Rectal Bleeding: Could It Be Colon Cancer?

Q: Rectal Bleeding: Could It Be Colon Cancer?

Hello： In response to your question, based on your description, it appears to be a case of internal hemorrhoidal bleeding, characterized by painless, significant bright red bleeding that typically resolves on its own within 2-3 days. <br>Treatment is indicated for persistent blee

I would like to know the reason?

Hello Dr.
Ke: Since July of last year, I have noticed bright red blood in my stool, regardless of whether it is soft or hard.
(Typically, I first pass hard stool, followed by soft stool, and then the bleeding starts.) The amount is significant enough to turn the toilet water red, and I can hear the sound of dripping blood.
If I remain seated on the toilet, the bleeding continues, but it stops when I stand up and tighten my buttocks.
I have felt the area and found that the bleeding is coming from the anal opening.
(Each symptom can last for 1-2 days, sometimes 3-4 days, and then it recurs after a few weeks.) Occasionally, during severe episodes, I even notice blood when urinating (possibly because I am sitting on the toilet, which stretches the anal area), but I do not feel any pain in the anal region.
This situation has been ongoing for nearly a year.
Recently, I have been hearing about symptoms of colorectal cancer, and I am very worried.
Is it possible that this could be colorectal cancer? I await your response! Thank you!

LIN, 30~39 year old female. Ask Date: 2007/05/23

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, based on your description, it appears to be a case of internal hemorrhoidal bleeding, characterized by painless, significant bright red bleeding that typically resolves on its own within 2-3 days.
Treatment is indicated for persistent bleeding or the occurrence of anemia.
If medical management is ineffective, surgical intervention may be considered.
In general, the bleeding associated with colorectal cancer tends to be less in volume and darker in color; however, to rule out this possibility, a colonoscopy or barium enema examination should be arranged for confirmation.

Reply Date: 2007/05/23

More Info

When it comes to rectal bleeding, particularly when it has been persistent and significant, it is essential to approach the situation with caution and seek medical evaluation. Your description of experiencing bright red blood during bowel movements, regardless of the consistency of the stool, raises several important considerations.

Firstly, the presence of bright red blood in the stool or on toilet paper typically indicates that the bleeding is originating from the lower gastrointestinal tract, which includes the rectum and anus. Common causes of such bleeding include hemorrhoids (piles), anal fissures, and less commonly, colorectal polyps or cancer. Given your symptoms, it is crucial to differentiate between these potential causes.

1. Hemorrhoids: These are swollen veins in the lower rectum or anus that can cause bleeding, particularly during bowel movements. They often result from straining during defecation, chronic constipation, or prolonged sitting on the toilet. The fact that you mention the blood stops when you stand up and clench your muscles suggests that it may be related to hemorrhoids, especially if you do not experience pain.

2. Anal Fissures: These are small tears in the lining of the anus that can occur due to passing hard stools. They can cause sharp pain during and after bowel movements, along with bleeding. However, you noted that you do not experience pain, which makes this less likely.

3. Colorectal Polyps or Cancer: While hemorrhoids and fissures are more common causes of rectal bleeding, it is essential to consider the possibility of polyps or colorectal cancer, especially given the duration and recurrence of your symptoms. Colorectal cancer can present with rectal bleeding, changes in bowel habits, and other gastrointestinal symptoms. However, it is more common in individuals over the age of 50 or those with a family history of colorectal cancer.

Given that you have been experiencing these symptoms for nearly a year, it is highly advisable to consult a healthcare professional for a thorough evaluation. This may include a physical examination, a digital rectal exam, and possibly a colonoscopy to visualize the colon and rectum directly. A colonoscopy is a crucial diagnostic tool that can help identify any abnormalities, including polyps or tumors, and allow for biopsies if necessary.

Additionally, your concern about colorectal cancer is valid, especially if you have a family history of the disease. Family history can increase your risk, and it is essential to discuss this with your healthcare provider. They may recommend earlier screening based on your family history and symptoms.

In summary, while your symptoms may suggest hemorrhoids or anal fissures, the persistence and severity of your bleeding warrant a comprehensive evaluation to rule out more serious conditions, including colorectal cancer. Do not delay seeking medical advice, as early detection and intervention are key to managing any potential issues effectively.

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