Rectal Bleeding: Symptoms, Causes, and Colonoscopy Costs

Rectal bleeding

Hello doctor, on October 12th, I noticed fresh blood while wiping after a bowel movement, and the entire toilet was filled with blood (similar to menstrual bleeding).
On November 13th, I experienced bleeding again, but it was not as much as the first time.
There was no bleeding in between, and after wiping 1-3 times, it stopped.
A week later, I noticed a little blood on the toilet paper again.
On the morning of November 25th, I had bleeding again, but my stool was yellow, and I did not have any abdominal pain.
I usually have bowel movements every 3-4 days, not exceeding 5 days.
I realize I haven't been drinking enough water, less than 2000cc.
The symptoms of colorectal cancer are very similar to those of hemorrhoids, and I am really scared, especially since my family is not well-off.
May I ask how much a colonoscopy costs? Thank you.

Q, 20~29 year old female. Ask Date: 2016/11/26

Dr. Ke Fangxu reply Surgery

This situation likely indicates a higher possibility of hemorrhoidal bleeding.
As long as there is no further bleeding, it should not be a concern.
It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements.
Warm sitz baths may also help alleviate symptoms.
You can purchase over-the-counter hemorrhoid suppositories and use stool softeners, but it is best not to take medications indiscriminately.
At the age of 22, the risk of developing colorectal cancer, while not zero, is generally very low.
If symptoms persist without improvement, you can ask a physician for medication.
If there is still no improvement or if you are very concerned, a colonoscopy can be arranged.
The colonoscopy itself is covered by health insurance, so there is no additional cost.
However, if you are afraid of pain and wish to undergo a painless colonoscopy, you will need to cover the anesthesia costs yourself, which can vary from 2,000 to 10,000 TWD depending on the hospital.

Reply Date: 2016/11/26

More Info

Rectal bleeding can be a concerning symptom, and it's understandable that you're feeling anxious about it. Based on the information you've provided, it seems like you've experienced episodes of bright red blood on toilet paper and in the toilet bowl, along with some changes in your bowel habits. Let's break down the potential causes, symptoms, and the importance of a colonoscopy in your situation.

Symptoms and Causes of Rectal Bleeding
1. Hemorrhoids: One of the most common causes of rectal bleeding is hemorrhoids, which are swollen veins in the lower rectum or anus. They can cause bright red blood during bowel movements, especially if you are straining or experiencing constipation. Given your mention of infrequent bowel movements (3-4 days apart), this could be a contributing factor.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during bowel movements and may also result in bleeding. The blood is usually bright red and may be seen on toilet paper or in the toilet bowl.

3. Diverticular Disease: This condition involves the formation of small pouches in the colon wall, which can become inflamed or infected, leading to bleeding.

4. Colorectal Polyps or Cancer: While less common, especially in younger individuals, polyps or colorectal cancer can also cause rectal bleeding. The blood may not always be bright red; it can also appear darker or mixed with stool.

5. Other Gastrointestinal Issues: Conditions such as inflammatory bowel disease (IBD), infections, or gastrointestinal bleeding from other sources may also lead to rectal bleeding.

Importance of a Colonoscopy
A colonoscopy is a procedure that allows a doctor to examine the inner lining of your large intestine (colon) and rectum. It is a crucial diagnostic tool for identifying the cause of rectal bleeding. Given your symptoms and the recurrence of bleeding, a colonoscopy is advisable for several reasons:
- Diagnosis: It helps in diagnosing conditions like hemorrhoids, fissures, polyps, or cancer.

- Prevention: If polyps are found, they can often be removed during the procedure, reducing the risk of developing colorectal cancer.

- Peace of Mind: Knowing the cause of your symptoms can alleviate anxiety and help you manage your health better.

Cost of a Colonoscopy
The cost of a colonoscopy can vary widely based on several factors, including your location, whether you have insurance, and the facility where the procedure is performed. In the United States, the average cost can range from $1,000 to $3,000 without insurance. However, many insurance plans cover the procedure, especially if it's deemed medically necessary due to symptoms like rectal bleeding. It's advisable to contact your insurance provider to understand your coverage and any out-of-pocket expenses you might incur.

Recommendations
1. Hydration: Increasing your water intake to at least 2 liters per day can help soften your stools and reduce the risk of constipation, which may alleviate some of your symptoms.

2. Diet: Incorporating more fiber-rich foods, such as fruits, vegetables, and whole grains, can help promote regular bowel movements and prevent straining.

3. Medical Consultation: Given the recurrence of your symptoms, it is crucial to consult a healthcare provider. They can evaluate your condition and recommend a colonoscopy if necessary.

4. Monitoring Symptoms: Keep track of any changes in your symptoms, including the frequency and amount of bleeding, as well as any new symptoms like pain or changes in bowel habits.

In conclusion, while hemorrhoids and anal fissures are common causes of rectal bleeding, it's essential to rule out more serious conditions through proper medical evaluation. A colonoscopy is a valuable tool in this process, and understanding the costs involved can help you make informed decisions about your health. Don't hesitate to seek medical advice, as early intervention can lead to better outcomes.

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