Leaking blood from rectum
February 29, 2024 5:51 PM Subscribe
A family member went into urgent care because they have been leaking blood from their rectum for about 48 hours. Trying to understand context and what the doctor said.
The amount of blood is enough that it’s clearly flowing without any pressure (i.e., not happening only during a wipe), but not enough that it’s leaking through clothing. Just a few drops through the day. Bright red.
The urgent care doctor used a scope to examine for hemorrhoids but didn’t see anything. They have him a stool test and told him to speak to his PCP once he has the results, in case it could be an infection.
He is concerned and unsure if these means that this is not hemorrhoids, or just that they were not visible. He’s concerned there’s a more serious underlying cause, of course. He’s in his mid 30s.
If symptoms clear up, should he go back and ask them to follow up / possibly schedule colonoscopy? Or would that indicate it’s likely something transient?
The amount of blood is enough that it’s clearly flowing without any pressure (i.e., not happening only during a wipe), but not enough that it’s leaking through clothing. Just a few drops through the day. Bright red.
The urgent care doctor used a scope to examine for hemorrhoids but didn’t see anything. They have him a stool test and told him to speak to his PCP once he has the results, in case it could be an infection.
He is concerned and unsure if these means that this is not hemorrhoids, or just that they were not visible. He’s concerned there’s a more serious underlying cause, of course. He’s in his mid 30s.
If symptoms clear up, should he go back and ask them to follow up / possibly schedule colonoscopy? Or would that indicate it’s likely something transient?
Best answer: This is not an urgent care issue. Urgent care is good for patch and go, this is a virus, this is bacterial infection, that is a sprain, or that requires an emergency room. Figuring out what it is outside of that is simply out of urgent care scope of practice. I'm really really surprised that the urgent care did a scope!
Make that PCP appointment and follow up as soon as possible to get this figured out. Let your pcp decide on any additional recommendations for screens and such if you have an accessible PCP.
posted by AlexiaSky at 6:18 PM on February 29 [12 favorites]
Make that PCP appointment and follow up as soon as possible to get this figured out. Let your pcp decide on any additional recommendations for screens and such if you have an accessible PCP.
posted by AlexiaSky at 6:18 PM on February 29 [12 favorites]
Bright red blood likely means it's a bleed from the colon or rectum - blood from further up the GI tract has been partially digested and is tarry and black/maroon. There are several possible sources and he's right to be appropriately concerned. Follow-up with a PCP is the best course of action - if he has an established relationship, he might send a message ahead of this appointment and see if he can get a GI doc referral started beforehand, to keep things moving forward.
If the bleed worsens beyond what it is now, or if he starts to be symptomatic (fast heart rate, lightheaded, short of breath) go to an emergency room. They'll have more capability (and be associated with a hospital) to help diagnose.
posted by Pantengliopoli at 8:39 PM on February 29 [1 favorite]
If the bleed worsens beyond what it is now, or if he starts to be symptomatic (fast heart rate, lightheaded, short of breath) go to an emergency room. They'll have more capability (and be associated with a hospital) to help diagnose.
posted by Pantengliopoli at 8:39 PM on February 29 [1 favorite]
I had a similar situation when I was a similar age. It turn out to be an anal fissure. That was a super fun thing to learn about that I never previously even suspected was a thing in the universe.
After going through all the various scopes and -oscopies that all came back completely clean - not even any hemorrhoids at that point - we asked the doctor, "Well then where is the BLOOD coming from?"
He looked puzzled for a while, but then examined very carefully, mostly by feel, and pronounced it an anal fissure.
What would happen is, when irritated by say a larger or harder BM than normal, it would open up and bleed a little. Then it would heal up. By the time you get to the doctor there isn't really any thing to see. But if perchance anyone happened to take a look at it just at that moment it would have been visible to the naked eye, just there in plain sight, no scopes or anything.
That is what we found out like $5000 and 6 months later.
And believe me, that thing could produce QUITE a lot of bright red blood. Only to have healed up completely to the naked eye by the doctor appointment next Wednesday.
