1

votes

SOS...4 Days on Paleo and Bloody Poop!!

Answered on August 19, 2014
Created May 20, 2011 at 4:24 PM

SOS! I really need your help with this one.

My brother has acute inflammations in his wrists (carpal tunnel at age 24?!), knees and other joints. The doctors say that if this continues, he'll have to get surgery. He suspects the culprit is either gluten or eggs, which he eats liberally (3 eggs, 1/2 loaf of french bread, bowl of oatmeal/granola a day). Our mom also has gluten and egg intolerances and I get inflamed from gluten.

After much persuading, I got him to exclude gluten (barley, rye, oats, wheat) and eggs from his diet to see if either one of those foods is the one that's doing him harm. After 4 days on his new diet, he sends me this email:

This morning I had the SOOOOO MUCH BLOOD IN MY POO. Like a FRICK'N LOT OF BLOOD!!! >:o

It looked like I MENSTRUATED into the crapper! WTF SOPHIA?! I'm not going down like that. If anything I'm going to get more inflammations by getting fecal matter into my bloodstream. OMG!!! When I wiped my butt the tissue was soaked in blood. I'm officially scared shitless (literally) of your palio diet.
* kicks it to the curb and kicks in some carbs *

Stats: He is 24 years old, Chinese-American, 5'9" and 135lbs. His past poops have been more on the sludgy side (due to excess consumption of wheat?) and now he says his poops are less frequent, harder and more substantial. The poop was red and it doesn't hurt whne he sits. Instead of grains, he eats potatoes. He also has been eating a ton of butter, fruit, veggies, nuts and meat (pork chops, sausage).

I'm really worried now and am not sure (1) why there is blood in his stool, (2) if paleo could really be the cause (diet change or poop quality?), (3) if this is hemorrhoids, (4) and lastly, HOW DO WE FIX THIS?!

He's resistant in calling the doctor just yet and wants to see if this continues. Any info is greatly appreciated.

048dd52752c45129c1212bfffb37ca72

(3150)

on May 06, 2013
at 10:47 AM

Me too and I was just going to suggest the same just in case she was being frightened for nothing.

9d43f6873107e17ca4d1a5055aa7a2ad

on December 10, 2011
at 04:57 PM

Closed because he should see a doctor.

1fc9c11cf23b2f62ac78979de933ad83

(2435)

on July 09, 2011
at 05:57 AM

This happened to me when I was 8 1/2 months pregnant. Totally forgot I ate them. Spent at least 20 minutes on the phone freaking out to my midwife.

4e184df9c1ed38f61febc5d6cf031921

(5005)

on May 31, 2011
at 08:35 AM

When I first went very low carb after eating the conventional diet, I had precisely the opposite - weeks of very liquid diarhea. Major problem and almost made me go back to conventional diet. I'd recommend he sees a doctor fast.

A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 22, 2011
at 12:59 AM

Some days I do... Other days, according to my husband, I'm full of it!! HA! :)

3c6b4eed18dc57f746755b698426e7c8

(5147)

on May 21, 2011
at 10:13 PM

His colon is probably dry as a bone, if he low-carbed without preparation. Yes, the stool will be denser if you cut out carbs and starch. But he also seems to be eating quite a bit of fiber if the stool is enlarged. This happens when you also add a significant amount of fiber all of a sudden. Hemorrhoids, fissures and rips in the colon will naturally occur as a result of this.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on May 21, 2011
at 03:40 PM

I agree that he probably needs a visit to the ER and a follow up visit to the GI afterwards to see what's causing internal bleeding. But I tend to think this is a rather common problem when people start low-carbing for the firs time cold turkey. We have to tell these guys to start it very slowly. Look for a soft landing when you low carb or Paleo; no need to go all out while you ate a bolw of pasta yesterday.

Cc93847bfa820f0f2da654060b401fa5

(746)

on May 21, 2011
at 08:41 AM

Go to the Dr. This is a situation for emergency medicine (what medicine does well ;) Ditch the gluten and any dairy asap. You'll see a huge drop in inflammation relatively quickly. I had CT surgery at 19.

072fd69647b0e765bb4b11532569f16d

(3717)

on May 21, 2011
at 02:50 AM

Wendy knows her sh*t, literally.

A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 21, 2011
at 01:03 AM

Good Calls, I concur!!

