Re: Rectal Bleeding

Posted By HFHSM.G.-mg on June 19, 1998 at 16:50:14:

In Reply to: Rectal Bleeding posted by TJ on June 14, 1998 at 00:56:01:






I am a 35 year old male who has for more than 20 years has bleeding from the rectom. It
has varied in severity, anything from a little bleeding to very heavy bleeding that almost
looks like a dark sludge and clots. I have also had hemoroids for just as long. Most times after
having a bowl movement I have to wait a while before being able to shower because if I showered
right away, my hemoroids would flair up and I would have days of discomfort. I assume this is not
cancerous since it has gone on for so long, but I have always
wondered what could be causing the bleeding. Like I said, there are times when the
toilet bowl is completely dark red and times when there is very little.
Thank you for your time.
__
Dear TJ,
There are many causes for rectal bleeding.  Some are trivial and do not require treatment, whereas others require medical or even surgical therapy. The fact that the bleeding has been ongoing for 20 years indicates that we are not dealing with an aggressive problem.    Hemarrhoids could bleed and be the cause of your symptoms.  Another possibility is a fissure, or a small tear in the anal canal which too can cause bright red blood from the rectum as well as pain.  There are, however, several points that are important to know before we can write off your problem to hemorrhoids or fissures. Have you had any weight loss, fever, change in bowel pattern, nocturnal stool, urgency to defecate, or blood mixed with the stool?
Another consideration for your problem is inflammatory bowel disease (IBD), also known as Crohn's disease or Ulcerative colitis, which commonly presents in the younger patient population.  IBD is a chronic condition which can present as rectal bleeding, but more commonly presents with additional symptoms such as abdominal pain, fever, weight loss, fatigue, or joint pain.  You're right to assume that your condition is probably not from cancer, but if your problem was as a result of IBD, then your risk for developing colon cancer would be increased.
Other possibilities for rectal bleeding are rectal polyps (tumor-like growths in the lining of the colon), rectal varicies (dilated veins like varicose veins--although rectal varicies are usually associated with cirrhosis of the liver), or trauma (from foreign bodies or anal intercourse).
In order to evaluate the cause of your rectal bleeding, my recommendation is to see your primary care doctor who can obtain a thorough history and perform a complete physical examination.  A flexible sigmoidoscopy is needed and possibly a barium enema or colonsccopy (depending on the details of your history),
This information is provided for educational purposes only.  Always consult your personal physician for specific medical issues.
If you want, we would be happy to see you in the Division of Gastroenterology at Henry Ford Hospital, in order to review your records and investigate your symptoms. Dr. Fogel of the Division of Gastroenterology would be able to see you and to quickly evaluate your symptoms.  He can be reached by calling the Henry Ford Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: rectal bleeding, hemarrhoids, fissures
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