My takeaways from the experience:
- Good news, *bright* red blood is usually a less serious thing, because it is being produced right there near the far end of the digestive system. The more serious situation (typically) is blood from further up - which won't be bright red. So hemorrhoids or some kind of irritation right there near the anus is the most likely cause. Don't delay or put off following up on this with your doctors, because in the 1 in 1000 or 1 in 10,000 chance it is something more serious finding it early is very helpful. You don't want to just let it go & pray. But by far the likeliest situation is some kind of tissue irritation very close to the end of your digestive system - something in plain sight, or very close to it. (Well, for anyone examining your nether regions...part of the problem here is that you just can't see yourself.)
- This part of your body is very venous, just filled with blood vessels. On the one hand, this means that it doesn't take much to produce A LOT of blood. A little scratch or scrape will do it. On the flip side, all that good circulation means things can heal up really fast. Things that look like a giant mess Day 1 can look pretty good Day 2 and by Day 3 it's hard to tell anything even happened (see my note above where the doctor couldn't even FIND the spot that had been bleeding a fair amount not that long before the exam).
- While you're waiting for various doctor appointments, tests, results from tests, further test (which will probably follow when they don't find anything from the first tests, which is paradoxically more likely to be the case if you don't actually have a serious problem) you can, and IMHO should, begin treating it as though it is something like a hemorrhoid, anal fissure, or some other irritation of the lower part of the rectum or anal area.
Doing so is not going to hurt anything and might help a lot.
So for one thing, you can google around a little to see what people do for hemerrhoids, anal fissures, and similar - because a lot of it is home remedy type stuff, salves and diet/lifestyle type changes to help things work out a little better, smoother, and easier down there.
- Try some of the basic hemorrhoid creams, treatments, and remedies that are available at your local drugstore. Even just something like a cream or gel like you might put on any scrape or wound to protect it an aid healing can help (one of the main active ingredients in Preparation H for example is simple petroleum jelly). Experiment to see if anything helps or doesn't.
- Work on increasing (perhaps even - gradually over time - rather hugely increasing ) dietary fiber. Large or hard stools will irritate or further irritate any problems or issues you have having in this area. Hard or large stools can both cause problems and prevent any existing issue from healing. Keeping dietary fiber high and stools soft is probably the #1 thing that is going to help with issues like this across the lifetime.
- Along the same lines you can experiment with fiber supplements and stools softeners. Some of these are available over the counter and they work just fine. You can also ask a doctor for a prescription and advice when you see them.
* Fiber supplements, you have to experiment as people tend to be very sensitive to the exact type/fiber source and the wrong source for the wrong person can actually make things worse. Start slow and work up gradually. Switch brands or types if one type doesn't agree with you. You are likely looking for something you'll take by the teaspoonful or even tablespoon - just for example a capsule with 1-2 grams of fiber isn't really going to do anything - unless you work up to taking like 5 of them with breakfast, 5 with lunch, and another 5 with dinner (and if you read the directions, that is about what they recommend). Example brands are Benefiber, Metamucil, Sunfiber or equivalent.
* Stool softeners of the Polyethylene Glycol type (MiraLax & similar brands) are something you can take literally every day for the rest of your life and they just help keep your stools soft. The ingredient absorbs a lot of water into your stool, keeping everything nice and soft, and just passes right through you without any other real effects. The other types of stool softener you'll see at the drugstore are more for very occasional use (Docusate Sodium, Magnesium Hydroxide).
- Fiber in food, fiber supplements & the Miralax type of stool softener (polyethlene glycol & similar) work by absorbing more water into your stool. Dry stool = hard = pain & injury. So whenever you take a fiber supplement, be sure to take it with plenty of water. But beyond that, generally monitor your water intake and take care to not get dehydrated at all. In fact, your body regulates your fluid levels in large part by moving water back & forth in your lower bowels. People who are very, or even mildly, dehydrated will therefore have harder bowel movements - the body has extracted more water in order to remain better hydrated. So, avoid this by staying well hydrated.
