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Forum Name: Gastroenterology Topics

Question: Rectal bleeding


 davep - Wed Oct 05, 2005 8:24 am

For about 3 months, after a bowel movement I have bright red blood on the toilet paper. After wiping and flushing I usually sit there for a minute. Several times in the last week I noticed after I stood up the toilet had a large amount of blood in it. I had to wipe again just to remove the blood. The blood looked to be dark in the bowl but not bright red as on the toilet paper.

I'm a 41 year old male. I have no pain. My stools have been soft but somewhat consistent. I have hemorrhoids but they don't hurt and aren't itchy.

Your thoughts would be appreciated.

Thanks,
Dave
 Dr. Safaa Mahmoud - Mon Dec 04, 2006 8:48 am

User avatar Hello,

Fresh Blood in stools, are usually due to lower GI bleeding.

Causes include
- Hemorrhoids or piles, they represent the most common cause of lower GI bleeding, and are easy to be diagnosed by clinical examination. Anorectal fissures as well can result in Bleeding per rectum and are easily diagnosed.

It is more likey to be the cause of your problem since you are known to have Hemorrhoids. You should follow with your doctor for proper examination.

After exclusion of the above causes, other causes to be excluded include:

- Inflammation of the mucosa lining the rectum or the rectum and colon a condition known as proctitis or proctocolitis respectively.
These conditions are either due to infectious diseases or non infectious disease as a part of inflammatory bowel disease (including Crohn's disease and Ulcerative colitis)
Infections include a variety of parasites and protozoa e. g. Entamoeba histolytica and Salmonella or
a part of sexually transmitted disease like herpes simplex and Chlamydia.
Diagnostic tests include stool analysis to check for parasites and protozoa. Samples are collected before receiving any medication and should be repeated for 3 times to find the possible organism causing the infection.

Other tests according to the suspected cause like segmoidoscopy and Colonoscopy to visualize the lining mucosa and take biopsy if needed.

- Irritable bowel syndrome IBS,
Commonly people who have IBS complain off
Abdominal pain or colic
A bloated abdomen
Gaseous distension
Either Diarrhea or Constipation or an alternating between both of them
Mucus or less commonly blood containing stools.

Other diseases that can give similar pictures to IBS and have to be excluded are Gastritis, GERD, and Peptic ulcer. But Blood in stools is usually occult and not fresh red.

- Polyps, diverticulosis and Colon cancer.
Colonoscopy is of choice in the diagnosis of these cases.

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