Fecal Occult Blood Tests in Long-Term Hemorrhoid Patients

Long-term hemorrhoid patients and fecal occult blood testing?

Hello doctor, I recently had a fecal occult blood test during my health check-up, and the result came back positive.
However, I know that I have had mild hemorrhoids for a long time (which I have shown to my doctor multiple times), and occasionally I notice blood in my stool.
I also had a colonoscopy about two years ago, which was normal.
Therefore, I would like to ask if, for someone like me who has chronic hemorrhoids, the fecal occult blood test is less meaningful, and if it is better to rely on regular colonoscopies to ensure that everything is fine? Additionally, how often should a colonoscopy be performed?

YAZOO, 30~39 year old female. Ask Date: 2018/10/01

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Mr.
The presence of bleeding from hemorrhoids can indeed lead to a positive fecal occult blood test.
However, a positive fecal occult blood test cannot solely rule out the possibility of deep-seated colorectal polyps or tumors based on medical history alone.
Therefore, physicians often recommend a colonoscopy for confirmation.
Additionally, it is advised not to submit visibly bloody stool samples for fecal occult blood testing to avoid complications.
The frequency of colonoscopy screenings depends on the patient's age and previous colonoscopy results.
Changhua Hospital cares about your health.
Sincerely, Chen Shidian.

Reply Date: 2018/10/01

More Info

Understanding fecal occult blood tests (FOBT) is crucial, especially for individuals with a history of hemorrhoids. In your case, the positive result from the FOBT can indeed be concerning, but it is essential to interpret this result in the context of your known condition.

Fecal occult blood tests are designed to detect hidden blood in the stool, which can be an indicator of various gastrointestinal issues, including colorectal cancer, polyps, or other sources of bleeding. However, in patients with hemorrhoids, the presence of blood can often be attributed to the hemorrhoids themselves, especially if you have experienced bright red blood during bowel movements. This is because hemorrhoids can cause bleeding, which may lead to a positive FOBT result.

Given that you have had a colonoscopy two years ago with normal results, it is reassuring. Colonoscopy is a more definitive test that allows for direct visualization of the colon and rectum, and it can help identify any abnormalities such as polyps or tumors. If your colonoscopy was normal and you have a history of hemorrhoids, it is possible that the positive FOBT is related to your hemorrhoidal condition rather than a more serious underlying pathology.

However, it is important to note that while hemorrhoids can cause bleeding, any new or persistent bleeding should be evaluated further. The FOBT is a screening tool, and a positive result typically warrants further investigation, especially if there are changes in your bowel habits or if you experience additional symptoms such as weight loss, changes in appetite, or abdominal pain.
In terms of follow-up, regular colonoscopy screenings are recommended based on individual risk factors and family history. For average-risk individuals, guidelines suggest that screening should begin at age 45 and continue every 10 years if the results are normal. However, if you have a history of hemorrhoids or other gastrointestinal issues, your healthcare provider may recommend more frequent screenings. It is best to discuss your specific situation with your doctor, who can provide personalized recommendations based on your health history.

In summary, while your history of hemorrhoids may explain the positive FOBT result, it is essential to remain vigilant. Regular follow-ups with your healthcare provider and adherence to recommended screening guidelines are crucial for maintaining gastrointestinal health. If you have any concerns or notice any changes in your symptoms, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

Similar Q&A

Understanding Positive Fecal Occult Blood Test Results: Key Concerns

Hello Dr. Ke, I am Ah-Jie. I have a habit of exercising and consuming fruits and vegetables regularly, but I still experience constipation. Therefore, I have been taking the following medications for a long time: magnesium oxide, motility agents (such as domperidone), and Laxat...

Dr. Ke Fangxu reply Surgery
1. It is necessary to confirm the diagnosis through a physician's examination. 2. There may be a direct correlation between the values presented by the immunological test and the amount of bleeding; if the bleeding is minimal, it is possible to obtain lower values. 3. It...

Can Hemorrhoids Affect Fecal Occult Blood Testing Results?

1. If the mother has colorectal cancer, is there a high possibility of hereditary risk despite no family history? I would like to start with a fecal occult blood test! 2. However, I have irritable bowel syndrome, and usually after my first meal, I experience mild abdominal pain...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Fecal occult blood sampling has specific methods to minimize the impact of hemorrhoidal bleeding. By following the sampling instructions, one can reduce the likelihood of false positives due to hemorrhoidal bleeding. As for irritable bowel syndrome, it should not have a si...

Will Hemorrhoid Bleeding Affect Fecal Occult Blood Test Results?

Hello doctor, today I went to the lab to test for fecal occult blood. After the test, I remembered that last Monday I had a hard stool that caused a tear and bleeding from my hemorrhoids. I would like to ask if this will affect the interpretation of the occult blood test results....

Dr. Cai Jinji reply Gastroenterology and Hepatology
Dear Mr. Xiao Ming: It is recommended that you discuss the examination results with your physician during your follow-up visit. Director Cai Jin-ji, Department of Hepatobiliary and Gastroenterology, Nantou Hospital.

Understanding Gastrointestinal Issues: Blood in Stool and Diagnostic Tests

Hello Doctor, three years ago I underwent a colonoscopy due to blood in my stool, which revealed diverticula and hemorrhoids. Recently, I have occasionally experienced diarrhea with blood streaks (approximately five times in the past two years). I have returned for follow-up visi...

Dr. Ke Fangxu reply Surgery
There are many reasons for a negative fecal occult blood test, including the possibility that there was no bleeding at the time of sampling or that the sampling site did not contain blood. The most common diagnoses, such as ulcerative colitis or Crohn's disease, require colo...