- Exercise, even just walking regular after meals, and generally keeping good bowel habits can make a huge difference over time. Straining at the toilet, for example, is known to cause and worsen hemorrhoids.
- Pay attention to how much, how often, and just how you are sitting. Sitting at certain angles, sitting for long times without a break, sitting for many hours, and a such is known to put a lot of pressure on blood vessels in the rectal area, exacerbating hemorrhoids (and possibly, similar/related conditions).
All this sounds like a lot of hokum. But I'll tell you, a year or two ago I had a hemorrhoid that I thought was going to kill me with the pain. At one of the early appointments I asked one of the doctors what I could do while we were waiting for tests, surgery availability, etc.
He said, "Well, OTC remedies like Preparation H might help. But if you want to know the really answer to the question, it is change your diet. Fiber."
I took this to heart and by the time the appointment to schedule the surgery came around, the hemorrhoid was gone. We literally cancelled the surgery right then & there. And it has never recurred.
But I didn't just take like a capsule of fiber a day. I literally turned my diet on its head. Whole grain everything, veggies, etc. Track the fiber with an app. ALSO take a fiber supplement, starting slow and gradually increasing. Somewhere along the way I heard that a typical hunter-gatherer diet contained something like 100-150 grams of fiber daily.
OK, for lots of Americans that is more like 10 grams/day. Literally the average for Americans is 16 grams/day. Recommended amounts are more like 25/35 grams/day. So even thinking about 150 grams of fiber daily was sort of mind altering.
(And by the way, don't try it - suddenly eating all that much fiber, particularly in the form of supplements which is the easiest way to do it, would lead to all sorts of bowel problems including serious ones like bowel blockage. You have to work up gradually and most of us realistically will never see 150 grams/day.)
Point is, previously I was probably getting 15-ish grams a day and feeling like if I got more like 30 grams, problem solved. Now my plan was to work up to more like 50-60 grams/day with the realization that is a very, very achievable objective and still not really all that high in the realm of human fiber intake.
That is a long way of saying, changes like this do work. Diet & exercise, fiber. Good luck!
posted by flug at 9:00 PM on February 29 [37 favorites]
After going through all the various scopes and -oscopies that all came back completely clean - not even any hemorrhoids at that point - we asked the doctor, "Well then where is the BLOOD coming from?"
He looked puzzled for a while, but then examined very carefully, mostly by feel, and pronounced it an anal fissure.
What would happen is, when irritated by say a larger or harder BM than normal, it would open up and bleed a little. Then it would heal up. By the time you get to the doctor there isn't really any thing to see. But if perchance anyone happened to take a look at it just at that moment it would have been visible to the naked eye, just there in plain sight, no scopes or anything.
That is what we found out like $5000 and 6 months later.
And believe me, that thing could produce QUITE a lot of bright red blood. Only to have healed up completely to the naked eye by the doctor appointment next Wednesday.
My takeaways from the experience:
- Good news, *bright* red blood is usually a less serious thing, because it is being produced right there near the far end of the digestive system. The more serious situation (typically) is blood from further up - which won't be bright red. So hemorrhoids or some kind of irritation right there near the anus is the most likely cause. Don't delay or put off following up on this with your doctors, because in the 1 in 1000 or 1 in 10,000 chance it is something more serious finding it early is very helpful. You don't want to just let it go & pray. But by far the likeliest situation is some kind of tissue irritation very close to the end of your digestive system - something in plain sight, or very close to it. (Well, for anyone examining your nether regions...part of the problem here is that you just can't see yourself.)
- This part of your body is very venous, just filled with blood vessels. On the one hand, this means that it doesn't take much to produce A LOT of blood. A little scratch or scrape will do it. On the flip side, all that good circulation means things can heal up really fast. Things that look like a giant mess Day 1 can look pretty good Day 2 and by Day 3 it's hard to tell anything even happened (see my note above where the doctor couldn't even FIND the spot that had been bleeding a fair amount not that long before the exam).
