Should You Get a Colonoscopy After Rectal Bleeding and Hemorrhoids?

If you do not understand the report, should you undergo a colonoscopy?

Due to the presence of blood in the stool, a rectoscopy and anal examination were performed.
The doctor mentioned that there was no evidence of bleeding within the intestines, but noted an engorged internal hemorrhoid that was bleeding.
However, today I checked the report on the National Health Insurance app, which indicates: "Inspection and digital exam: mild external hemorrhoids.
Anoscopy: multiple internal hemorrhoids, grade I, with engorged vessels, active bleeding noted for over 6 minutes.
Sigmoidoscopy: negative up to 14 cm except for some loose mucofeces, sharp angulation above."
Could you please clarify if this means there are polyps in the rectum that would require a colonoscopy? The translation from Google seems to suggest there are some protrusions, and I am quite confused and scared.
I apologize for bothering you.

Xingxing, 30~39 year old female. Ask Date: 2024/05/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

The content highlights the presence of mild internal hemorrhoids accompanied by bleeding.

Reply Date: 2024/05/19

More Info

When it comes to rectal bleeding and the presence of hemorrhoids, the decision to undergo a colonoscopy can be a nuanced one. Based on your description, it appears that you have already undergone a thorough evaluation, including a digital exam, anoscopy, and sigmoidoscopy, which revealed multiple internal hemorrhoids with active bleeding. The sigmoidoscopy showed no significant abnormalities in the rectum up to 14 cm, aside from some loose mucofeces.

Understanding Your Situation
1. Hemorrhoids and Rectal Bleeding: Hemorrhoids are swollen blood vessels in the rectal area that can cause bleeding, especially during bowel movements. The bleeding you experienced may indeed be attributed to these engorged vessels, particularly if the bleeding was noted during the examination. The fact that the doctor observed active bleeding from the hemorrhoids suggests that they are the likely source of your symptoms.

2. Sigmoidoscopy Findings: The sigmoidoscopy results indicate that there were no significant findings in the lower part of the colon, which is reassuring. The presence of "loose mucofeces" and the mention of a "sharp angulation" could suggest some normal variations in bowel habits or anatomy, but they do not necessarily indicate a serious condition.

3. Need for Colonoscopy: The primary purpose of a colonoscopy is to visualize the entire colon and rectum to rule out any serious conditions such as polyps, tumors, or inflammatory bowel disease. Given that your sigmoidoscopy did not reveal any concerning findings and the bleeding is attributed to hemorrhoids, a colonoscopy may not be immediately necessary. However, if you have risk factors for colorectal cancer (such as a family history or age over 45), or if your symptoms persist or worsen, it would be prudent to discuss the need for a colonoscopy with your healthcare provider.

Recommendations
- Monitor Symptoms: Keep an eye on your symptoms. If the bleeding continues, increases in volume, or is accompanied by other symptoms such as significant pain, changes in bowel habits, or weight loss, you should seek further evaluation.

- Follow-Up with Your Doctor: Since you have concerns about the findings and the potential for polyps or other issues, it would be beneficial to have a follow-up appointment with your healthcare provider. They can explain the findings in detail and help you understand whether a colonoscopy is warranted based on your individual risk factors and symptoms.

- Lifestyle Modifications: In the meantime, consider lifestyle changes that can help manage hemorrhoids and prevent further bleeding. This includes increasing dietary fiber, staying hydrated, and avoiding straining during bowel movements.

Conclusion
In summary, while your current symptoms and examination findings suggest that hemorrhoids are the likely cause of your rectal bleeding, the decision to undergo a colonoscopy should be made in consultation with your healthcare provider. They will consider your overall health, family history, and any ongoing symptoms to determine the best course of action. Remember, it’s always better to err on the side of caution when it comes to gastrointestinal health, so don’t hesitate to seek further clarification from your doctor.

Similar Q&A

Is a Colonoscopy Necessary After Experiencing Rectal Bleeding?

Six months ago, I experienced rectal bleeding (in significant amounts) and self-diagnosed it as hemorrhoids. After observing for six months, I have not had any further rectal bleeding. Is there still a need for a colonoscopy? (After all, it is an invasive procedure.)

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Based on the description, the likelihood of hemorrhoids is the highest; further observation may be warranted. Best wishes, Dr. Chi-Feng Chen, Taoyuan Hospital, Department of Health.

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