Q. I am experiencing frequent bowel movement and hematuria. Is it due to low digestive enzymes?

Answered by
Dr. Naresh Kumar Monigari
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 29, 2019

Hello doctor,

I have been experiencing trouble with my bowels for the past one and a half weeks. I would normally have big stools, and go often daily, sometimes every other day, and rarely once every three days. I have been having more frequent bowel movements, but they have become much smaller and also have hematuria. My PCP first informed me of hematuria a week ago, and a urologist today confirmed it was still there but there was less blood than last time.

I have been having urinary issues, which the urologist suggested is because of bowel problems, and directed me to speak with a naturopath. I had a prostate exam (which was fine), and a bladder scan to ensure it was emptying. I took Colace in the evening, and the next morning I had very thick, greasy creamy stool. After eating cheerios for breakfast I experienced discomfort and gas all day long. Today, I had minor gas and discomfort, and I am experiencing a decrease in appetite, and I have lost 4 lbs in the last week. In each of the stools, I noticed solid, reddish-orange chunks that I tried to break in my tissue, which almost felt like a gummy bear. I also had corn in my last few bowel movements, which I ate the before evening. Is it possible I am suffering from low digestive enzymes? I had a frequency in urination as well, and I am drinking 50 oz of water roughly ever day. Could I have hematuria due to intestinal bleeding? After each bowel movement, I still feel like I have more to release. I have an appointment with a naturopath and looking for relief sooner though. I have done CT scan, x-ray and blood tests.

Dr. Naresh Kumar Monigari

General Medicine Internal Medicine


Welcome to icliniq.com.

I had gone through all the data you have posted. There is no such intestinal cause for hematuria. Hematuria may be microscopic or macroscopic.Microscopic can be known only through urine examination, as you told that you were told to have hematuria I suppose you have microscopic hematuria. The common cause for hematuria is calculus in the urinary system anywhere along kidneys down till the bladder and urethra, glomerulonephritis or pyelonephritis (infection in the kidney), or taking warfarin oral anticoagulation.

Kindly repeat a complete urine examination after five days and ask to look for dysmorphic RBC (red blood cells) in the urine. Coming to your second problem stools, for passage of stools freely kindly increase dietary fiber content in your diet and stay yourself hydrated. Stool like chunks indicates low dietary fiber content and low water content. eat fruits like banana, orange, watermelon. You can try powder Lactihusk which contains dietary fiber. If it does not work then, you need to take laxatives like Cremaffin (Paraffin and milk of magnesia) syrup or Sodium picosulfate syrup. Avoid spicy foods, drink plenty of water, including fruits and vegetables in your diet.

Intestinal enzyme deficiency is commonly seen in patients with pancreatitis. But in this condition stools will be large and are called steatorrhea which is not true in your case. I hope this helps.

Regarding follow up:

Kindly upload all the reports and repeat the urine routine.

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