- While you're waiting for various doctor appointments, tests, results from tests, further test (which will probably follow when they don't find anything from the first tests, which is paradoxically more likely to be the case if you don't actually have a serious problem) you can, and IMHO should, begin treating it as though it is something like a hemorrhoid, anal fissure, or some other irritation of the lower part of the rectum or anal area.
Doing so is not going to hurt anything and might help a lot.
So for one thing, you can google around a little to see what people do for hemerrhoids, anal fissures, and similar - because a lot of it is home remedy type stuff, salves and diet/lifestyle type changes to help things work out a little better, smoother, and easier down there.
- Try some of the basic hemorrhoid creams, treatments, and remedies that are available at your local drugstore. Even just something like a cream or gel like you might put on any scrape or wound to protect it an aid healing can help (one of the main active ingredients in Preparation H for example is simple petroleum jelly). Experiment to see if anything helps or doesn't.
- Work on increasing (perhaps even - gradually over time - rather hugely increasing ) dietary fiber. Large or hard stools will irritate or further irritate any problems or issues you have having in this area. Hard or large stools can both cause problems and prevent any existing issue from healing. Keeping dietary fiber high and stools soft is probably the #1 thing that is going to help with issues like this across the lifetime.
- Along the same lines you can experiment with fiber supplements and stools softeners. Some of these are available over the counter and they work just fine. You can also ask a doctor for a prescription and advice when you see them.
* Fiber supplements, you have to experiment as people tend to be very sensitive to the exact type/fiber source and the wrong source for the wrong person can actually make things worse. Start slow and work up gradually. Switch brands or types if one type doesn't agree with you. You are likely looking for something you'll take by the teaspoonful or even tablespoon - just for example a capsule with 1-2 grams of fiber isn't really going to do anything - unless you work up to taking like 5 of them with breakfast, 5 with lunch, and another 5 with dinner (and if you read the directions, that is about what they recommend). Example brands are Benefiber, Metamucil, Sunfiber or equivalent.
* Stool softeners of the Polyethylene Glycol type (MiraLax & similar brands) are something you can take literally every day for the rest of your life and they just help keep your stools soft. The ingredient absorbs a lot of water into your stool, keeping everything nice and soft, and just passes right through you without any other real effects. The other types of stool softener you'll see at the drugstore are more for very occasional use (Docusate Sodium, Magnesium Hydroxide).
- Fiber in food, fiber supplements & the Miralax type of stool softener (polyethlene glycol & similar) work by absorbing more water into your stool. Dry stool = hard = pain & injury. So whenever you take a fiber supplement, be sure to take it with plenty of water. But beyond that, generally monitor your water intake and take care to not get dehydrated at all. In fact, your body regulates your fluid levels in large part by moving water back & forth in your lower bowels. People who are very, or even mildly, dehydrated will therefore have harder bowel movements - the body has extracted more water in order to remain better hydrated. So, avoid this by staying well hydrated.
- Exercise, even just walking regular after meals, and generally keeping good bowel habits can make a huge difference over time. Straining at the toilet, for example, is known to cause and worsen hemorrhoids.
- Pay attention to how much, how often, and just how you are sitting. Sitting at certain angles, sitting for long times without a break, sitting for many hours, and a such is known to put a lot of pressure on blood vessels in the rectal area, exacerbating hemorrhoids (and possibly, similar/related conditions).
All this sounds like a lot of hokum. But I'll tell you, a year or two ago I had a hemorrhoid that I thought was going to kill me with the pain. At one of the early appointments I asked one of the doctors what I could do while we were waiting for tests, surgery availability, etc.
He said, "Well, OTC remedies like Preparation H might help. But if you want to know the really answer to the question, it is change your diet. Fiber."
I took this to heart and by the time the appointment to schedule the surgery came around, the hemorrhoid was gone. We literally cancelled the surgery right then & there. And it has never recurred.
But I didn't just take like a capsule of fiber a day. I literally turned my diet on its head. Whole grain everything, veggies, etc. Track the fiber with an app. ALSO take a fiber supplement, starting slow and gradually increasing. Somewhere along the way I heard that a typical hunter-gatherer diet contained something like 100-150 grams of fiber daily.