Aead76beb5fc7b762a6b4ddc234f6051

(15239)

on May 20, 2011
at 08:58 PM

my father just got out of ICU- he was transfused three times, and his BP suddenly dropped to 50/13 (yes, thats right). he had an asymptomatic GI bleed and felt fine until he collapsed at home. if he had been alone, he would have died. he played golf that morning. he had bloody stools after the game, but because he otherwise felt ok, he blamed it on hemorrhoids. its not something to mess around with.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on May 20, 2011
at 08:40 PM

Me too! I was seventeen the first time I drank beet juice, and when I saw the result I had a 24-hour panic attack. The Beet Council should do some sort of PSA!

3c6b4eed18dc57f746755b698426e7c8

(5147)

on May 20, 2011
at 08:24 PM

It's natrual that your stool will be less frequent when you start low carbing. As for the bulk, what is he eating: heavy fiber or fiber enriched products? Your stool should be smaller unless you're eating lots of fiber-enriched products, avocadoes, a ton of vegetables or some Konji stuff. This is from the diet change: the phenomenon of constipation is kind of kept quiet but this has to be addressed. Far too many people suffer from constipation when they first start low carbing.

4145b36f1488224964edac6258b75aff

(7821)

on May 20, 2011
at 07:38 PM

It could also just be a relatively minor crack in the rectum due to straining from harder stools than he's used to. There's a lot of ways this could not be bad, it's just that the ways that could be bad are pretty bad.

072fd69647b0e765bb4b11532569f16d

(3717)

on May 20, 2011
at 05:49 PM

I don't want to downplay what might be very serious, but there could also be other factors in play. As noted above, I jacked up a hemorrhoid one day during an intense rowing workout. The next morning, I thought I was dying. I had bloody stools for about a week.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on May 20, 2011
at 04:55 PM

Had the same experience with beets. I thought my world was over, lol.

E2456a3b347d37b526a6b8293faae77b

(758)

on May 20, 2011
at 04:50 PM

Thanks for the quick response, guys. I sent him the link to this post so maybe that will convince him to call a doctor ASAP!

47a42b6be94caf700fce9509e38bb6a4

(9647)

on May 20, 2011
at 04:45 PM

See the FAQs about questions that are better suited for doctors than paleohacks. Hope your friend feels better real soon.

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12 Answers

best answer

5
3c6b4eed18dc57f746755b698426e7c8

on May 20, 2011
at 07:51 PM

My hunch is that this is a classic case of doing very low carb (VLC) without sufficient prep. If you do VLC cold turkey, your stool will become dry as rocks and your colon will lose moisture. It will be like trying to give birth to jagged pieces of rock.

You have to go VLC gradually. Immediately add back some safe starch: in your case, sweet potatoes or white rice. I would add about 250g of sweet potatoes or yams to start. Portion control if you have to if you have BG issues.

Ask your bro if he has any moisture in his colon: he can tell you immediately. Most people who are constipated say they're constipated, but they should be able to give you relevant details. Is it Bristol chart 1? Zero moisture? You have what Paul Jaminet calls the "danger of VLC diets" or what Konstantyn calls "fiber menace", i.e., doing Atkins without sufficiently preparing yourself for the smaller, denser stool resulting from a high-fat/low-carb diet.

Solution: add back starch. If you have to VLC, do so gradually. Slowly decrease your starch intake. Otherwise, stay above ketosis by doing about 100g of carbs.

Btw, most Asians aren't supposedly gluten sensitive to the degree caucasians are. But if you're confirned as being so, then it's likely that your bro also is.

Also, don't do VLC and then all of a sudden start eating 3 packs of Shirataki or Konji noodles or 3 avocadoes in a day. The sudden influx of fiber and mass will just overwhelm your colon, resulting in fecal impaction --- that's actually worse in many ways than just a case of bloody stool. Been there done that.

Lost of water, yes. But beware, lots of coffee and tea could also dehydrate you and worsen your constipation or fecal impaction.

Another thing he can do is use suppositories for the interal fissures/hemorrhoids he presumably has. Get some hemorrhoid cream for the ousdie and apply every morning to the outside and inside. If his skin is dry, also apply some moisturizing lotion to his buttocks. This should take care of the internal and external hemorrhoids and will stop irritating the hemorrohids in a week or so.

A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 21, 2011
at 01:03 AM

Good Calls, I concur!!

4e184df9c1ed38f61febc5d6cf031921

(5005)

on May 31, 2011
at 08:35 AM

When I first went very low carb after eating the conventional diet, I had precisely the opposite - weeks of very liquid diarhea. Major problem and almost made me go back to conventional diet. I'd recommend he sees a doctor fast.

10
Aead76beb5fc7b762a6b4ddc234f6051

(15239)

on May 20, 2011
at 04:37 PM

tell him to turn off his computer and to call his doctor, STAT.

