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Gastroenterology  (Expert Forum)
 | 
Bright red blood in toilet
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

Bright red blood in toilet

by Hussafuss, Mar 24, 2004 12:00AM
F/Age 36/No family history of colon cancer/Father has Crohn's Disease and had most of his bowel removed, colostomy not needed.

Here's my story. I normally have very soft stools and in many cases diarrhea. I thought nothing of it because I had a gastric bypass in 2000, and that seems to be the norm for most people with this surgery. I had a blood test done in December 2003 which showed I was slightly anemic (10.8), so my Doc advised me to take OTC Slow Fe Iron. As I took the iron, I noticed my stools became firmer and had a more normal form.

In January 2004, I noticed during a bowel movement that my stool was streaked with bright red blood. I thought nothing of it, since my anal area was somewhat tender and rationalized I had a tear.

Well, 3 weeks ago, I had several (3) bowel movements in one day and forced the last before bedtime. I usually only have 1 bowel movement per day. With the last bowel movement, I noticed quite a bit of blood on the tissue and then saw quite a bit of blood in the toilet, enought to turn the water red. FYI...there was no pain. I was so freaked that I woke up my husband to show him. He said it happens to him too, so I calmed down and went to bed, not totally convinced this was nothing.

Two days later, I went to my Primary to follow up. I did have a bowel movement right before I went to see him, and it was normal. He gave me a rectal exam and fecal occult test (negative) and said he felt something but wasn't sure it was a hemorroid. My bowel movements have been pretty hard due to the iron supplements, so he thinks the change in the bowel habits has caused the bleeding.

I spoke with the gastroenterologist on 3/11/04 with a copy of a CT scan done 8 months ago on my conplete abdomen with oral and injected contrast. Report concluded the small and large bowel were normal. He said this scan was useless and said I needed a colonoscopy (which I already knew).

I have an appointment for a colonoscopy on Monday 3/29/04,
and here are my questions.

1.Could the bleeding had been from a hemorroid and reduced in size by the time I saw the doctor 2 days after?

2.Are CT scans really that inaccurate to see a polyp or colon cancer?

3. In the event I do have colon cancer, is bleeding an early symptom or a death sentence?

4. At what stage of cancer I,II,III or IV does bleeding usually show up on average?

5. Due to my age, could the colon cancer be all that advanced?

Well I think that is it. BTW...I got the CT scan to look for adhesions in my URQ because I occasionally experience what feels like a "charlie-horse" in this area. Sometimes it happens during a bowel movement, other times it is when I lift something heavy or move the wrong way.

Sorry so long, just wanted to give an accurate description.
Thanks so much...Dottie














by Kevin Pho, MD, Mar 25, 2004 12:00AM
To answer your questions:
1) Yes, the bleeding may be caused by a hemorrhoid, and it may have reduced in size.

2) CT scans typically are not sensitive enough to evaluate for polyps or cancer.

3) If the bleeding is caused by colon cancer, the prognosis would depend on what stage it is.  It can be curable if detected at an early enough stage.

4) Bleeding can occur at any stage of colon cancer.

5) Being age 36, it is less likely that it is caused by advanced stage colon cancer.  The colonoscopy would be the most comprehensive test to evaluate for this.  

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.
Member Comments

by jpforbiz, May 03, 2004 12:00AM
Just started bleeding from my stool. Scared.  I'm 30 and i drink. It started bleeding when i was taking asprin (8) a day to kill the pain from my broken rib. I've stoped taking the asprin for two days but still bood.

by Gayleb, Oct 03, 2008 07:35AM
A related discussion, Blood in toiler atfer bowel movement was started.
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