OK, for lots of Americans that is more like 10 grams/day. Literally the average for Americans is 16 grams/day. Recommended amounts are more like 25/35 grams/day. So even thinking about 150 grams of fiber daily was sort of mind altering.
(And by the way, don't try it - suddenly eating all that much fiber, particularly in the form of supplements which is the easiest way to do it, would lead to all sorts of bowel problems including serious ones like bowel blockage. You have to work up gradually and most of us realistically will never see 150 grams/day.)
Point is, previously I was probably getting 15-ish grams a day and feeling like if I got more like 30 grams, problem solved. Now my plan was to work up to more like 50-60 grams/day with the realization that is a very, very achievable objective and still not really all that high in the realm of human fiber intake.
That is a long way of saying, changes like this do work. Diet & exercise, fiber. Good luck!
posted by flug at 9:00 PM on February 29 [37 favorites]
The scope that the urgent care doctor performed was most likely done with an anoscope, as any more involved scoping requires preparation. An anoscope is a clear plastic speculum that is inserted into the anal canal to inspect the walls of the anal canal.
Your family member should follow up with their PCP. There are other benign causes of small-volume rectal bleeding other than hemorrhoids (sometimes the mucosa can just break from straining, for example) and there are ways to examine the distal rectum (where "a few drops of blood" might have originated from) that are not a full colonoscopy - like flexible sigmoidoscopy which does not usually require sedation. Your PCP will have encountered this scenario many times and has more tools to help you than the urgent care center. They will also know your personal medical history and family history better.
posted by M. at 10:16 PM on February 29 [2 favorites]
Your family member should follow up with their PCP. There are other benign causes of small-volume rectal bleeding other than hemorrhoids (sometimes the mucosa can just break from straining, for example) and there are ways to examine the distal rectum (where "a few drops of blood" might have originated from) that are not a full colonoscopy - like flexible sigmoidoscopy which does not usually require sedation. Your PCP will have encountered this scenario many times and has more tools to help you than the urgent care center. They will also know your personal medical history and family history better.
posted by M. at 10:16 PM on February 29 [2 favorites]
Best answer: I had a very similar experience to your family member’s, and it turned out to be exactly what flug said above.
My doctor recommended I start taking Metamucil (a fiber supplement), and after a while (a few weeks? I don’t exactly remember) the problem went away and has not returned.
So I recommend starting a fiber supplement while you wait to talk to the doctor. Can’t hurt, might help!
posted by peperomia at 11:24 PM on February 29 [2 favorites]
My doctor recommended I start taking Metamucil (a fiber supplement), and after a while (a few weeks? I don’t exactly remember) the problem went away and has not returned.
So I recommend starting a fiber supplement while you wait to talk to the doctor. Can’t hurt, might help!
posted by peperomia at 11:24 PM on February 29 [2 favorites]
This is not urgent care stuff, but it is very likely that your relative should get a sigmoidoscopy or colonoscopy at the next available appointment (not urgent urgent, but not something to put off for months either).
Until then, more fiber / miralax, less alcohol and red meat as things that strain or irritate the colon and anus can exacerbate whatever is causing the bleeding.
posted by zippy at 11:24 PM on February 29
Until then, more fiber / miralax, less alcohol and red meat as things that strain or irritate the colon and anus can exacerbate whatever is causing the bleeding.
posted by zippy at 11:24 PM on February 29
Metamucil is just an expensive way to buy artificially flavoured psyllium husk. The much cheaper plain husk tastes blandly inoffensive (kind of oatmealish) so I don't understand why anybody not advertising-addled ever buys the branded stuff more than once.
Any form of psyllium husk makes a fairly unappetizing slime when mixed with water and allowed to sit for more than a few seconds. I don't much enjoy chugging that texture, so I take mine sprinkled on other foods with high water content such as cole slaw or fruit salad.
It also works well as a thickener in soups, stews and sauces if used with restraint; too much and it can turn them kind of slimy, way too much and they go kind of rubbery.
