Blood on toliet paper

I'm a 33 yr old female, no family history of any cancer. Generally in ok health, gallbladder removed in 98. 40 pounds overweight, past 2 weeks I've started to work out everyday.  I've had vague abdominal discomfort for 3 months now, had a CT scan, Barium upper GI, abdominal ultrasound, pelvic ultrasound, this week had a CBC, H.pylori, and thyroid blood test and urine test done.  ALL of my above test have come back very normal.  I have regular bowel movements, 1 to 2 times a day.  The pain/discomfort resides mostly on my far right side, hip/buttock/pelvic area.  Today my 1st bowel movement was after lunch, everything seemed fine, my next bowel movement was at the gym after my workout, I had to go several times, it wasn't watery, nor was it like diaherra (diarrhea).  After the movement I notice a significant amount of Bright red blood on the toliet paper, but only after the first movement, I didn't notice any blood in the toilet or in stool or after other times of having to wipe.  This is the first time this has happened to me.
What could be the cause?  My PCP and 3 other physicans suggested that I have a severe case of IBS, but IBS doesn't make you bleed.  Can you please give me some advice or your opinion of what the cause of Bright red blood.  What should I do? I'm a bit scared now and thinking the worse.  Could it be hemorroids (hemorrhoids)? anal fisure?  Please help.  At what point do I see my PCP

[Kevin Pho, MD]

Rectal bleeding certainly needs to be evaluated.  The most common causes in your age group would be hemorrhoids or an anal fissure.  Other possible, less likely, causes would be polyps, cancer, diverticulosis, or inflammatory bowel disease.  I agree that bleeding is not common with IBS.

I would suggest workup including an anoscopy (looking for hemorroids (hemorrhoids)) and/or a flexible sigmoidoscopy.  The sigmoidoscopy would determine if there are any distal colorectal polyps or cancer present.  These tests can be discussed with your personal physician.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[jakey2]

FORGOT TO MENTION, AFTER THE BOWEL MOVEMENTS AT THE GYM MY ANUS WAS VEY IRRITATED, ITCHY AND SOMEWHAT PAINFUL, ALMOST AS IF I HAD BEEN USING THE TOLIET ALL DAY LONG

[greenland]

Hi,..Just so you don't panic,...it most likely is an anal fissure. These can be very annoying and unforgiving for a long while if not handled properly. It can result from a strenuous exercise or stress in that anal region as a result from exercise and/or diet.

I actually seem to have them re-occur when I do crazy fitness routines involving heavy heavy strain and lack of concentration.

If I lift heavy weights,..I do so very cautiously and with much concentration and then follow it with plenty of rest in between and I drink LOTS and LOTS of water!!! Be sure to drink water and include ample fiber in your diet.

My feeling was soreness and itchiness and the constant feeling as if someone just kicked me in that area with a steel toed shoe. It took a layoff from all fitness activity and a close attention to diet and  stress avoidance for about 2 weeks.

I know this sounds like overkill and silly, but until someone has these symptons, they just don;t realize what it's like.

Keep the fiber coming and drinking of fluids because you want to keep your BM's as easy and comfortable as possible.

My two cents

td