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Occult Blood in stool

overtheedge

Senior Member
Messages
258
What could this mean, I think I may have LGS, have dysbiosis every time i take a stool test or at least have several confirmed pathogens in my gut, always take something to kill them that my doc prescribes but then have different pathogens the next time.

What is the significance of occult blood, should note my stool color is always rather pale, golden in color, never any of the colors that would indicate bleeding.

Any supplements/Rx's I should get, any tests I should run?
 

overtheedge

Senior Member
Messages
258
Thank you, i read the article, good stuff

I wonder if I should have a colonoscopy

I mean, I only want to know about what is causing this if it could have something that could help me beat my CFS or if if it turns out to be life threatening which I honestly don't think I could handle with how bad my health is
 

Kati

Patient in training
Messages
5,497
Hi, @overtheedge please see your doctor, or go to a gastro-enterologist. They will decide with you what the next steps are. A colonoscopy may well be recommended but do make sure you also get blood work which would include hematology, anemia investigation, liver enzymes and the like.

Best wishes
 

overtheedge

Senior Member
Messages
258
my liver enzymes are fine
CBC's are almost always normal for me with the exception of the occasionally high bilirubin
 

Kati

Patient in training
Messages
5,497
my liver enzymes are fine
CBC's are almost always normal for me with the exception of the occasionally high bilirubin
High bili is not normal and part of liver function. Once more, please seek out medical advice.
 

BeADocToGoTo1

Senior Member
Messages
536
...
What is the significance of occult blood, should note my stool color is always rather pale, golden in color, never any of the colors that would indicate bleeding.

Any supplements/Rx's I should get, any tests I should run?

It looks like this is an old post, but just in case it can still help. The stool color can be a sign of poor fat/food break down. This can point to gallbladder and pancreas issues.

Is it also sticky (smears on the bowl), smellier?

Do you notice more yellow when you meal was a bit fattier?

Have you been checked for gallbladder health, exocrine pancreatic insufficiency (EPI)?

How about an MRI with MRCP of the abdomen?

Any 24 hour fecal fat, fecal fat Distribution, Elastase and Chymotrypsin stool tests completed?

Chymotrypsin blood test?

Have you completed any metabolite and nutritional testing such as Genova Diagnostics FMV, Great Plains Lab Organic Acid Test or Spectracell?
 

overtheedge

Senior Member
Messages
258
Hey have u found out the cause? How’s your cfs now?
CFS is actually worse due to constant infections this past 15 months though i think i figured out the source of each of them, only threat now is likely to be family members in house getting sick as i can't seem to avoid getting it somehow despite my best efforts.

So i went to a Gastroenterologist, he ran a colonoscopy, upper gut scope down to the duodenum, and a small bowel barium xray, the xray showed my small intestine to be fine but the colonoscopy showed colitis, Focal Active Colitis he called it, not crohns or ulcerative colitis. It isn't nearly as severe as the other two but it is definitely something, it also showed the rectum is kinda worse and that's probably the source of the occult blood, there is bleeding sometimes if i strain but it's almost certainly entirely from that area as the recal area hurts, my tissues in general seem very bad at regenerating themselves so that might have something to do with it, dunno if that's hemorrhoids or what, gonna have to ask the doc, we were focused elsewhere last visit.

I'm two months into Mesalamine treatment for the colitis, felt real good the first week but unfortunately the first month i had several infections which completely drained my energy, energy like i had before that is only just coming back to me now it seems. No change in the beige color of the stools anyway.

The upper gut scope showed some antral gastritis of unknown cause, he said usually the only reason to deal with this is if it's causing pain, when CFS came back for me 6yrs ago I was taking perhaps too much betaine hcl, i wonder if that might have caused all this though my health was burning out in any case so maybe not, followed the advice of taking increasing betaine hcl till burning is felt, got up to 9 pills without burning then felt strange tingling all through my body and decided to stop, might have something to do with antral gastritis or even the colitis though i know now the colitis was there before this. I had a colonoscopy done months before my health burned out that showed colitis but i was doing enemas around the time and the images just looked like marks from the enema tube and i didn't go back to see the doc. The new GI doc ive seen pointed out that the diagram only shows it around the rectum but the write up in the report said the colitis was at points much higher that the diagram doesn't have anything pointing to and so didn't include, for all i know the colitis might have been round even before the first long while of cfs years before that first colonoscopy.

A number of people on the yahoo SCD forums mention having had both colitis and very low energy before starting the diet which they say fixed up their colitis and their energy, dunno if they had PEM though, I do have PEM btw.


It looks like this is an old post, but just in case it can still help. The stool color can be a sign of poor fat/food break down. This can point to gallbladder and pancreas issues.

