulose for constipation?

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your case history in detail. My opinions are the following. 1. Constipation is the most common cause of per rectal bleeding. It can be due to hemorrhoids or anal fissures mostly. Hemorrhoid bleeding is painless, and anal fissure bleeding is mostly painful. 2. Lactulose is a good laxative, and if you are passing stools after the laxative without bleeding, that is great. Try to drink a lot of water and a high-fiber diet to avoid constipation in the future, which is a precipitating factor for bleeding. 3. Green color stools are fine. There is a spectrum of stool colors, from light yellow to dark brown, even green. 4. Three colors of stools that are not normal, including red (which means blood), maroon colored (which means clotted blood), and last is black stools (again suggestive of bleeding from the stomach or small intestine). Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You can attach pictures and any investigations you have. I can review them. Other than Lactulose, consider some food products you have consumed in the last 48 hours. Maybe color is coming from there too.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

From the reports attached (attachments removed to protect the patient's identity), the first one is fresh red blood, which is always alarming, and you need a physical examination by a nearby doctor so that one can determine the cause of the bleeding. I have already mentioned the two most common causes, hemorrhoids and anal fissures (the clinical difference is hemorrhoidal bleeding is usually painless fresh red color, and anal fissure bleeding is painful fresh red color, and later, you even cannot sit for a while after passing stools due to severe pain at anal verge).

In the second picture (attachments removed to protect the patient's identity), there are green stools, which is normal, but there is some blackish brown component as well, which you have to monitor.

My suggestions will be:

1. Avoid constipation. This is the first-line treatment for hemorrhoids and anal fissures.

2. Apply Lidocaine local anesthesia gel. If there is any pain at the anal verge, you can use it three or four times per day, before or after passing stools.

3. Monitor for fresh bleeding or maroon or black colored stools. If persistent, you need to visit a nearby hospital for a physical examination of the anal verge and some blood tests.

4. Take a soft home-cooked diet. If possible, avoid green-colored food products for two or three days.

I hope the above points will help you out.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Simple antral gastritis will not cause such a bleed, and your stool color was green. This seems to be local pathology in your lower gut, likely near the anal verge. Antibiotics can cause loose stools, but green-colored food is not because of that. Bile is normal liver juice secreted in the small intestine. Sometimes mild excess secretions can cause green stools if food is not the cause.

That is great, doctor over there can physically examine you to make a final diagnosis.

I hope this information, will you.

Thank you.