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Doctors' Answers to "Frequently Asked Questions" - Rectal Problems

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 06/2/2000]
Question: I have intense rectal itching and believe it may be due to the minocycline I've been taking. If that is the cause, would an ointment like Cortizone 10 only treat the symptom and not the cause, or would an anti-fungal like Clotrimizole get rid of the problem. I don't know which is the more appropriate treatment. Thanks

Answer: Probably the cortisone, common things being common sounds like a hemorrhoid being irritated. Sitting in 4 inches of very hot water 2-3 times a day will also help.

[posted 01/11/2000]
Question: The past couple of times that I have gone to the bathroom and have had a bial movement I have had a little bit of blood come out. This has never happened before and I don't now why it is happening. So what does this mean??? Should I be worried??

Answer: No way of knowing without a rectal examination. Rectal bleeding is usually from hemorroids, but needs to be evaluated if it persists.

[posted 11/6/1999]
Question: I have just recently noticed (this week) that my stool is very black. I take lipitor 10mg and have regular blood tests and all's been well so far. I have also started taking a couple of new vitamins Ginkgo Biloba and Kava. I can't remember if my stool was black before or after I started these new vitamins. Black stool usually indicates bleeding, doesn't it? So I am am concerned. My stomach hurts a little, which is unusual, and I have been under a lot of stress for some time. I hate to go to the Doctor if it's nothing, yet I am concerned. What do you suggest?

Answer: Black stool can be from lots of things one of which is bleeding. This type of bleeding would be from your stomach or duodenum since acid is required to turn it black. Colon bleeding is not black. Most drug stores have kits for 10$ or so which will check your blood, merely put a strip of paper in the toilet. In the meantime, won't hurt to stop the Ginkgo Biloba, Kava and any aspirin or like product. OTC drugs like Zantac is a good treatment for gastritis. But, if it is positive, better to see your md.

[posted 10/4/1999]
Question: I am a 29 year old female. I have had rectal bleeding on and off for over a year. This does not only occur after a BM, but at other times as well. I am writing to you because of the huge amounts of blood that fills the tlilet, and covers the tissue. I am not able to find any information on the amount of blood that is common for such things as hemorrhoids. I have also noticed, at times, a "moucas" type blood clot on the tissue. What is this? I do no have significant pain. No itching or irritation. As I mentioned, the bleeding comes and goes. Is this typical symptoms of hemorrhoids or is this something to be more concered with? ANY INFORMATION WOULD BE GREATLY APPRECIATED. NO SEEMS TO WANT TO ANSWER MY QUESTIONS. (I guess this is a very common subject). THANKS SO MUCH FOR YOUR TIME!
"Searching for information"

Answer: There is no way to tell from the volume if it is hemorrhoids or not. With this persistence, you need a GI specialist to look at your colon. The mucous would be atypical for hemorrhoids-more typical of different types of colitis.

Stool Size; Rectal Problems
Question: I have noticed over the last 6 months that my stool has become flattened. I have gone to a specialist and underwent a flexible sigmoidoscopy but they found nothing wrong. The problem has not gone away. I have also noticed that when having a bowl movement, I cannot pass all the stool. Some of it stays just inside the rectum. This becomes a very uncomfortable feeling and causes itching around the anal opening because of slight leakage. Any ideas what could be causing this?

Answer: Did they perform a voiding barium study? This can show problems with the anal sphincter and retention not shown on a flex sig. A colo-rectal surgeon would be a good pick instead of a gastroenterologist.

Blood in stool
Question: This question is regarding my wife. She keeps on complaining about blood coming with her stool. She is in her 20's, and she has lost her periods since Dec 1996. I am wondering if she is pregnant, or is there something else wrong with her?

Answer: Continued blood from the stool needs to be investigated. There is no possibility pregnancy would produce this condition. Repeated rectal bleeding may be as simple as a hemorrhoid or as serious as colitis or cancer. I would strongly recommend that she consult her physician.

Blood in stool
Question: I am a 23 year old female. Every once in a while, when I have a bowel movement I notice that there is blood in my feces. It doesn't hurt and isn't very often that this happens. I was just wondering what could cause this and why it happens? Should I go to a doctor and have it checked out or is it nothing to really worry about?

Answer: The most common cause of blood in the feces is hemorrhoids. However, persistent blood needs to be checked to rule out tumors or colitis. If you are young and have no family history of colon cancer, this probably is nothing to be concerned about. You can check the interior of the feces for occult blood by getting a hemocult or equivalent (sometimes available in stores). However, this probably needs a rectal examination and may need further tests depending on your family history.

Blood in stool
Question: This morning I noticed blood in my excrement. This is the first time I have noticed this. What might be some of the known causes of this. I am a 31 year old male with no known health problems.

Answer: For young people, blood in the stool usually indicates hemorrhoids only. However, repeat tests should be done to ensure that blood does not persist in the stool. A physician’s visit for a manual rectal is also a good idea. If you have no family history or colon cancer there is a low (not zero) risk of cancer. Other causes are bowel infections and inflammatory conditions of the bowel. These would necessitate further evaluation.

Rectal Bleeding
Question: I am a 36 year old male. The only medications I am taking is methadone. I have been taking it for seven years. I have had bleeding from my rectum sometimes and the doctors can not find anything wrong with me.

Answer: What have the doctors done? Persistent rectal bleeding usually requires a colonoscopy. However, sometimes in spite of this, no source is found. Occasionally, tagged red blood cells will find the spot of the bleeding.

Rectal Bleeding
Question: I recently saw a great amount of blood accompany my last bowel movement. There was no pain involved and no chapping of the sphincter to cause this, but it was obviously internal. I have also had slight discomfort on the my lower right abdomen. I took a Doxycyline pill in hopes that if it is some sort of "bug" than that would take care of it. Is Doxycyline is a possible solution? could this be some sign of an ulcer? I am a 23 year old male in good health.

Answer: At your age cancer is remote to non-existent. Bleeding from the rectum (with no family history of colon cancer) before the age of 40 is either 1) hemorrhoids 2) Inflammatory Bowel Disease 3) Colonic infection. Infection is usually accompanied by diarrhea. 4) Congenital defect. Of these, hemorrhoids is by far the most common. I'd get some stool blood strips at a local drug store. If the blood persists you'll need to see a physician. If it doesn't you probably have little to be concerned about.

Rectal bleeding
Question: My husband experiences rectal bleeding after a bowel movement, although there is no blood present in his stool. Is this something to be concerned about?

Answer: Rectal bleeding can be a sign of a serious problem or merely bleeding hemorrhoids. This type of bleeding is statistically bleeding hemorrhoids. However, if the bleeding persists he needs to see his physician for a rectal examination and possibly an anoscopy. If he has a family history of colon cancer, inflammatory bowel disease, or is over 50, the odds of a serious problem increase.

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