The Blood Conversation: Why I Stopped Waiting to Tell My GI

Let's talk about the thing nobody wants to talk about: blood.

If you have ulcerative colitis or Crohn's disease, you've probably seen it. In the toilet, on the paper, in your underwear. It's one of the most common symptoms of IBD, and also one of the hardest to talk about—even with your doctor.

For years, I would downplay it. Minimize it. Wait to see if it went away on its own before mentioning it. And that habit almost cost me a lot more than a few uncomfortable conversations.

Why We Don't Say Anything

Talking about blood is hard. There are a lot of reasons we stay quiet:

It's embarrassing. Even though your GI talks about this stuff all day, every day, it feels deeply personal to us. Describing what you see in the toilet to another human being? Not exactly comfortable.

We normalize it. When you've had IBD for a while, a little blood can start to feel... normal. "Oh, that's just my UC acting up." It becomes background noise that you learn to tune out.

We don't want to be "that patient." The one who calls for every little thing. The one who's always worried. The one who takes up too much of the doctor's time. We don't want to seem dramatic or needy.

We're scared of what it means. Mentioning blood might lead to tests. Tests might lead to bad news. If we don't say anything, maybe we can pretend everything is fine.

We're hoping it'll go away. "Let me just wait a few more days." We bargain with ourselves, setting arbitrary timelines. If it's still there next week, then I'll call.

I've felt all of these. Every single one.

The Cost of Waiting

Here's what I learned the hard way: the longer you wait to report symptoms, the harder they are to treat.

IBD inflammation is like a fire. A small fire is easy to put out. You might just need to adjust your maintenance medication, add a short course of something, or make some temporary changes.

But if you let that fire burn for weeks because you didn't want to make a phone call? Now it's spread. Now it's going to take more aggressive treatment to get it under control. Maybe steroids. Maybe a hospital stay. Maybe damage that can't be undone.

I know this because I lived it. I saw blood for weeks before telling my GI. By the time I finally called, I was so far into a flare that I ended up hospitalized on IV steroids. If I'd called at the first sign? Maybe just a medication adjustment.

What Your GI Actually Wants to Know

Your gastroenterologist isn't going to be shocked or disgusted by anything you tell them. They chose this specialty. They spend their entire day talking about intestines and everything that comes out of them.

When it comes to blood, here's what they actually want to know:

• When did it start? Was this the first time, or has it been happening for a while?
• How often? Every bowel movement? Once a day? Occasionally?
• How much? A few drops? Streaks on the stool? Filling the toilet bowl?
• What does it look like? Bright red (usually from lower in the GI tract) or dark (might indicate higher up)?
• Any other symptoms? Pain, urgency, increased frequency, fatigue?

That's it. They're not judging you. They're gathering data to help you.

How I Changed My Approach

After my hospitalization, I made a deal with myself: no more waiting. If I see blood, I report it. Not in a week. Not if it gets worse. Right away.

Here's what that looks like in practice:

I track every day. Using Flare Log, I note whether there was blood, and if so, roughly how much. This takes literally five seconds. But it means I have data instead of vague memories.

I set a threshold. If I see blood two days in a row, I contact my GI's office. Not panic, just a heads up. "Hey, I've noticed blood the past couple of days. Should I be concerned, or should we watch it?"

I use the patient portal. Most GI offices have an online messaging system. Sending a message is way easier than making a phone call. I can describe what I'm seeing without having to say it out loud to a receptionist.

I remind myself that this is literally their job. My GI didn't go through a decade of training to be protected from hearing about blood. This is what they signed up for. They want to know.

Scripts for the Conversation

If you're not sure what to say, here are some examples:

For a patient portal message:

"Hi, I wanted to let you know I've noticed blood in my stool the past three days. It's been a small amount, bright red, mostly on the paper. I'm also having more urgency than usual. Should I come in, or is there anything I should do in the meantime?"

For a phone call:

"I'm a patient of Dr. [Name] with ulcerative colitis. I've been seeing blood in my stool this week and I wanted to report it. Can I speak with a nurse, or should I leave a message?"

If you're embarrassed:

"I know this is probably routine for you, but it's a little hard for me to talk about. I've been noticing blood when I go to the bathroom..."

You don't have to be clinical or formal. You just have to get the information across.

What If They Say It's Fine?

Sometimes you'll report blood and your GI will say, "That's within normal range for your condition. Keep an eye on it and let us know if it gets worse."

That's okay. That's actually good news. You're not wasting their time—you're doing exactly what they want you to do. They'd rather hear from you ten times when it turns out to be nothing than miss the one time it's serious.

Think of it like this: you wouldn't feel bad about telling your mechanic about a weird noise in your car, even if it turns out to be nothing. Your body is more important than your car. Report the weird noises.

The Mindset Shift

The thing that finally changed my behavior was reframing how I thought about reporting symptoms.

Old mindset: "I don't want to bother my doctor unless it's serious."

New mindset: "My job is to report. Their job is to assess. I'm not qualified to decide what's serious—they are."

It's not my job to diagnose myself or predict whether something is a big deal. It's my job to notice what's happening in my body and communicate it accurately. That's the only part I'm responsible for.

When I stopped trying to be my own gatekeeper, everything got easier. I report more, I worry less, and my care is better because my GI has more complete information.

You're Not Bothering Anyone

I want to say this directly, because I needed to hear it: you are not bothering your doctor by reporting symptoms.

They became gastroenterologists because they want to help people with GI diseases. You having symptoms and telling them about it is literally the entire point of the relationship. It's not an imposition—it's what they're there for.

If your GI makes you feel bad for reaching out, that's a them problem, not a you problem. (And maybe a sign to find a different GI.)

Most GI teams are grateful when patients are proactive. It makes their job easier. It leads to better outcomes. It's what they want.

So the next time you notice blood, or any symptom that concerns you: don't wait. Don't minimize. Don't hope it goes away. Pick up the phone, send the message, log the symptom.

Your future self will thank you.