Bleeding During BM - ?s for Dr. visit

Hello - I am a healthy 29 year old female with two small children.  In the past 6 weeks I have experienced bleeding during a bowel movement ~10 times.  It usually appears as a small streak of blood on the surface of the stool.  Twice I saw bright red blood while wiping after a bm.  I will have normal movements for a few days, and then see a streak of blood again.  Nothing like this has ever happened to me before.  

After this happens, I will feel an itchy, burning sensation in my bottom for the rest of the day.  There is also a pressure feeling.  This goes away after a day or so and comes back the next time I have a bm with blood.

I have also had a dull ache/sore feeling in the area around my tailbone, that hurts more when I put pressure on it - i.e. sitting on a hard surface.

Nothing else has been unusual, except I had a small ovarian cyst rupture during this time.

Does this problem sound like hemrrhoids, or something more serious?

I have an appointment on 5/31 with a gastroenterology physician's assistant.  I am wondering what questions he might ask, or what tests he might schedule at this appointment?  I am also wondering if he will do any tests during the appointment?  I would like to go in feeling prepared.

Thank you in advance for your advice on this rather embarassing problem!

- Becky

[Kevin Pho, MD]

Hemorrhoids are the most likely cause.  Other causes would include an anal fissure, inflammatory bowel disease, a polyp or cancer (less likely).  

I would consider an anoscopy to visualize any possible hemorrhoids.  A more thorough evaluation can be done via a flexible sigmoidoscopy.

These options can be discussed with the GI 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.

Kevin, M.D.
kevinmd_

[Nursgirlie23]

becky,
This sounds a lot like a fissure to me.  I have an anal fissure that is going to need to be surgically repaired.  I've been dealing with it since august of 2005.  There is sometimes blood on the toilet tissue, and sometimes on the stool itself.  They can cause a lot of discomfort.  The longer I've had mine, the more it seems to hurt.  It actually makes me not want to eat, so I won't have to have a bowel movement!! The pain can last for a long time after I've had the bowel movement.  The creams and suppositories haven't helped me at all.  The only thing that seems to help is sitting in a hot bath for about 20 minutes.  The heat helps the sphincter muscle to relax.  The best way for me to describe how it feels is to say it feels like there is a sparkler up there!! lol.  
When i went to the doc for mine, they did an anal exam and found the fissure.  I haven't had to have any other testing for it.  They gave me some steroid  suppositories, and nitro paste for it, with no improvement.  So, now I'm scheduled for surgery!
You may just have a hemorrhoid though, those can be painful also.. either way the docs should be able to give you something to help you! Good Luck!

[beckymoore77]

To follow up with my post, I have a sigmoidoscopy scheduled for 6/22.  

The physician's assistant I saw really scared me about colon cancer, and now I feel very anxious about it.

I had a CT scan of the abdomen 11 months ago which was normal.  If I had colon cancer, would it have shown up on this scan?

Thanks,
Becky