Rectal Bleeding: Causes, Risks, and When to Seek Help - Surgery

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Rectal bleeding can be a concerning symptom, and it’s important to understand its potential causes, risks, and when to seek medical help. Based on your description, let's address your two questions.


Question 1: Causes of Rectal Bleeding and Concerns About Rectal Cancer
You mentioned that you have experienced rectal bleeding since sixth grade, with recent episodes involving bright red blood during bowel movements, accompanied by pain. The blood you described does not mix with the stool, which is a common characteristic of bleeding from the lower rectum or anus, often associated with conditions like hemorrhoids or anal fissures.

While hemorrhoids can cause significant bleeding, it’s understandable to be concerned about more serious conditions like rectal cancer. Rectal cancer can indeed present with rectal bleeding, but the nature of the bleeding can vary. In early stages, patients might experience minor bleeding, but as the disease progresses, the bleeding can become more pronounced. Typically, rectal cancer may present with other symptoms such as changes in bowel habits, unexplained weight loss, or abdominal discomfort.
Given your history of rectal bleeding and the fact that you have not had a follow-up colonoscopy since your last examination, it would be prudent to consider further evaluation. A colonoscopy is the gold standard for investigating rectal bleeding, as it allows direct visualization of the colon and rectum, and can help rule out or confirm the presence of polyps, tumors, or other abnormalities.

Question 2: Abdominal Pain and Mucus in Stool
Regarding the abdominal pain you experience on the left side of your navel, along with the presence of mucus in your stool, this could be indicative of several conditions. Mucus in the stool can be a normal finding, especially if it is minimal. However, if it is accompanied by changes in bowel habits, pain, or other concerning symptoms, it could suggest conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even infections.

The intermittent pain you describe, especially if it is not associated with tenderness upon palpation, could be related to functional gastrointestinal disorders, but it is essential to rule out any structural issues. The presence of mucus, particularly if it is excessive or associated with other symptoms like diarrhea or constipation, warrants further investigation.


Recommendations
1. Seek Medical Evaluation: Given your history of rectal bleeding and abdominal pain, I recommend scheduling an appointment with a gastroenterologist. They may suggest a colonoscopy to evaluate the source of the bleeding and assess for any potential lesions or abnormalities.

2. Monitor Symptoms: Keep track of your symptoms, including the frequency and amount of bleeding, any changes in bowel habits, and the nature of the abdominal pain. This information will be valuable for your healthcare provider.

3. Dietary Considerations: Ensure you are consuming a high-fiber diet to help prevent constipation, which can exacerbate hemorrhoids and anal fissures. Staying hydrated is also crucial.

4. Avoid Self-Diagnosis: While it’s natural to research symptoms online, it’s important to consult with a healthcare professional for an accurate diagnosis and appropriate management.

In conclusion, rectal bleeding and abdominal pain are symptoms that should not be ignored, especially with your history. Early evaluation and intervention can lead to better outcomes, so do not hesitate to seek medical advice.