Rectal Bleeding and Endocarditis

[durhash]

Hi everyone,

I have a somewhat embarrasing question, but I've been thinking about it and really need an answer! I am 29 years old and I have a mechanical aortic valve (On-X) that was placed in January. I've been having problems with constipation for they past few days. When I have a bowel movement, I've getting some bleeding. Nothing too serious, and my INR is fine. What worries me is if this somehow puts me at risk for bacteria getting into my bloodstream and causing endocarditis? The bacteria Enterococcus is present in huge quantities in the stool and it is a well known cause of endocarditis. My worry is that bacteria could be entering my bloodstream when I am bleeding. Has anyone ever heard of this before? Any advice would be greatly appreciated!

 

[RBCola]

In my 3 years of medical school, I have not heard of rectal bleeding (from hemorrhoids or fissure) causing endocarditis. Endocarditis is associated with invasive procedures like dental work, colonoscopies and bladder procedures like cystoscopies (also stuff like IV drug use). Yes, the stuff that comes out from down there is filled with lots of bacteria, but our bodies are pretty damn good at protecting us from infection. With your symptoms, I'm assuming your rectal bleeding is from hemorrhoids. Just increase your fiber with something like metamucil and be sure to drink LOTS of water. When the constipation goes away, so will the rectal bleeding. If the bleeding does not stop, go see your doctor.

 

[Bill B]

Funny you should ask. There is essentially no information on this. I have worried about the same thing even from before my mechanical valve. It must be exceedingly rare even though it seems plausible that fecal matter passing through a bleeding rectum could lead to bacteremia. I have reason to believe it could, but there is only one obscure reference to the possibility in a "throw away" journal and I cannot find the full text. Kirkland LR: Hemorrhoids as a source of bacteremia. Hosp Pract (Off Ed). 1989 May 15;24(5):14

So, other than that, I can tell you no one seems to have ever encountered it or reported a case.

My solution: Raisin bran every day.

 

[Rachel]

Thanks for bringing up this issue! I've wondered the same thing!

And I've found that 13g fiber cereal, prune juice, and pears are my friends!!!

Rachel

 

[Eva]

.... With your symptoms, I'm assuming your rectal bleeding is from hemorrhoids. Just increase your fiber with something like metamucil and be sure to drink LOTS of water. When the constipation goes away, so will the rectal bleeding. If the bleeding does not stop, go see your doctor.

Ditto!

Here is also a list of high fiber food taken from "DLife":

Quote:
To help you reach the recommended 25g to 35g per day, here are some fiber superstars you can keep in your fridge and sprinkle on top of salads, soups, sides and more:

2 Tbsp. Chia Seeds: 11g fiber (12g carbs)
1/4 cup Roasted Soybeans: 7.5g fiber (14.5g carbs)
1/4 cup Toasted Wheat Bran: 7g fiber (10g carbs)
1 ounce Coconut Flakes, unsweetened: 5g fiber (7g carbs) 1/4 cup Almonds: 4.25g fiber (7.75g carbs)
1 ounce, Toasted Sesame Seeds: 4g fiber (7g carbs)
2 Tbsp. Ground Flaxseed: 4g fiber (4g carbs)

Unquote

I personally add a teaspoon of flaxseed with a teaspoon of honey to hot water the morning, or any other drin, add it to fried eggs, salad, etc.

Here is also a PDF list of high fiber food: http://www.dlife.com/diabetes/information/slide_show_pdf_files/new_pdfs/12_Best_Fiber_Foods.pdf

Since we started high fiber diet, we started losing weight and feeling much healthier.

Good luck.

 

[JeffM]

Not to get too far off topic, but doesn't all that fiber give you people an unbelievable amount of gas and bloating? If I eat that much, I might as well stay home that day and avoid any open flames.

 

[JeffM]

And no, Beano, doesn't work....

 

[Eva]

Not to get too far off topic, but doesn't all that fiber give you people an unbelievable amount of gas and bloating? If I eat that much, I might as well stay home that day and avoid any open flames.

Jeff,

You need to increase your fiber intake gradually. Otherwise it will!

Start slowly by getting most of your fiber from fruits and from grains that cause no gases like lentils. I did it this way and it worked great for me. Two months and I feel much healthier ... no cravings for sweets or carbs as before and thus shedding weight off has become much easier!

Note: try to add some cumin to the beans. It takes care of the bloating and of the gases.

 

[TheGymGuy]

JeffM, there are several fiber supps that give people lots of gas. I found that sticking to natural fiber from fruits, veggies and grains eliminates all of that gas.

 

[Bina]

A very good question and you have gotten some very good answers.
Put me down for:
Mueslix cereal (with bran, almonds, raisins, dates) every morning.
Snacks of nuts and seeds.
Pears and Plums
Peas, broccoli, etc.
Avoid foods that may bind you up.....white bread, white rice are killers.

 

[tom in MO]

I have hemrhoids and all my doctors have indicated that it does not increase any risk of blood infection and that if my INR is in the correct range, there will be no bleeding problems.

If you are constipated don't just up your fiber, you need water to hydrate your colon and you need activity (e.g. walking) to get it moving.

If you have a hemrhoid, the best OTC product is Calmol-4, but it is hard to find in stores. It was recommended by my colorectal surgeon and I've been using it successfully for years.

Bleeding could be from a anal fissure; mild ones heal on their own. In either case, don't strain, just let go

 

[JeffM]

GymGuy (Hey neighbor) and Eva - Thanks for the suggestions. I don't take supplements but I definitely have an issue with patience, so, Eva, I'll try your gradual method. I do eat cereal every morning with a ton of fiber and non fat yogurt and blueberries and my diet consists of lots of legums and veggies like broccoli and cauliflower. But it's not consistent. One day I'll eat pizza for dinner....with broccoli as a topping. Back to the original topic though....if the original poster's (Durhash), bleeding is from hemerhoids that aren't going away over time even with the relief of constipation, he may want to see a doctor about getting them removed.

 

[sarahsunshine]

Another very important thing to do is to get a stool (8" or so) to put your feet on while you are on the throne. North Americans are known to have the worst bathroom habits and the worst problems with their colons because (of our diet and) most of the rest of the world squats to deficate - a position that makes your colon straighter (not bent like sittiing).