Psyllium husk is very high in soluble fibre, which acts in the gut to make stool boluses more cohesive and slipperier. It won't do much to make them softer, though; for that you want insoluble fibre. You can get enough of that if your diet is high in crunchy raw vegetables, whole grains and/or pulses, but if you're looking to amend an existing fibre-deficient diet that's working well for you in other respects, a bran supplement is your friend.
If bran is your main source of dietary fibre, though, you will likely get sloppy stools that call for annoying amounts of TP to clean up after, and this may itself irritate an anus prone to fissuring. So if you're going to try adding bran, start with a 2:1 mix of bran and psyllium husk and see which way your body tells you to shift that balance.
Also, after any step change in the amount of fibre you're regularly consuming, give your gut flora at least a week to adapt to their new playground facilities before drawing any conclusions about how well the change is working for you.
posted by flabdablet at 4:33 AM on March 1 [2 favorites]
Any form of psyllium husk makes a fairly unappetizing slime when mixed with water and allowed to sit for more than a few seconds. I don't much enjoy chugging that texture, so I take mine sprinkled on other foods with high water content such as cole slaw or fruit salad.
It also works well as a thickener in soups, stews and sauces if used with restraint; too much and it can turn them kind of slimy, way too much and they go kind of rubbery.
Psyllium husk is very high in soluble fibre, which acts in the gut to make stool boluses more cohesive and slipperier. It won't do much to make them softer, though; for that you want insoluble fibre. You can get enough of that if your diet is high in crunchy raw vegetables, whole grains and/or pulses, but if you're looking to amend an existing fibre-deficient diet that's working well for you in other respects, a bran supplement is your friend.
If bran is your main source of dietary fibre, though, you will likely get sloppy stools that call for annoying amounts of TP to clean up after, and this may itself irritate an anus prone to fissuring. So if you're going to try adding bran, start with a 2:1 mix of bran and psyllium husk and see which way your body tells you to shift that balance.
Also, after any step change in the amount of fibre you're regularly consuming, give your gut flora at least a week to adapt to their new playground facilities before drawing any conclusions about how well the change is working for you.
posted by flabdablet at 4:33 AM on March 1 [2 favorites]
I've been making this seed bread recipe (with a few modifications) to reach strange new heights of dietary fibre intake.
CW if you are allergic.
posted by Jessica Savitch's Coke Spoon at 5:54 AM on March 1
CW if you are allergic.
posted by Jessica Savitch's Coke Spoon at 5:54 AM on March 1
I am not a doctor and I urge you to get info from real doctors about this.
But if you are going to do water-soluble fiber (I think this is a good thing to try, and I don't think it can hurt anything), buy store-brand over name brand like Metamucil. The price difference is jaw dropping. Same water-soluble fiber derived from plants, but like half the price. Buy the powder you mix in water. You have to swallow so many capsules for it to make any difference that it's just gross eating all those dissolving pellets. The flavored stuff tastes fine, not wonderful... kind of like Tang. Dissolve it in cold water and drink it right away. If you wait, or sip it slowly, it starts to gel in the glass and it's not as palatable IMO.
posted by SoberHighland at 6:27 AM on March 1
But if you are going to do water-soluble fiber (I think this is a good thing to try, and I don't think it can hurt anything), buy store-brand over name brand like Metamucil. The price difference is jaw dropping. Same water-soluble fiber derived from plants, but like half the price. Buy the powder you mix in water. You have to swallow so many capsules for it to make any difference that it's just gross eating all those dissolving pellets. The flavored stuff tastes fine, not wonderful... kind of like Tang. Dissolve it in cold water and drink it right away. If you wait, or sip it slowly, it starts to gel in the glass and it's not as palatable IMO.
posted by SoberHighland at 6:27 AM on March 1
Buy the powder you mix in water.
