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Gastroenterology (Expert Forum)
recent, persistent rectal bleeding, etc.
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.
recent, persistent rectal bleeding, etc.
by Michelle123, Mar 03, 2003 12:00AM
Thank you for your forum. My question is somewhat complicated: I am 40 yrs, female, with a history of undiagnosed digestive problems, sporadic - about 10 years or so. Intermittant cramping, blood in toilet or on paper, diarrhea, hemorrhoids, etc - usually following obvious dietary indiscretions. I drink wine every night, and have been known to overindulge on occassion in fatty foods and alcohol, too much over the last 20 years. My family has no history, to my knowledge, of colon cancer. Within the last three years or so, I have experienced increasing and most recently, persistent, digestive difficulties ranging from days of watery diarrhea - usually in the morning after having eaten something, but not exclusively so. This has been, for the last four months or so, preceeded by severe stomach aches, not cramping. This is relieved after a BM (no, not a Bloody Mary - I'm not that much of an alcoholphile) - also, the BM's are not always diarrhea - there are occassions when it appears normal or what I would perceive as normal. They have varied in consistency and color more frequently within the last couple of years, also. Forgive the graphics.
Well, about a week ago, after having experienced for about two months persistent watery diarrhea interspersed with occasional "normal" passings, I had a major bout of diarrhea and that triggered a very large, what I thought and think to be, hemorrhoid, that after about a day began to bleed. Slightly (pinkish) at first, then more abundantly and of a brighter color (red). Then after about 5 days, it started to seem to me to shrink and the bleeding has lessened - but I am not entirely convinced the bleeding is exclusively caused by what I think is a hemerrhoid. Soooo, to make a short story long, does this sound like symptoms and a history that may very well indicate colon cancer? Yes, I am going to see my doctor - but I have not visited a doctor for anything like this ever. In fact, I go at the drop of a hat for things I may deem non-life-threatening, but I am frightened beyond comprehension to go for what could be. So I would like your thoughts on this, if you have the time.
Thanks very much for whatever information you can provide.
Well, about a week ago, after having experienced for about two months persistent watery diarrhea interspersed with occasional "normal" passings, I had a major bout of diarrhea and that triggered a very large, what I thought and think to be, hemorrhoid, that after about a day began to bleed. Slightly (pinkish) at first, then more abundantly and of a brighter color (red). Then after about 5 days, it started to seem to me to shrink and the bleeding has lessened - but I am not entirely convinced the bleeding is exclusively caused by what I think is a hemerrhoid. Soooo, to make a short story long, does this sound like symptoms and a history that may very well indicate colon cancer? Yes, I am going to see my doctor - but I have not visited a doctor for anything like this ever. In fact, I go at the drop of a hat for things I may deem non-life-threatening, but I am frightened beyond comprehension to go for what could be. So I would like your thoughts on this, if you have the time.
Thanks very much for whatever information you can provide.
Doctor's Answer
by Kevin Pho, MD, Mar 04, 2003 12:00AM
, Mar 04, 2003 12:00AM
Hello - thanks for asking your question.
A lower GI bleed (i.e. bloody diarrhea) is always an indication for endoscopy (colonoscopy or flexible sigmoidoscopy) to determine what is causing it.
There are several conditions that you may want to discuss with your personal physician. These results are from a study determining the cause of lower GI bleeding:
Diverticulosis — 33 percent
Cancers/polyps — 19 percent
Colitis/ulcers (including Inflammatory bowel disease, infectious, ischemic, and radiation colitis, vasculitis and inflammation of unknown cause) — 18 percent
Unknown — 16 percent
Angiodysplasia — 8 percent
Miscellaneous (postpolypectomy, aortocolonic fistula, stercoral ulcer, anastomotic bleeding) — 8 percent
Anorectal (hemorrhoids, fissures, and idiopathic rectal ulcers) — 4 percent
Thus, colon cancer is always a possibility with lower GI bleeding, but as you can see, there are many other causes as well.
Please visit your personal physician as soon as possible to schedule an endoscopy.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
A lower GI bleed (i.e. bloody diarrhea) is always an indication for endoscopy (colonoscopy or flexible sigmoidoscopy) to determine what is causing it.
There are several conditions that you may want to discuss with your personal physician. These results are from a study determining the cause of lower GI bleeding:
Diverticulosis — 33 percent
Cancers/polyps — 19 percent
Colitis/ulcers (including Inflammatory bowel disease, infectious, ischemic, and radiation colitis, vasculitis and inflammation of unknown cause) — 18 percent
Unknown — 16 percent
Angiodysplasia — 8 percent
Miscellaneous (postpolypectomy, aortocolonic fistula, stercoral ulcer, anastomotic bleeding) — 8 percent
Anorectal (hemorrhoids, fissures, and idiopathic rectal ulcers) — 4 percent
Thus, colon cancer is always a possibility with lower GI bleeding, but as you can see, there are many other causes as well.
Please visit your personal physician as soon as possible to schedule an endoscopy.
I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (1)
by wishingyouwell, Mar 04, 2003 12:00AM
To: michelle
michelle, the best thing you can do for yourself at this moment in your life is to put your fear aside and go see a gastro/specialest .i know fear can be a monster to fight, but it sound to me like you realy need to see a doc asap.most digestive/colon /cancer,etc. can be treated if caught in time but the longer it is put off the more you indanger your health i faced the same fear you are dealing with , so i do understand .i have had colon surgery and i have many other digestive disease/disorders .but had i not taken control of things it could have been much worse .the fact of the matter is it could be something quite simple but you can not afford to guess work your health . so bite the fear bullet and see the gastro/specialest .the doctor is correct the best test to have done so nothing is missed is the colonoscopy ,that is how they finally found mine after many doctors and test.so please for your own well being go to the doc.god bless, wishing you well
