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Nadim Al-Mubarak
Nadim Al-Mubarak, Doctor
Category: Medical
Satisfied Customers: 379
Experience:  MD at University Hospital Case Medical Center
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The first part of July, my husband passed two toilets of

Customer Question

The first part of July, my husband passed two toilets of blood, was sweating and dizzy. A trip to the e.r. for CT scan, blood and urine work only showed his hemoglobin is low 10.8. A week ago he was scoped from both ends, 4 biopsies taken that came back normal.
His hemoglobin is now down to 8.1. He was instructed to take 325 mg of iron 3 x's a day. He has no pain but he's tired and his color is bad. Compounding this is his restless leg syndrome. He was a painful mess last night, unabe to sleep or find relief.
He's been going to work, but it's so hot he's having trouble staying hydrated.
He was a patient at Mayo in 2010. He had a valve repaired and a Whipple resection. He had a mass on his pancreas.
His name is***** for advice please. Thank you.
Ann Siems
Submitted: 1 year ago.
Category: Medical
Expert:  DrRussMD replied 1 year ago.


I am a double board certified US doctor of 20 years experience and I can help you with this.

Not sure what your question is.

We do not diagnose or treat. We answer questions.

I can help you with direction here though.

When this happens, angiodysplasia of the bowel is likely.

It can show negative results, but bleed.

A red cell scan [tagged scan] is an older test that will work when he is bleeding to indicated the location.

I would ask about this.

OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. Also, please click a positive rating [hopefully excellent (5)—that’s how we are paid, per rating]. If you forgot something, just use reply and come back. I am here

Expert:  Nadim Al-Mubarak replied 1 year ago.


  • A more common source of intestinal bleed with frequently negative scopes of both ends, is Diverticulosis, with bleeding diverticula, which are multiple small pouches in the wall of the colon that can intermittently bleed. They may or may not be seen during endoscopy.
  • Hi fiber diet and adequate fluid intake can help stabilize diverticulosis
  • Tagged blood cells test, at this point, is useless as he is not actively bleeding. It will not change treatment
  • His fatigue and tiredness are related to the anemia which will eventually, slowly, improve with iron pills as his bone marrow replaces his lost blood. This process can be facilitated best by intra-venous iron infusion along with folic acid (one of the B vitamins) which will more efficiently stimulate his intrinsic blood build up

Best wishes

Expert:  Nadim Al-Mubarak replied 1 year ago.

Let me know if you have any more questions