I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
I agree that this is worrisome. But this may not be necessarily serious. It is difficult to exactly predict the cause, without a physical exam and investigations, but the commonest cause is a bleeding disorder. Following blood work would be able to identify a bleeding disorder;
1) platelet count,
2) bleeding time (BT),
3) prothrombin time (PT),
4) activated partial thromboplastin time (aPTT),
5) thrombin time (TT)
6) peripheral blood smear,
7) platelet aggregation in response to ADP, epinephrine, collagen, and ristocetin;
8) platelet release assays,
9) coagulation factor assays,
10) assessment of factor XIII activity via clot solubility testing
11) Tests of fibrinolysis; measurement of fibrin split products and D-dimer levels.
You would also require medical imaging like a CT scan and an ultrasound for the evaluation. So investigations on the above lines of causes is the first step for the evaluation. Kidney and liver function tests, blood work for lupus and may be viral culture may be contemplated by your hematologist (specialist which manages this)or primary care physician.
So these are causes which explain bleeding from both the areas (intestine and urinary tract collectively). But there can be two different causes responsible for the bleeding from both the areas. Blood in stool is commonly caused by the hemorrhoids in your age group and blood in urine is caused by infection or stone.
A prolonged or recurrent bleeding from rectum needs investigations and a physical examination by either a gastroenterologist or a surgeon. The common causes can be;
1) Hemorrhoids or piles
2) Anal fissure
3) Polyp rectum
5) Inflammatory bowel disease like crohn's disease
6) Growth in rectum or colon
Investigations needed to establish the cause are;
3) Barium enema
The various causes for the bleeding in urine (called as hematuria) can be;
1) Kidney and bladder stones
2) Urinary Tract Obstruction
3) Urinary Tract Trauma
4) Excessive exercise
5) Urinary tract Infection
6) Sickle Cell Disease
7) Kidney and bladder tumor
Urine culture and an ultrasound are the first investigative protocol. Intravenous pyelography, CT scan, cystoscopy, etc may be followed depending on the initial investigative results. The investigation of hematuria begins with a search for bacteruria (bacteria in urine) or pyuria (pus in urine). If either is present, a urine culture should be ordered to confirm urinary tract infection (UTI). Following would be required in step wise fashion;
1) Intravenous pyelography
2) Multidetector CT urography
3) Cystoscopy (camera examination)
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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