Hi Ekta,
Since ultrasound was normal, but the pain is sharp and persistent, and localized to an area with surgical history, a CT scan can give more detail.
Please do a CT scan abdomen + pelvis. It can detect: Adhesions Stump appendicitis Small abscesses or bowel wall thickening IBD features
Also do Colonoscopy, since there is recurrent blood in stool, even if due to piles, it’s best to confirm the source by a colonoscopy
Please don’t ignore this pain or try to manage it just with over-the-counter medication, especially if it’s not improving. Since you already took a good step by getting ultrasound and blood work done, the next logical step is CT abdomen and possibly a colonoscopy
Feel free to talk Thank you dear
1. Your reports are mostly normal, which is reassuring, but pain and bleeding cannot be ignored.
2. Black stool in the past suggests old bleeding from the stomach or intestine, while fresh red blood usually comes from piles or fissure.
3. Since you had constipation and piles earlier, they are the most likely reason for the red blood now.
4. Pain near your old appendix surgery site could be due to gas, muscle spasm, or adhesions from the old surgery.
5. Mild anemia shows that repeated bleeding has affected your blood count, so this needs correction.
6. To prevent further issues, keep stools soft with high fiber diet, plenty of water, and avoid straining.
7. If bleeding continues or pain worsens, you must see a gastroenterologist for colonoscopy to rule out any deeper cause.
Better follow your nearest physician. Don’t take medicine here without giving full history to us. I NEED counselling for your problem
Hello Ekta, I understand your concern and I know that this must be disturbing. The problems that you are facing might be due to any of these reasons - Gastric/Intestinal issues, recurrence of piles/fissure, post surgical adhesions or Gynecological issue. To find out the exact reason, you need further evaluation. So here is my advise for management of your condition and further evaluation -
1. Diet & Lifestyle - High-fibre diet (green vegetables, fruits, salads). 2–3 litres water daily. Avoid spicy/oily foods, excess tea/coffee. Regular exercise / brisk walking.
2. Medicines (short-term relief) - Syp. Lactulose 15–20 mL at night if constipated. For piles/fissure: sitz bath (warm water sitting) Tab. Drota + Mf , whenever the pain is severe.
3. Further Evaluation - Since USG and blood tests are normal, if symptoms continue, get done a Colonoscopy / Proctoscopy, also get done this blood test - PT-INR. Then, CECT abdomen if pain persists unexplained.
4. When to Re-consult Urgently-Persistent or worsening sharp pain. Recurrent heavy bleeding in stool. Fever, vomiting, severe bloating. Weight loss, loss of appetite.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med
Hello dear
As u said you operated for appendicitis then this is not issue
It’ can be infective colitis.
Cbc rule out anemia
Investigation
Sigmodoscopy or colonoscopy
It’s likely inflammation of sigmoid colon
That why you have frequent constipation
Drink plenty of water
Consult to gastroenterologist
Don’t take medication like without sigmoidoscopy
Thanks
Hello Your symptoms are recurrent. Your condition demands proper examination and investigations after SURGEON’s opinion.
DON’T DO ANY TESTS BEFORE CONSULTATION. Take care
Hello Ekta,
I understand your concern — let’s go step by step:
1. Constipation, blood in stool, piles
Your earlier constipation and piles can explain red blood per rectum.
Bright red blood usually means the source is lower intestine / anal region (like hemorrhoids, fissure).
2. Black stool
You had black stool for a period — that usually suggests upper GI bleeding (stomach/duodenum), though it resolved on its own.
3. Current right lower abdominal pain
Pain at the site of previous appendectomy could be due to:
Adhesions / scar-related pain (common after abdominal surgery).
Colitis / constipation-related spasm.
Urinary / gynecological causes (though your USG was normal except for a small follicular cyst, which is benign).
Severe, persistent pain despite antacids + painkillers means it’s not simple gastric acidity.
4. Investigations so far
USG normal, blood tests okay except mild anemia.
Anemia + history of black stools + blood per rectum → you should rule out GI causes (ulcer, polyp, IBD, hemorrhoids).
5. What you should do
Do not ignore persistent pain + bleeding.
Please see a gastroenterologist for further evaluation. They may suggest:
Colonoscopy / proctoscopy (to directly see piles, fissures, colon lining).
Upper GI endoscopy (since you had black stools earlier). Meanwhile:Keep stools soft (fiber, fluids, stool softener if needed). Avoid heavy painkillers like NSAIDs (Zerodol, Powergesic), as they can worsen GI bleeding. Track frequency and severity of pain + bleeding
Experiencing sharp pain in the right lower abdomen, especially after a previous appendectomy, indeed calls for careful attention. It’s understandable to be concerned, especially when your various tests appear normal but symptoms persist. The pain could stem from several issues, which might not have been picked up in your initial tests. One potential cause is adhensions from your past appendix surgery. These are bands of scar tissue that might be compressing portions of your intestine, leading to pain, intermittent obstruction, or even changes in bowel habits—this might explain the constipation and blood in stool. Although ultrasound can rule out many issues, sometimes detailed imaging like a CT scan might be more revealing if adhesions are suspected.
Another consideration might be Irritable Bowel Syndrome (IBS), particularly with a history of constipation, which often presents with abdominal pain relieved by defecation. The presence of blood in the stool complicates this picture a bit; conditions like hemorrhoids or anal fissures can cause fresh, red bleeding, especially with constipation, but this blood shouldn’t be present during urination.
If your doctors think bleeding could be more serious or originating from higher in the gastrointestinal tract, they might suggest an endoscopy to observe the inside of your digestive tract directly.
Given your medical history, recent symptoms, and the complexity of your case, I would strongly suggest following up again with your healthcare provider. A thorough evaluation by a gastroenterologist could be beneficial. This would clarify whether it’s a recurrent issue with your bowels or something related to your surgical history. They may recommend additional tests or a different approach to treatment. Do remember that serious, rapid changes in symptoms like continuous bleeding or severe pain should prompt immediate medical attention. Avoid over-the-counter pain relief without professional approval as they can potentially mask important symptoms or worsen gastrointestinal bleeding. Focus on a diet aiming to soften stools to prevent straining, including enough fiber and fluids, until you get further evaluation.
