Follow up:
Clarification / Comment by Dr.Kokil Mathur on Mon 25, Jan 2010 05:35pm:
Hi Blake70605!
Dr Rowena has given you a very good outline of the possibilities, diagnosis and treatment options for your
symptoms. Bright red blood in stool is usually from the lower portion of the gut, normally from the rectum or
anus. Hemorrhoids or piles is the commonest cause. However as Dr Rownea said it could also be due to fissures,
diverticulosis (outpouchings from the bowel wall), inflammatory bowel disease, or dysentery and polyps in
rectum too. In hemorrhoids the blood falls after the stool. In fissures it lines the stools. In all other
problems the blood is mixed with stools.
Most doctors can diagnose hemorrhoids, polyps, fissures by clinical examination of the anal opening or by
proctoscopy (inserting a proctoscope, an instrument to visualize the anal mucosa better). Further
investigations may be required after this initial assessment as mentioned by Dr Rowena. As Dr Rowena said,
treatment will depend on the diagnosis. However increasing fiber in diet will help. A stool examination to
rule out infection should also be done. Do consult your doctor. You may need to consult a colo-rectal
specialist. Please feel free to ask anything else you may want to know. Take care!
Clarification / Comment by blake70605 on Mon 25, Jan 2010 05:42pm:
Thank you for your answers. my biggest concern is obviously the big C word. My problem however, is that I am 3
months from having health coverage and am scared of being diagnosed with a condition before I have coverage
which will lead to it not being covered. With the fact there is no pain associated, and no family history of
serious health issues, is it potentially dangerous to wait for diagnosis?
Clarification / Comment by Dr Rowena S, MD on Mon 25, Jan 2010 06:03pm:
Hi,
I understand your concern about cancer. While blood in the stool is also one symptom of colon cancer, risk
factors should also be considered. This includes any of the following: age ( older than 60 years), African
American and eastern European descent, a diet high in red or processed meat, presence of cancer elsewhere in
the body, presence of colorectal polyps presence of inflammatory bowel disease, smoking cigarettes, drinking
alcohol, a family history of colon cancer and also a personal history of breast cancer. Certain genetic
syndromes also increase the risk of developing colon cancer such as hereditary nonpolyposis colorectal cancer
(HNPCC),and familial adenomatous polyposis (FAP). If you have more than one of these risk factors, it is best
that you have it checked for proper evaluation.
Clarification / Comment by Dr.Kokil Mathur on Mon 25, Jan 2010 07:14pm:
Hi!
Since the symptoms started only a couple of days ago and the blood is bright red, in all probability it is due
to hemorrhoids. It does not look like cancer. Try and speed up getting your health insurance. Meanwhile there
are hemorrhoidal creams available in the market which you can apply locally after passing stool. 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. Try this for a week. See if you get relief. If not then you will need to
consult a doctor and get this investigated sooner than your health insurance coverage. Take care!
Clarification / Comment by blake70605 on Mon 25, Jan 2010 07:19pm:
I may have hemroids even though I have no pain or visible signs of them? I do smoke however I am trying to
quit.
Thank you for the responses.
Clarification / Comment by Dr Rowena S, MD on Mon 25, Jan 2010 07:39pm:
Hemorrhoid can be classified as internal or external. If it originates at the top of the anal canal, it is
referred to as an internal hemorrhoid while if it originates at the lower end of the anal canal near the anus,
it is referred to as an external hemorrhoid. This means it can not be seen visually but may become enlarged
and swell. Do you experience abdominal pain or constipation? Another common cause of bleeding as I have
mentioned earlier is diverticulosis, which is also not visible. We can only enumerate the differentials or
possible conditions but not the diagnosis because of the limitation of internet. This is why we recommend that
you have this evaluated sooner if it persists. Best regards.
Clarification / Comment by blake70605 on Mon 25, Jan 2010 09:11pm:
I have never experianced constapation, and I don't have any abdominal pain. I know that from this limited
interaction, a diagnosis is impossible, but I'm just trying to weigh all the factors. Can a person have
a type of hemroids with out ever experiancing pain. I have noticed a tendency to have more bowel movements in
the last coue of weeks, and the blood is a recent development. My stress level is MUCH higher than it's
ever been due to professional and financial pressures.
Clarification / Comment by Dr Rowena S, MD on Mon 25, Jan 2010 10:46pm:
Too much stress is often linked to peptic ulcer diseases and other gastrointestinal issues ( heart burn,
increased bowel movement, diarrhea, constipation, etc). There are cases that the only symptom for hemorrhoids
is the blood in the stool. If you do not have co-morbid conditions like hypertension or heart disease, like Dr
Kokil said, in all probability it can be from hemorrhoids. I understand how difficult it is to decide while
still waiting for your health coverage. But I strongly suggest that if it persist, have this checked to rule
out possible pathologic cause. Do not be scared to be seen by a doctor. On the other side of the coin, knowing
the underlying cause sooner (if it is indeed just hemorrhoids) will lessen the anxiety and additional stress.
follow the suggestions of dr. Kokil and if nothing happens, see your doctor.
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