Rectal Bleeding: Insights on Colonoscopy and Internal Hemorrhoids

Blood in stool and bowel movement issues?

Doctor: I occasionally experience rectal bleeding, which is usually diagnosed as internal hemorrhoids through a digital rectal exam at the clinic.
Over the past few years, the shape of my stool has changed to either soft or watery, or sometimes it appears as thin strips.
Recently, I had another episode of rectal bleeding, so I went to a clinic equipped with a colonoscope and informed the physician of my symptoms.
After examining my colon, the doctor told me that the color of my intestines looked very healthy and no abnormalities were found, except for a few small red spots at the end of the colon, which are likely indicative of mild inflammation and not a major concern.
The doctor also showed me the internal hemorrhoids and mentioned that the rectal bleeding is probably related to them.
I have a habit of smoking and drinking, and I enjoy spicy food, often eating greasy meals.
My question is: Can a colonoscopy effectively detect cancer? Thank you.

A Guo, 40~49 year old female. Ask Date: 2017/03/29

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Modern dietary and lifestyle habits make it difficult to avoid the occurrence of hemorrhoids.
If a colonoscopy refers to a full colonoscopy, the diagnostic accuracy is very high, and it is rare for any cases to go undetected.

Reply Date: 2017/03/29

More Info

Understanding rectal bleeding can be a complex issue, especially when considering the potential causes and the role of diagnostic procedures like colonoscopy. Based on your description, it seems that you have been experiencing intermittent rectal bleeding, which has been attributed to internal hemorrhoids by your healthcare providers. You also mentioned changes in stool consistency, with episodes of soft or watery stools and thin, ribbon-like shapes.
Colonoscopy is a critical diagnostic tool in evaluating the lower gastrointestinal tract, particularly for identifying conditions such as colorectal cancer, inflammatory bowel disease, and other abnormalities. The fact that your colonoscopy showed no significant issues, aside from some inflammation and the presence of internal hemorrhoids, is reassuring. However, it is essential to understand the limitations and capabilities of this procedure.

Colonoscopy is indeed effective in detecting colorectal cancer, especially in its early stages. The procedure allows for direct visualization of the colon and rectum, enabling the physician to identify polyps or lesions that may be precursors to cancer. If polyps are found, they can often be removed during the procedure, which can significantly reduce the risk of developing colorectal cancer. The sensitivity of colonoscopy for detecting colorectal cancer is high, but it is not infallible. Factors such as the quality of bowel preparation, the skill of the endoscopist, and the presence of overlapping conditions can affect the outcomes.

In your case, the small red spots observed at the terminal end of the colon may indicate mild inflammation, which could be related to your dietary habits, such as consuming spicy foods and alcohol, or even the presence of hemorrhoids. Hemorrhoids can cause rectal bleeding, particularly during bowel movements, and are often exacerbated by straining, constipation, or prolonged sitting. The fact that your bleeding is intermittent and associated with bowel movements further supports this diagnosis.

However, given your history of changes in stool shape and consistency, it is prudent to remain vigilant. While the colonoscopy did not reveal any alarming findings, it is essential to monitor your symptoms closely. If you experience any new symptoms, such as significant changes in bowel habits, persistent abdominal pain, or if the bleeding worsens, you should consult your healthcare provider promptly.
Additionally, lifestyle modifications may help alleviate some of your symptoms. Increasing dietary fiber intake, staying hydrated, and avoiding foods that may irritate your gastrointestinal tract can be beneficial. Regular exercise can also promote healthy bowel function. If hemorrhoids are indeed the cause of your bleeding, over-the-counter treatments, such as topical creams or suppositories, may provide relief.

In conclusion, while your colonoscopy results are reassuring, it is essential to maintain an ongoing dialogue with your healthcare provider about your symptoms. Regular follow-ups and monitoring are crucial, especially considering your lifestyle factors and the potential for changes in your gastrointestinal health. If you have any concerns about colorectal cancer or other gastrointestinal issues, do not hesitate to discuss them with your doctor, who may recommend further testing or monitoring as necessary.

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