Is it also sticky (smears on the bowl), smellier?

Do you notice more yellow when you meal was a bit fattier?

Have you been checked for gallbladder health, exocrine pancreatic insufficiency (EPI)?

How about an MRI with MRCP of the abdomen?

Any 24 hour fecal fat, fecal fat Distribution, Elastase and Chymotrypsin stool tests completed?

Chymotrypsin blood test?

Have you completed any metabolite and nutritional testing such as Genova Diagnostics FMV, Great Plains Lab Organic Acid Test or Spectracell?

Not sticky or smelly

No change from fatty meals

It's been a while since i had gallbladder and pancreas assessed by ultrasound, what would you suggest besides the MRI with MRCP, never had the MRI by the way and the ultrasound I had done back before this pale stool and most recent form of CFS started 6yrs ago only showed the tail of the pancreas to be slightly smaller than expected/gallbladder was completely fine

Chymotrypsin yes, so i had a Comprehensive Digestive Stool Analysis by genova done, chymotrypsin was low on first one, normalized on second one after i started taking digestive enzymes again, fecal lactoferrin was high on first but normal on second test, occult blood on both which led me to take an immuno occult blood test which was also positive, cholesterol is yellow high on first test, red high on second while all the other things in the absorption catagory are normal(triglycerides, long chain fatty acids, phospholipids, fecal fat(total). Cholesterol was also high on a gi fx test i had done 3-5 years earlier back when my health was in a CFS state but was overall very different.

Don't know if that fecal fat total will count as fecal fat distribution, the gdx test was a 3 day test, dunno if that is equivalent to the 24hr fecal fat type test. no elastase or blood test of chymotrypsin yet.

I have done a Nutreval, gone over it in detail, haven't done much treatmentwise though even though it was two years ago i took it, have had many other things i wanted to test and so many setbacks. Seems like anytime i test two treatments at once lately one of them has some bad side effects and i have to start things all over
 

Tella

Senior Member
Messages
397
CFS is actually worse due to constant infections this past 15 months though i think i figured out the source of each of them, only threat now is likely to be family members in house getting sick as i can't seem to avoid getting it somehow despite my best efforts.

So i went to a Gastroenterologist, he ran a colonoscopy, upper gut scope down to the duodenum, and a small bowel barium xray, the xray showed my small intestine to be fine but the colonoscopy showed colitis, Focal Active Colitis he called it, not crohns or ulcerative colitis. It isn't nearly as severe as the other two but it is definitely something, it also showed the rectum is kinda worse and that's probably the source of the occult blood, there is bleeding sometimes if i strain but it's almost certainly entirely from that area as the recal area hurts, my tissues in general seem very bad at regenerating themselves so that might have something to do with it, dunno if that's hemorrhoids or what, gonna have to ask the doc, we were focused elsewhere last visit.

I'm two months into Mesalamine treatment for the colitis, felt real good the first week but unfortunately the first month i had several infections which completely drained my energy, energy like i had before that is only just coming back to me now it seems. No change in the beige color of the stools anyway.

The upper gut scope showed some antral gastritis of unknown cause, he said usually the only reason to deal with this is if it's causing pain, when CFS came back for me 6yrs ago I was taking perhaps too much betaine hcl, i wonder if that might have caused all this though my health was burning out in any case so maybe not, followed the advice of taking increasing betaine hcl till burning is felt, got up to 9 pills without burning then felt strange tingling all through my body and decided to stop, might have something to do with antral gastritis or even the colitis though i know now the colitis was there before this. I had a colonoscopy done months before my health burned out that showed colitis but i was doing enemas around the time and the images just looked like marks from the enema tube and i didn't go back to see the doc. The new GI doc ive seen pointed out that the diagram only shows it around the rectum but the write up in the report said the colitis was at points much higher that the diagram doesn't have anything pointing to and so didn't include, for all i know the colitis might have been round even before the first long while of cfs years before that first colonoscopy.

A number of people on the yahoo SCD forums mention having had both colitis and very low energy before starting the diet which they say fixed up their colitis and their energy, dunno if they had PEM though, I do have PEM btw.




Not sticky or smelly

No change from fatty meals

It's been a while since i had gallbladder and pancreas assessed by ultrasound, what would you suggest besides the MRI with MRCP, never had the MRI by the way and the ultrasound I had done back before this pale stool and most recent form of CFS started 6yrs ago only showed the tail of the pancreas to be slightly smaller than expected/gallbladder was completely fine

Chymotrypsin yes, so i had a Comprehensive Digestive Stool Analysis by genova done, chymotrypsin was low on first one, normalized on second one after i started taking digestive enzymes again, fecal lactoferrin was high on first but normal on second test, occult blood on both which led me to take an immuno occult blood test which was also positive, cholesterol is yellow high on first test, red high on second while all the other things in the absorption catagory are normal(triglycerides, long chain fatty acids, phospholipids, fecal fat(total). Cholesterol was also high on a gi fx test i had done 3-5 years earlier back when my health was in a CFS state but was overall very different.

