From the Guidelines
You should attend the scheduled follow-up appointment with your provider to discuss the blood in your stool and your elevated blood count results, as the presence of blood in stool can indicate various conditions ranging from hemorrhoids to more serious issues like polyps or colorectal cancer, and your elevated red blood cell count (RBC) and hemoglobin (Hgb) levels could indicate polycythemia, a condition where your body produces too many red blood cells 1.
The evidence from the American College of Radiology suggests that upper gastrointestinal bleeding (UGIB) can present with hematemesis or melena, but can also result in hematochezia, which is the presence of blood in the stool 1. Given your stool test results showing blood in your stool, it is essential to investigate the cause of this bleeding. Your CBC results show a high red blood cell count (RBC) of 5.94 and high hemoglobin (Hgb) level of 17.2, which could be indicative of polycythemia, a condition that requires medical evaluation 1.
Some key points to consider while waiting for your appointment include:
- Monitoring for any symptoms like dizziness, fatigue, abdominal pain, or changes in bowel habits
- Avoiding aspirin or NSAIDs, which can increase bleeding risk
- Staying hydrated and maintaining a high-fiber diet to ease bowel movements
- Being prepared to discuss your medical history, including any previous episodes of bleeding or anemia, with your provider
Your provider will likely recommend additional tests, such as colonoscopy, to identify the source of bleeding and may order specialized blood tests to determine the cause of your elevated red blood cell parameters 1. It is crucial to follow your provider's recommendations and attend the scheduled appointment to ensure proper evaluation and management of your condition.
From the Research
Stool Testing and Blood in Stool
- The presence of blood in stool, as indicated by stool testing, can be a sign of gastrointestinal bleeding 2.
- Gastrointestinal bleeding can be acute or overt, visible in the form of hematemesis, melena, or hematochezia, or chronic and occult, presenting as positive fecal occult blood or iron deficiency anemia 2.
CBC Results
- The provided CBC results show:
- Hct (Hematocrit) of 50.9, which is within the normal range for adults.
- Platelets of 221, which is within the normal range for adults.
- WBC (White Blood Cell count) of 4.09, which is within the normal range for adults.
- RBC (Red Blood Cell count) of 5.94, which is higher than the normal range for adults.
- Hgb (Hemoglobin) of 17.2, which is higher than the normal range for adults.
- These results do not directly indicate gastrointestinal bleeding, but the presence of blood in stool, as indicated by stool testing, suggests the need for further evaluation 3.
Evaluation and Management of Gastrointestinal Bleeding
- The evaluation of gastrointestinal bleeding typically includes a complete blood count, basic metabolic panel, coagulation panel, liver tests, and type and crossmatch 3.
- Endoscopy is a crucial diagnostic tool for gastrointestinal bleeding, and it is recommended to be performed within 24 hours after presentation 4, 5.
- The timing of endoscopy has been a topic of debate, but recent studies suggest that endoscopy within 6 hours of presentation does not improve outcomes compared to endoscopy within 24 hours 4, 5.
- The management of gastrointestinal bleeding may include endoscopic therapy, proton pump inhibitor therapy, and transfusion of red blood cells 6.