Hidden Blood

[Sharon Sokol]

I went for a visit with a specialist for rectal pain and hemorrhoids and during the exam he tested me for "hidden blood" doing a stain in the office.  This test turned out to be positive, and during a follow up visit he told me I would need a colonoscopy and x-rays of the small intestines- even though my symptoms are gone and I'm feeling okay.  When I protested all these tests he gave me an order for a barium enema, and acted very concerned I might have something serious.  

I went for a second opinion to a gastroenterologist who didn't think the barium enema was a good idea but he sent me home with an occult blood test and will discuss the issue further when I get the results.  He also had mentioned a colonoscopy.  I was taking Tequin during the first hidden blood test and eating red meat, taking iron etc..  

My question is if my second occult test comes back negative is it necessary to go through a colonoscopy, and couldn't the test in the doctor's office be a false positive from the hemorrhoids?  I have no symptoms of colon cancer but have mitral valve prolapse and supraventricular tachycardia.  I take inderal and xanax.  I'd rather not take the risk of an unnecessary test.  I am a thin 42 year old female, non-smoking, non-drinking  with no history of colon cancer in my family.

[Kevin Pho, MD]

If one of the occult tests comes back positive, I would err on the cautious side and suggest the colonoscopy.  A colonoscopy is recommended at the age of 50 in asymptommatic people anyways.

Blood in the stool is never normal - benign things that can cause it are hemorrhoids or diverticulosis.  The thing that you want to ensure its not is colon cancer.  The colonoscopy would be the bottom-line test to ensure this is not the case.  

Other acceptable options instead of a colonoscopy would be a flexible sigmoidoscopy (less invasive), or the double-contrast barium enema.  You may want to discuss these other tests 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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[tessa0825]

If given the choice between sigmoidoscopy and barium enema or a colonoscopy I would just have the colonoscopy. They use consious sedation so you aren't in a deep state of sedation but it is enough that you don't even realize the test is being done. It's completely painless. On the other hand the other options are done with no sedation. They are very uncomfortable!

[lil sunshine]

I totally agree with Tessa , the other options are worse than the colonoscopy. And if they see something that needs investigating you would then have to do the Colonoscopy anyway. tHe worst part of the C is drinking the prep. My 11 year old says to hold your nose and it helps you swallow things you don't like the taste of.
The barium swallow thing is horrible. The upper isn't quite so bad but the lower you have to drink 3 cups of that stuff. I nearly gagged to death!
Good luck,
Bonnie