Or just buy plain psyllium husk, whose tiny flakes I honestly do not understand why anybody bothers further reducing to powder.
posted by flabdablet at 6:45 AM on March 1
Or just buy plain psyllium husk, whose tiny flakes I honestly do not understand why anybody bothers further reducing to powder.
posted by flabdablet at 6:45 AM on March 1
Use the method of getting fiber that works for you personally, because the format does not really matter if it's just taking up shelf space and not roto-rooting your plumbing.
All-Bran Buds is my doctor's starter recommendation (it's the only cereal that has psylliyum husk, and it's also quite tasty, I like mine with kefir) because people tend to be pretty compliant with it. If a month with your daily Buds gets results, you can consider moving on to cheaper more efficient options.
posted by Lyn Never at 9:34 AM on March 1 [2 favorites]
All-Bran Buds is my doctor's starter recommendation (it's the only cereal that has psylliyum husk, and it's also quite tasty, I like mine with kefir) because people tend to be pretty compliant with it. If a month with your daily Buds gets results, you can consider moving on to cheaper more efficient options.
posted by Lyn Never at 9:34 AM on March 1 [2 favorites]
Best answer: Just to concur 100 % with flug. Like flug I talk from personal experience but, unlike flug, from the personal experience of the 1 out of 1000. Your family member needs to follow up with their PCP asap. Intervention may be time-critical.
posted by bluedora at 10:53 AM on March 1 [5 favorites]
posted by bluedora at 10:53 AM on March 1 [5 favorites]
I'll put in a good word for ground flaxseed as a psyllium alternative. I find it easy to eat on my morning English muffin, and it's comparable in fiber content.
But yeah, seeing the PCP seems like a really good idea.
posted by humbug at 6:09 PM on March 1
But yeah, seeing the PCP seems like a really good idea.
posted by humbug at 6:09 PM on March 1
Disclaimer: Australian, non-male
As a patient, I'm all over this. Bleeding haemorrhoids, Dr recommends a stool softner and exterior wipes or ointment for pain relief. Internal, same deal, but pain relief is over the counter.
Internal bleeding (not bright red, with gut pain that lay me out on my office floor and an ambulance called for me, straight into emergency and what they were most concerned with how much blood I had left (<8>
So, I'm not surprised by the reaction in ER and sure, if the regular doctor doesn't want to follow up or explain anything, it's your right to ask.
posted by b33j at 11:30 PM on March 1
As a patient, I'm all over this. Bleeding haemorrhoids, Dr recommends a stool softner and exterior wipes or ointment for pain relief. Internal, same deal, but pain relief is over the counter.
Internal bleeding (not bright red, with gut pain that lay me out on my office floor and an ambulance called for me, straight into emergency and what they were most concerned with how much blood I had left (<8>
So, I'm not surprised by the reaction in ER and sure, if the regular doctor doesn't want to follow up or explain anything, it's your right to ask.
posted by b33j at 11:30 PM on March 1
Best answer: PLEASE follow up with primary care even if symptoms clear up. My close person went to the emergency room with very similar symptoms, was told that it was probably hemorrhoids even though there was no sign of hemorrhoids and told to follow up with primary care. The bleeding stopped of its own accord.
He did follow up with his primary care provider and primary care recommended a colonoscopy which revealed Stage 3 colon cancer. He is still in treatment for this and likely will be for the rest of his life.
It is worth noting that the ER actually also did a CT scan for tumors which showed nothing. Do not be reassured by a CT scan, get that colonoscopy!
posted by Jenny'sCricket at 9:03 AM on March 2 [4 favorites]
He did follow up with his primary care provider and primary care recommended a colonoscopy which revealed Stage 3 colon cancer. He is still in treatment for this and likely will be for the rest of his life.
It is worth noting that the ER actually also did a CT scan for tumors which showed nothing. Do not be reassured by a CT scan, get that colonoscopy!
posted by Jenny'sCricket at 9:03 AM on March 2 [4 favorites]
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Hemorrhoids can be internal or external manifesting. The stool test would tell us more (what kind of blood, how long has it been in the stool i.e. how far up the intestines did it come from, etc.) Definitely schedule PCP ASAP, but no need to panic.
posted by kschang at 6:16 PM on February 29 [1 favorite]