Don't know if that fecal fat total will count as fecal fat distribution, the gdx test was a 3 day test, dunno if that is equivalent to the 24hr fecal fat type test. no elastase or blood test of chymotrypsin yet.

I have done a Nutreval, gone over it in detail, haven't done much treatmentwise though even though it was two years ago i took it, have had many other things i wanted to test and so many setbacks. Seems like anytime i test two treatments at once lately one of them has some bad side effects and i have to start things all over
Thanks a lot for the update. I wish u all the best !
 

BeADocToGoTo1

Senior Member
Messages
536
...
Not sticky or smelly
No change from fatty meals

It's been a while since i had gallbladder and pancreas assessed by ultrasound, what would you suggest besides the MRI with MRCP, never had the MRI by the way and the ultrasound I had done back before this pale stool and most recent form of CFS started 6yrs ago only showed the tail of the pancreas to be slightly smaller than expected/gallbladder was completely fine

Chymotrypsin yes, so i had a Comprehensive Digestive Stool Analysis by genova done, chymotrypsin was low on first one, normalized on second one after i started taking digestive enzymes again, fecal lactoferrin was high on first but normal on second test, occult blood on both which led me to take an immuno occult blood test which was also positive, cholesterol is yellow high on first test, red high on second while all the other things in the absorption catagory are normal(triglycerides, long chain fatty acids, phospholipids, fecal fat(total). Cholesterol was also high on a gi fx test i had done 3-5 years earlier back when my health was in a CFS state but was overall very different.

Don't know if that fecal fat total will count as fecal fat distribution, the gdx test was a 3 day test, dunno if that is equivalent to the 24hr fecal fat type test. no elastase or blood test of chymotrypsin yet...

Hi @overtheedge

A few more thoughts in the hope it can help you.

Lots of things can change in the last time you had the ultrasound. With your stool color and symptoms, the MRI MRCP with contrast is worth considering in that case. It gives a 3D picture of the gallbladder and high resolution liver, pancreas, gallbladder, ducts, stomach intestines. Have you been checked for gallstones; there could be a link there with cholesterol? The stool pancreatic elastase is a standard test and worth doing since you have not yet. You mention digestive enzymes, what type are you taking? Are you able to get a prescription for a tightly controlled one such as Creon?

Something is irritating your 'internal skin' terribly so having a hard, honest look at everything that goes into your mouth is worthwhile. Food, drink, water quality (often overlooked), supplements, medicines, smoking, alcohol, etc. Have you had any food sensitivities or allergy tests done? Have you tried elimination diets or a reset diet to see which elements may be causing issues? Have you done fasting blood sugar tests: e.g. HbA1c, triglycerides, c-peptide, insulin, ketones, glucose? Do you know how many grams of carbs you eat per day and per meal? Again the cholesterol comes into play here. Do you give your digestive system a break for 12-14 hours each day? What is your diet like?
 

overtheedge

Senior Member
Messages
258
Hey @BeADocToGoTo1

Sorry for late reply, energy has been bad

About the MRI MRCP with contrast, should i ask my gastroenterologist for it or is there another type of doctor i should see?

The ultrasound was the only thing that would have checked me for gallstones

Haven't had a stool pancreatic elastase yet, it's been on my list though since i researched the Gi Fx test which has elastase as an addon

I have tried many pancreatic enzymes, a number of which were professional grade, no luck there.

I've been on several different types of diets, some of which were very restrictive so it's unlikely to be anything lik food allergy i'd guess. i usually only drink water, I was drinking filtered water but I've been buying gallons of spring water and only drinking that lately and I've also lived at another house for two months and drank water there that went through a different filtration system so I should be good on that level. I don't have any supplements I've taken the entire illness, don't smoke/drink.

Had two allergy tests done, both came up with different answers, one of the diets i did was an elimination diet, it was even a rotating diet.

HbA1c, tryglycerides, and ketones are fine. Don't know if i ever had one for insulin or c-peptides done. Are they done as a part of any popular testing panels? If so i can check. Glucose is always around 90, fasting or not.

As far as low carb alone goes I have been on one diet but it wasn't well designed for low carb, I had a really good reaction to scd diet at the start but then added low fodmap on top of that and the diet stopped working, been meaning to go back to that, might have been in ketosis during the scd diet with how low carb it was, was definitely in ketosis after doing the low fodmap based on at home blood test and the nutreval levels of BHBA, ketones returned to normal after stopping the low fodmap/scd diet and have stayed normal since. Gonna retry the scd before too long and be testing for ketosis routinely to see if it might be the thing causing the upshift in health and therefore should be considered as the potential cause of the bettered health. Don't know how well it will work though.

