Blood on Tissue

[tooyoungtodie]

I am a healthy 42 year-old male who has not visited a doctor in 20 years.  About a year or two ago I began to notice a small dot of blood on the tissue while wiping.  This isn’t even damp blood, just bright red dried blood.  Recently it has grown to be a small streak of bright red dried blood.  I have never had blood on or in the stool or in the toilet.  My bowel movements tend to be normal to a little loose but not too uncomfortable.  I tend to be gassy but nothing too uncomfortable.  I never have pain or cramps.  My stomach bloats after I eat but this has happened all of my adult life.  My appetite is down slightly and I think I’ve lost a few pounds but that’s it.  My concern is that I feel fatigued, especially when I wake up in the morning, even when I get plenty of sleep.  I work in a major metro area and with my commute I walk 2 miles a day.  I can handle that but if I climb three flights of stairs I am gasping for air and lightheaded.  I am obviously not in good cardiovascular condition but this seems to go beyond that.  I guess my main question is if the bleeding is caused by a minor condition like hemorrhoids would that cause my fatigue or could there be something else going on here.

[Kevin Pho, MD]

There are many causes for rectal bleeding, including hemorrhoids, an anal fissure, colonic polyps, cancer as well as inflammatory bowel disease.  The fact that you feel fatigued may suggest excessive blood loss amongst other things.  

The test to consider would be some sort of lower endoscopy - including a colonoscopy or flexible sigmoidoscopy.  Those would be the most comprehensive tests ensure there isn't anything more serious going on.  A gastroenterology consult for further evaluation should be considered.  

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.

[surgeon]

if it's due to hemorroids (hemorrhoids), or a fissure (a tear in the skin at the anal opening), both of which are common and non-serious, they wouldn't also cause fatigue. You need to have both things (the blood and the fatigue) evaluated by your doctor.