Bowel Concern

[engcan]

I am a 28 yr old male and a few months ago (April I think), whilst I think I was a little constipated, I discovered blood on the toilet paper. I didn't pass hardly anything, but I was trying/straining hard as I knew I was constipated. I didn't think I was initially alarmed as I have had hemorrhoids before which caused the same (or more) amount of blood.

It must have been on my mind though, as ever since I have been monitoring what has been going down the toilet. I became convinced that I kept seeing blood mixed in with the stool. It was small specks of bright red, with a consistency of tomato paste. It wasn't happening all the time, maybe once or twice a week, but now I was panicking.

So in July, I went to the Doctor and said I wasn't sure whether I was having blood mixed with my stool or not. He said blood of that consistency would likely not be bright red, rather maroon or even darker, maybe appearing brown/black. He asked me to complete a FOBT and if it was positive, I should go for a colonoscopy. During the collection of 1 of the samples, I was convinced I saw a small streak of bright red blood on the outside of the stool. There was also a very small amount of mucus on the outside, kind of yellow/brown in colour. I included a bit of what I thought was blood in that particular sample. Then I panicked more, went to the Doctor and asked for a colonoscopy anyway.

The wait time turned out to be insane! So I paid for a virtual colonoscopy in the meantime to try and determine if there really was a problem. The virtual colonoscopy was performed late July and the results came back fine; no masses, no imflammation, everything looked a.ok. The FOBT came back fine as well, which was a bit of a surprise. I asked about going for the regular colonoscopy as well and my Doctor said it wasn't necessary. He said when the hospital rings me for an appointment, just tell them to cancel it as the virtual colonoscopy should be enough.

However I am still paying close attention to my bowel movements and its a constant source of stress, so much so that its still affecting my life/work. In the last month I have got concerned about my bowel habits and mucus. Before all this started (ie previous to July), I would generally go once daily. Every now and then I would go twice in a day or miss a day. Since July I would say that I have gone slightly more frequently, sometimes I feel like I need to go, but it turns out to just be gas. Mostly its still once a day, but the occurrences of twice a day has risen to maybe twice a week. Occasionally I have gone 3 times in a day. I wouldn't say I have had any diarrhea, I have had the odd loose movement, but they have all have been one off occurrences. Sometimes I have very small amounts of visible mucus on the outside of the stool, this happens maybe once a week or less. However it is generally only 'visible' when I really look for it, as opposed to just glancing down the toilet. Although 1 time I passed a small amount after passing stool. I also feel bloated quite frequently lately, but I don't have any abdominal pain. I have seen blood on 1 occasion about a month ago, again a small streak on the outside of the stool.

I am still not convinced everything is OK, it is still constantly on my mind and causes me stress. Does anyone think I have anything to worry about from what I have said above? Have i become a hypochondriac?
I read hemorrhoids can cause a small amount of mucus as well as bright red blood. Is this the most likely scenario, along with stress being the most likely cause for my slight increase in bowel movements (i.e. a touch of stress related IBS)?

Thanks in advance for anybody's input!

[engcan]

Thanks for the fast reply.

I think my problem is that I have had occasional bright red blood and havent had a definitive diagnosis. The anal exam (finger only, no proctoscopy) in July was normal, no obvious hemorrhoids. But the doctor did say that internal hemorrhoids aren't always detectable with just a finger when they are only small.

Do you (or anyone else) think that my slight change in bowel habits is a concern? Could I be causing this with stress?

Is it wise to rely on the fact that the FOBT and virtual colonscopy were fine to say for certain nothing is wrong?

[Dr. Kokil Mathur]

Hi
Welcome to the forum!
Bright red blood and mucus mixed with stool is a symptom of hemorrhoids. There are hemorrhoidal creams available in the market which you can apply. Sit in a tub of warm water for 10 mins at least twice a day. Increase fiber in your diet. Eat lots of fresh fruits, vegetables, oats, porridge etc. Consult your doctor regarding this. Most doctors can diagnose hemorrhoids by clinical examination of the anal opening or by proctoscopy (inserting a proctoscope, an instrument to visualize the anal mucosa better).
No, this does not sound like IBS.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!