Patient's Query
Hello doctor,
About two weeks ago, I noticed some bleeding from the anal passage. I visited the doctor two days later, and he examined the back passage, and nothing was found other than a small external hemorrhoid. He also examined the stomach area, and nothing concerning was found. I do have chronic constipation and do have to strain on occasion. I have been on Laxido medication for the past 18 months. I have not lost weight or do not feel any tiredness. I did a colonoscopy two years ago, and all was clear – the reason for this is that my stools got large all of a sudden. A CT scan was done of the pelvic area two years back, and everything was normal. A few days after I went to the doctor, I noticed some small amounts of blood for a few days. However, after not being able to see any blood, I did a FIT home test. It can be positive, although the line was faint. I did have some bleeding last year, and a qFIT test was done. And it came back just over the fit level at 13, as 10 is the cut-off point. It was told at that time that this was due to hemorrhoids, and owing to recent investigations, they did not think any further investigation was needed. Can both visible and invisible blood be due to hemorrhoids, or could chronic constipation do this? I was told that colon cancer can be slow-growing. Kindly suggest.
Hello,
Welcome to icliniq.com.
I understand your concern.
Based on your clinical history, this can be due to hemorrhoids and constipation. Because when the patient is constipated, the stool becomes hard, and it causes tiny hemorrhoids, which bleed while passing stool. So, if we treat constipation completely, then your symptoms will disappear automatically. Another thing is that colonoscopy reports are more reliable than the qFIT (quantitative fecal immunochemical test), so please do not worry about the qFIT test. It does not give 100 % accuracy, but colonoscopy is best, and in your case, it is clear, so there is nothing to worry about any other pathologies like cancer and all. Constipation occurs due to a low-fiber diet and dehydration. So I would suggest you make changes in your diet by eating a high-fiber diet, such as bananas, papaya, green vegetables, and oranges. Avoid dairy products, coffee, and dark chocolates. Drink plenty of fluids throughout the day. By doing this, your constipation will improve. Do you have any other associated factors like smoking, stress, and high blood pressure? Please let me know so I can help you accordingly. I hope you find this helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you for your response.
The fact is that colonoscopy was done two years ago, and this is still considered relevant. Can constipation or hemorrhoids cause occult bleeding that you cannot see? The only reason that the medics could come up with the constipation was due to menopause. I have struggled with stress for years. I do not smoke and never had. My blood pressure is fine; the last time it was done a month ago, it was 120/80.
Hello,
Welcome back to icliniq.com.
Occult bleeding is rare in these conditions and is not common for any gastric or intestinal diseases. Occult bleeding is more common in pelvic disease or uterus-related conditions. Occult bleeding will cause pain, bulge, and pressure in the area, and it will be difficult for you to pass stool. So, in my opinion, there is no occult bleeding; the only reason that is causing these symptoms is constipation. Kindly resolve this, and everything else will be fine automatically. If you need anything else, please let me know. I hope you find this helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you once again. I just want to check, given that my colonoscopy and a CT scan of the pelvic area were two years ago. Are these still relevant? Kindly suggest.
Hello,
Welcome back to icliniq.com.
I understand your concern.
If you have not had any critical symptoms or significant changes in the past two years, then we can consider them relevant. But if your symptoms increased significantly and bleeding was more with no improvement in the past two years despite medical treatment and lifestyle changes, then I would suggest you go for a colonoscopy once again. But before that, you should follow proper lifestyle changes such as rehydration, a high-fiber diet, and control of constipation. After doing all these, if symptoms persist, then you should go for a colonoscopy once again. I hope this information helps you. If you need anything else, please let me know.
Thank you.
Patient's Query
Hi Welcome back to icliniq Thank you for quick response Yes nothing is required as per now , just take high fibre diet ,drink plenty of fluids throughout the day. You can continue taking syrup lactulose 15 ml once before sleeping ( night time ) this will help to prevent constipation. If anything else please let me know anytime at icliniq.com/drsugreevsingh Thank you
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Answered byDr. Sugreev Singh
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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