Aead76beb5fc7b762a6b4ddc234f6051

(15239)

on May 20, 2011
at 08:58 PM

my father just got out of ICU- he was transfused three times, and his BP suddenly dropped to 50/13 (yes, thats right). he had an asymptomatic GI bleed and felt fine until he collapsed at home. if he had been alone, he would have died. he played golf that morning. he had bloody stools after the game, but because he otherwise felt ok, he blamed it on hemorrhoids. its not something to mess around with.

6
9a5e2da94ad63ea3186dfa494e16a8d1

on May 20, 2011
at 04:52 PM

Blood in the "bowl" sometimes looks like more than it is (a few drops of food coloring looks like a gallon). That said, if it really was more than the little bit you might get from hemorrhoids, then he needs to see a doctor. If he's really bleeding, he should consider the ER.

A funny story to lighten the mood... a while back I made roasted beets for a bunch of friends for a big dinner. They were just fresh beets, roasted with olive oil. Well something you may know about fresh (not canned) beets is that if you eat a bunch of them, you will see the beet color in your pee or poop. Well my buddy had no idea about this and had apparently never had fresh beets before, and ate a whole lot of them. He thought he was bleeding internally when he saw all of the red in the bowl the next morning. He freaked out and told his wife who said she had the same thing. They were both freaking out for a while, wondering how they could have both come down with a mysterious illness at the same time, and were ready to head to the ER, when they finally figured it out. He called me later in the afternoon and told me the story and I nearly fell out of my chair laughing.

50637dfd7dc7a7e811d82283f4f5fd10

(5838)

on May 20, 2011
at 04:55 PM

Had the same experience with beets. I thought my world was over, lol.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on May 20, 2011
at 08:40 PM

Me too! I was seventeen the first time I drank beet juice, and when I saw the result I had a 24-hour panic attack. The Beet Council should do some sort of PSA!

1fc9c11cf23b2f62ac78979de933ad83

(2435)

on July 09, 2011
at 05:57 AM

This happened to me when I was 8 1/2 months pregnant. Totally forgot I ate them. Spent at least 20 minutes on the phone freaking out to my midwife.

048dd52752c45129c1212bfffb37ca72

(3150)

on May 06, 2013
at 10:47 AM

Me too and I was just going to suggest the same just in case she was being frightened for nothing.

5
4145b36f1488224964edac6258b75aff

(7821)

on May 20, 2011
at 04:45 PM

If he's not exaggerating about SOOOO much blood, get him to a hospital IMMEDIATELY! That much blood would mean he has an acute problem which could kill him.

If he is exaggerating and it's just a little, a doctor IMMEDIATELY.

He needs to get tested for celiac, Crohn's, Ulcerative Colitis and about a dozen other things. Yes, it could just end up being hemorrhoids. It could also be much worse.

4 days to bloody poop is a record. If his dietary change made his stools transit slower, they could have picked up more blood from whatever the underlying problem is. I have a bowel disorder and have had bloody stools in the past, and paleo was the cure, not the problem - 4 days, however, is not nearly enough time to make things magically better. Months to a year is more realistic.

4145b36f1488224964edac6258b75aff

(7821)

on May 20, 2011
at 07:38 PM

It could also just be a relatively minor crack in the rectum due to straining from harder stools than he's used to. There's a lot of ways this could not be bad, it's just that the ways that could be bad are pretty bad.

072fd69647b0e765bb4b11532569f16d

(3717)

on May 20, 2011
at 05:49 PM

I don't want to downplay what might be very serious, but there could also be other factors in play. As noted above, I jacked up a hemorrhoid one day during an intense rowing workout. The next morning, I thought I was dying. I had bloody stools for about a week.

3c6b4eed18dc57f746755b698426e7c8

(5147)

on May 21, 2011
at 10:13 PM

His colon is probably dry as a bone, if he low-carbed without preparation. Yes, the stool will be denser if you cut out carbs and starch. But he also seems to be eating quite a bit of fiber if the stool is enlarged. This happens when you also add a significant amount of fiber all of a sudden. Hemorrhoids, fissures and rips in the colon will naturally occur as a result of this.

5
4fcdbafdb1e8cb536c7e0858ba99c446

on May 20, 2011
at 04:44 PM

I agree with everyone else! Call a doctor! I really don't think eating paleo could do that!

5
A8d95f3744a7a0885894ee0731c9744c

(3761)

on May 20, 2011
at 04:40 PM

A hospital is probably better suited to take care of that problem than we are...

