Blood in pull ups. Can anyone help narrow down the possibilities?

Make an appointment with her PCP for a medical evaluation and lab tests. Don't attempt to diagnose it yourself.

Not your role, get her seen by a doctor.

Short of a gynecological exam you cannot tell and that's hardly an option for you. I would go to your Mom's doctor with this concern.

Dear Day,
If your Mom, "my mom (88) has brain injury related memory issues"
how do you know if she can express her pain to you?

If you receive enough "caregiver advice" to have her seen by her doctor, will you be following that advice?

If you want to diagnose the bleeding yourself, you can try this:
Do not share the commode with another patient.
Answer this:
How much blood?
Did it happen again?
Fresh blood?
What color is the blood?
Can you insert a gloved finger with vaseline into her rectum to determine if the blood is coming from her anus?

Discovering all that, if you can, will you be taking her to the doctor?

You won't be expected to identify the source of the blood, but the doctor you speak to will want to know:

how much blood
pink diluted or bright fresh blood
what does it look like
how frequently do you observe it
when did you first notice it
whether there are any clots

If there's any question of its being cause for concern, she'll need to be examined anyway.

In general it's a bad idea to suggest a source or a cause to doctors or nurses because it tends to narrow their focus: you say "I think it's coming from her urethra," they immediately think uti (especially if you have scientific credibility, as you would do) and may (although they shouldn't) be less likely to exclude other possible causes of blood in a pull-up.

If their thinking after an examination doesn't include something you were expecting it to, that's when you can ask the question.

You are not expected to 'narrow down the problem' for the doctor; that's his or her job. All you're expected to do is report the problem, blood in the brief, and let the experts take the matter from there.

When I noticed blood in the toilet after urination, my doctor sent me for a bladder scan (colposcopy) to eliminate the possibility of bladder cancer (I was post menopausal at the time). The test was negative and that was that. Sometimes there is blood in the urine from something as simple as a broken blood vessel, but it's up to your mother's doctor to make a decision about the next step to take.

Good luck.

Hemorrhoids can bleed. How much blood are you seeing?

Thanks everyone, I appreciate the input. My situation is challenging. I live with my parents. Dad is 95 (and he reminds me of this at least a dozen times each day!) My mom is 92 and has advancing dementia. Dad has just started losing his memory and is becoming very difficult to deal with because of this. I’m sure he’s feeling that his independence is diminishing. I can’t leave either one home alone to visit the doctor, though our doc makes home visits.
As it turns out, I believe the blood was from a hemorrhoid. Will discuss with the doc when he visits.
One other question: My dad is driving me absolutely crazy by second-guessing me all that time. He tells me I’m in charge of things, then the next minute he makes a decision about something (usually wrong and inappropriate) and I have to fix things. He tried 3 times in 5 minutes this evening to share cantaloupe with mom who’s having diarrhea at the moment. Nothing I say or do sticks with him. Any advice?

Thanks.

You can't fix dad who's lost his short term memory, or make him understand why what he's saying or doing is wrong. Same as you can't fix things with dementia, which is probably the road your father is going down himself. Nothing is going to 'stick with him', no matter what you do. Trying to care for 2 elders with dementia is quite a huge job which may be more than you can handle alone. Hire in home caregivers to help you daily (on your parent's dime) or consider placing them together in Memory Care Assisted Living if/when things become too much to deal with.

I suggest you read this 33 page booklet ( a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580


Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behavior to adapt to the dementia because the person with the disease cannot.

Best of luck.