Digestive Issues: Is It Gastrointestinal or Hemorrhoids?

Q: Digestive Issues: Is It Gastrointestinal or Hemorrhoids?

Hello, sir： Based on what you've described, there seems to be slight bleeding near the rectum/anus. <br>You may observe it for now, but if the bleeding continues, please return to the clinic for an examination. <br>Additionally, you have irritable bowel syndrome, so it is advisab

Gastrointestinal issues or internal hemorrhoids?

Over the past year, I have undergone gastroscopy, colonoscopy, and fecal occult blood tests.
The gastroscopy showed no issues.
During the colonoscopy, the doctor was unable to get a clear view due to insufficient bowel preparation, but based on the existing images, he concluded that everything was fine.
At that time, my bowel movements had not changed.
However, six months later, I began to experience more frequent abnormal bowel movements.
My stools have mostly been unformed and loose, sometimes yellow, dark green, or even black, and occasionally there appears to be a layer of oil on top.
I returned to the hospital for another fecal occult blood test, and the doctor again said there were no problems.
During that period, I was taking medication prescribed by the doctor and paying attention to my diet, which seemed to normalize my bowel movements.
However, in the past month, I have started experiencing abnormal bowel movements again.
Yesterday, I noticed a drop or two of bright red blood in my stool, along with a white, mucus-like substance.
My recent lifestyle and diet have been irregular, with prolonged sitting.
When I press on the left side of my buttocks, I feel a lump; could this be an internal hemorrhoid? Could the bleeding be caused by internal hemorrhoids? I have done some research online, as I don't want to keep using medical resources for unnecessary tests, but I still feel worried.
As someone who often eats out, I generally enjoy meat and eat some vegetables, but not enough.
I also like fried foods, although I try to moderate my intake.

Liao Xiansheng, 20~29 year old female. Ask Date: 2015/09/27

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir: Based on what you've described, there seems to be slight bleeding near the rectum/anus.
You may observe it for now, but if the bleeding continues, please return to the clinic for an examination.
Additionally, you have irritable bowel syndrome, so it is advisable to avoid oily and spicy foods, maintain regular meal times and portion sizes, and consider medication if necessary.
Changhua Hospital cares about your health.
Chen Shih-Tien

Reply Date: 2015/09/27

More Info

Based on your detailed description of symptoms and previous medical evaluations, it appears you are experiencing a combination of gastrointestinal issues that may be related to both functional gastrointestinal disorders and possibly hemorrhoids. Let’s break down your symptoms and the potential underlying causes.

1. Changes in Bowel Movements: You mentioned that your bowel movements have become irregular, with stools that are often unformed, sometimes oily, and occasionally black. These changes can be indicative of several gastrointestinal conditions. Unformed stools can be associated with irritable bowel syndrome (IBS), which is characterized by abdominal pain and altered bowel habits. The presence of oily stools may suggest malabsorption, which can occur in conditions like pancreatitis or celiac disease. Black stools, on the other hand, can indicate upper gastrointestinal bleeding, although you mentioned that your stool tests for blood were negative.

2. Presence of Blood: The fresh red blood you observed during bowel movements is concerning and could be attributed to hemorrhoids, especially if you have been experiencing straining during defecation. Hemorrhoids are swollen veins in the rectal area that can bleed, particularly when passing hard stools. The white mucus-like substance you described could be related to mucus production in response to irritation or inflammation in the intestines.

3. Previous Investigations: You have undergone both gastroscopy and colonoscopy, which did not reveal any significant issues at that time. However, the fact that your bowel prep was not entirely effective during the colonoscopy could mean that some conditions might have been missed. It is essential to ensure that the bowel is adequately prepared for such examinations to get a clear view of the intestinal lining.

4. Diet and Lifestyle Factors: You mentioned that your diet consists of a lot of meat and fried foods, with limited vegetable intake. A diet low in fiber can contribute to constipation and irregular bowel movements. Increasing your fiber intake through fruits, vegetables, and whole grains can help regulate your bowel movements and may alleviate some of your symptoms. Additionally, staying hydrated is crucial for digestive health.

5. Mental Health and Stress: Stress and anxiety can significantly impact gastrointestinal function, leading to symptoms like those you are experiencing. If your lifestyle has been stressful, it may be worth considering stress management techniques or speaking with a mental health professional.

6. Next Steps: Given your ongoing symptoms, it would be prudent to follow up with a gastroenterologist. They may recommend repeating the colonoscopy with proper bowel preparation to rule out any underlying conditions that may have been missed previously. Additionally, they might suggest imaging studies or further blood tests to evaluate for any malabsorption syndromes or inflammatory bowel diseases.

In conclusion, while hemorrhoids could explain some of your symptoms, the combination of irregular bowel movements, changes in stool appearance, and the presence of blood warrants further investigation. It’s essential to address these concerns with a healthcare provider who can guide you through the necessary diagnostic steps and treatment options. Remember, maintaining a balanced diet, staying hydrated, and managing stress can significantly improve your digestive health.

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