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Forum Name: Gastroenterology Topics

Question: Rectal bleeding for a week, dr. confirmed not hemorrhoid


 Ruby63 - Sun Jun 27, 2010 7:49 pm

After a bout of constipation, brought on by not eating and taking vicodin while waiting for my appt. for a root canal, I finally went, a lot after an enema. But, the morning after there was a good amount of blood in stool and toilet. My PC told me to go to the er, so I did. They thought it was an internal hemorrhoid, so told me to take Mira Lax and see if it improved, and if not to come back. That was a week ago. It has not stopped. The blood in the stool sometimes, and other times when I go there is just a fair amount of blood in the toilet. at least 6 times a day. The past 24 hours I have also had diarrhea, so I went back to the ER, and he confirmed with some kinda scope thing that it was not an internal hemorrhoid. But since I didn't have a fever, my BP was good and my blood count was good that I would just have to wait it out for a gastro consult for a colonoscopy. It's going to be about a week or two wait to get it done. Meantime I am really, really worried at this point. I thought maybe this forum could help. I'm really scared because something is going on, and I can't see it, and really have no pain except slight cramping when I go to the bathroom. Thanks.
 Dr.M.Aroon kamath - Thu Jul 01, 2010 11:00 am

User avatar Hi,
It appears that you had a bout of lower gastro-intestinal (GI) hemorrhage.

There are a number of causative factors such as
- Hemorrhoids,
- Anal fissure,
- Diverticulosis,
- Colonic cancers and polyps,
- proctitis and Colitis,
- Meckel's diverticulum,
- Angiodysplasias, &
- other rare causes.

I am not aware of the country of your residence. This information is very useful, as intestinal helminthic infestations are fairly common in some of the more underdeveloped countries.Some of these helminthic infestations are known to cause lower GI bleeding. I will discuss some of the important ones here, as these are at times overlooked while evaluating a case of lower GI bleed.

- T trichiura is the third most common roundworm seen in humans. Massive infestation sometimes leads to dysentery, rectal prolapse and bleeding. Heavy trichuriasis is more common in children than in adults.

- E. vermicularis infestation: Common symptoms are weight loss, abdominal pain, chronic diarrhea, rectal bleeding, or urinary tract infections(esp; in children). In some cases, may be associated with acute appendicitis.

Dignosis: only about 5% of individuals infested pass eggs in their stool. The cellophane tape test is useful for a quick diagnosis. This test involves placing a piece of tape on a slide with its adhesive surface facing upwards and then applying the tape on the perianal region several times. The slide and affixed tape are then examined under the microscope to look for the eggs.

Apart from these helminthic infestations, one other condition that deserves mention is Typhoid fever. Some cases may present with massive lower Gi hemorrhage. Bleeding generally occurs from the typhoid ulcers ulcers in the ileum or the proximal colon.

I hope this information will be useful to you.
Best wishes!
 Ruby63 - Sat Jul 03, 2010 10:49 pm

Thank you so much Dr. M. Aroon kamath for replying- My primary care physician was fairly confident that I was having a bout of colitis, or ulcerative colitis, but he tested me for c-diff, salmonella and two other things I can’t remember just to be sure I didn’t pick something up (I live in the United States, by the way). Still waiting for results on some of the tests, but the ones he has gotten back so far have been negative. I have a gastro consult set up, but it isn’t for 3 weeks, my primary care doc wants me to have a colonoscopy done to find out exactly what it is, but he told me not to worry about anything like cancer (which is was I was really, really, scared of) because my blood work all looks good and my body is healthy enough to make up and compensate for the blood loss. I may call one of the larger hospital’s to see if I can get in for a gastro consult a bit sooner, I don’t want to go on bleeding for another 3 weeks before I confirm the cause. Thank you again for answering my question.
 Dr.M.Aroon kamath - Mon Jul 19, 2010 2:00 am

User avatar Hi Ruby63,
Thanks for your update. Hope your problem gets sorted out soon. Best wishes!

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