Unfortunately i cant do much fasting, I have to eat constantly or i feel like im starving, if i don't eat for a stretch of 4 hours or so at any point in the day it will be hard to sleep at night due to hunger which i cant seem to satisfy without eating several meals which have to be broken up since i cant eat much at one time without feeling unusually bad.
 
Last edited:

BeADocToGoTo1

Senior Member
Messages
536
Hi @overtheedge
Sorry, this all really sucks. Both the MRI and elastase are done by a gastro usually, but I had my primary care physician order it mine. I guess it depends on insurance, which is one to check since MRIs are expensive. Any change in diet or enzymes, SIBO or Candida overgrowth (been checked for those?) take a while to impact.

On another note, how thorough has your liver and liver function been tested? Hepatitis (all forms), cirrhosis, structures, Gilbert's syndrome, etc.? The MRI MRCP will also check the liver.
 

overtheedge

Senior Member
Messages
258
Did you get a different price on the mri from your gastro? Should i call around to different imaging centers or something of the sort?

SIBO has always come up positive in one form or another, it's near the top of my treatment list, I've tried quite a number of things on it, currently I'm thinking about which doctor I should see cause I have the methane version and OTC herbal antibioics haven't been able to beat it and my old functional medicine doc only uses xifaxan which didn't beat the methane. Tested for SIFO a number of times but it has never been positive though it was borderline once. Have done nystatin, diflucan, other treatments but they didn't do anything.

I've had a number of the typical liver panels, they almost always come up fine, used to have high biliruben but that went away several years ago, also used to get borderline low and sometimes actually low alkaline phosphatase, don't know if that is still the case. Read up on it but nothing really jumped out at me.
 

BeADocToGoTo1

Senior Member
Messages
536
Your doctor should be able to arrange the best one that your insurance will cover, but these days with the US insurance/medical mess it is always a good idea to get a pre-approval by contacting the insurance to confirm the price. I once got a $10K bill for an MRI that was done in the emergency room, followed by the usual 'balanced billing' scamming that seems to be the norm these days.

Regarding low ALP, it can indicate malnutrition, protein, zinc, folic acid, phosphorous, vitamins B6, and C deficiencies. With low ALP it might be worthwhile to check the following tests and the functioning of the parathyroid:
  • calcium
  • albumin (for corrected calcium calculation)
  • ionized calcium (bound to other minerals)
  • parathyroid hormone PTH (helps regulate calcium, vitamin D, and phosphorus levels in the body)
  • osteocalcin (vitamin K dependent calcium binding protein)
Regarding SIBO, I will copy a section of a post I had done for someone else in case you had not seen this and perhaps gives you some ideas.

SIBO and Candida

I would test it first to make sure that is even an issue, as resolving it requires anti-biotics (2 types) for SIBO and anti-fungals for Candida. This took 2-3 months. Have you done a breath test for SIBO or a urine metabolite test for SIBO and Candida? How about a Candida blood test to see whether it is systemic?

It might be best to find a functional/integrative medicine doctor who has experience with SIBO and Candida treatments. In my experience Rifaximin alone is not effective for methane related SIBO, which is what many prescribe. You will also need supplements to attack the biofilm (important!), pre- and pro-biotics. I took a 10 day course of both Neomycin and Rifaximin together along with all the other steps. For Candida yeast overgrowth some of the steps are similar, but the anti-fungal I used was Nystatin (From a compounding pharmacy, 1 million units per day for a month is what I did) along with things like botanical agents, enzymes, molybdenum, probiotic yeast, biofilm attacking supplements. But you have to also tackle food and beverage intake and be quite strict for a few months to not overfeed the critters whilst trying to rebalance the microbiome. I dedicated a chapter to the SIBO, Candida and acid reflux (not sure if this is an issue) steps I had to take to rebalance as it requires a multi-pronged approach. Temporarily stricter on yeast containing products (if you have Candida overgrowth), no milk, very limited fruit, no juices, no sodas, no alcohol, no deli meat (sugar), no gluten, etc. Have a look at what Mark Sisson or Chris Kresser mention about food, SIBO, Candida. There are herbal anti-microbial drops like Biocidin, oregano oil, molybdenum, Serralase (enzymes), Interfase Plus (biofilm disruptor), coconut oil (MCT), cinnamon, garlic, mustard, thyme, that are all non-prescription things that helped me.

Here is a study that might be of interest which covers a few of those natural treatments:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/