### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Im having abdominal pain, loss of appetite, going days without eating and when I do experiencing severe lower stomach pain and watery stools, lightheadedness that is getting progressively worse to the point of feeling Im going to faint, joint pain in shoulder and knee also severe at times, fatigue,. It started months ago at first seeing small amounts of blood after a BM. My BMs were very inconsistent. Sometimes they were almost black looking, sometime normal looking but looked as though they had some hints of almost looking as though there was mucus in it but always in small little balls. Occasionally I would have bigger BMS that would be real sticky and tary feeling and feeling as though you couldnt wipe enough to get clean. But the last solid BM I had was at the beginning of Aug. it was 2 small pieces the size of a quarter and it hurt so bad I felt like it was ripping me apart. When I wiped and looked at the tissue it was completely covered in bright red blood. Had to wipe another three times to get clean. I wasnt constipated and seldom do. And still at time when I would poop the little balls feeling tike I was tearing I would see small spotting of blood. Have never seen blood in toilet or on poop. And never to the point of what I saw the time there was so much blood. The closest ive come to anything solid was diareha this past Sunday. I have lost twenty pounds This has al transpired within a couple months.

### output:

Hello, Thanks for posting, You are obviously suffering from chronic enterocolitis which you have obviously chosen to ignore as the situation requires immediate medical attention. Blood in stool is considered emergency you're having episodes of diarrhea which alternates with hard stools plus blood is mere indication that you are suffering from a bowel infection which should normally have been treated long ago when it first started. There are a wide range of microbes that could be responsible and most of them are invasive microbes such as salmonellosis, ETC, shell etc In order to determine the possible cause, you will need a stool exams + culture, blood tests such as CBC, CRP, ESR, serum electrolytes, Tidal test etc. If infection is the cause, you will definitely require a course of antibiotics for a couple of days to eradicate the germs. Now if we look at the possibility infection is not the cause, then you might be having a bowel tumor, hemorrhoid, diverticulosis etc. You will require colonoscopy to be able to identify any of these causes. I suggest you go to the hospital as soon as possible. Hope this helps