4
A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 20, 2011
at 06:11 PM

I'm with UncleLongHair here, a drop of blood in the toilet looks like a gallon. You can lose alot of blood before you'd ever notice in your symptoms or the way you feel. If it is red, like really red, then is is from somewhere closer to his anus (large intestine/rectum) if it is brown/coffee ground looking then it is from somewhere higher up (small intestine/stomach) and therefore much more problematic. He needs to make sure that he is taking in enough fiber (vegetables and fruit - fruit has more pectin which sequesters water in the gut making the BM softer, vegetables scrub the intestine keeping it healthy) for his protein otherwise he will have constipation. If fact that they are hard tells me that he is eating plenty of meat and fats, but not enough fruits and veggies and probably not enough water (in addition to whatever else he drinks). I don't believe paleo could be doing that, but a lack of vegies and fruit could be doing that.

Couple of things - When he goes to the bathroom, does he sit there a while, if so he is increasing the blood to his rectum, putting him at risk for hemorrhoids. He should go when he has to, not sit there all day, not push because then he is guarantee to inflame and harm an already unhappy gut.

You can have hemorrhoids anywhere on the anus and rectum and they bleed like its going out of style. Is he dizzy? That would be a sign that he has lost a significant amount of blood. In the mean time increase fluids to maintain blood pressure.

He can go to his doc or to the ER. They should do an anoscope (where they insert a tube into the anus to look at the rectum). This is uncomfortable, doesn't require sedation, but quick and doesn't require another appointment because it can be done on the fly. They might want to follow up with other tests later, but initially this is a good and quick start!

For the future, if this happens again, one of my low tech, low medicine intervention BM technique it hot/warm prune juice 4-8 oz. I can't even tell you how it works, but I swear its magic. It can be used for those that are pregnant or people who don't like to take medicine, its very gentile but effective. And it has iron in it. Yeah its juice, and yeah its got sugar in it, but its not medicine and you can repeat it every hour until you have 'results'. if you want something a bit faster, have the prune juice with a milk of mag chaser and wait an hour or so. And then follow up with more prune juice.

He might have created a temporary ulcerative colitis with whatever he had going on before and then a diet change from what he was previously eating might have been too much change too soon.

In addition he needs allergy testing to get definitive input on what is going on with all this inflammation.

The blood is scary and he needs to see someone sooner, rather than later. Get him to someone (Internal med, family med, urgent care, ER) today because healthcare over the weekend can be more problematic and he could fall through the cracks.

Good Luck!

072fd69647b0e765bb4b11532569f16d

(3717)

on May 21, 2011
at 02:50 AM

Wendy knows her sh*t, literally.

A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 22, 2011
at 12:59 AM

Some days I do... Other days, according to my husband, I'm full of it!! HA! :)

3
7bf306ada57db47547e9da39a415edf6

(11214)

on May 20, 2011
at 06:25 PM

Well, if it's bright red, fresh blood, the doctors may not even do anything about it. The old, brownish blood, evidence of internal bleeding higher up and further in, is more of a reason for immediate medical action.

In any case, this definitely doesn't have anything to do with Paleo. These symptoms are experienced by a wide variety of people, and, like most problems suffered by SAD eaters, if anything, Paleo will help, not exacerbate.

1
2e841984c55e1f346f6e38f60c1620a6

(540)

on May 20, 2011
at 08:50 PM

As everyone has stated go to the ER immediately!

I had a episode cause by an ulcer that caused me to nearly bleed to death.

If the blood was bright red then most likely it is a hemroid or a tear in the large intestine. If it was black and tar like then it is something father up in the colon and far more dangerous.

0
1a98a40ba8ffdc5aa28d1324d01c6c9f

(20378)

on May 21, 2011
at 08:28 AM

Emergency Room ASAP!!!

This just happened to my friend and his kidneys are failing. Whatever it is this is

Nothing to hesitate about.... ER ASAP!

0
53254ec3a1a3820101bbebd80a3f3645

(0)

on May 20, 2011
at 07:54 PM

A similar thing happened to me about 2 weeks in to going low carb. Depending on how much his carb intake has decreased he might be in the same position, although 4 days does seem a bit quick. It had me completely freaked out. However, I do believe now that it was just a hemorrhoid. I hadn't done my research, wasn't drinking nearly enough water and was also avoiding fat. Several large glasses of water and upping my fat intake seemed to take care of it in a couple of days.

That said, if he can easily do it, he should check with a doctor just to be sure.

-2
Cf4576cbcc44fc7f2294135609bce9e5

on December 10, 2011
at 02:41 PM

he had a hard stool and he had some tearing in his butt hole. nothing to worry about. Just proves he doesnt take dong in the dung hole

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