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Suggest Treatment For Occasional Rectal Bleeding While Having Ulcerative Colitis
Question: I have a history of ulcerative colitis but have been in remission for probably 8 years or so. Currently, I am experiencing the following systems, which together do not seem like any colitis attack I have ever had. It seems more like internal hemorrhoids but not sure. My symptoms:
-occasional rectal bleeding; most times not bleeding at all; sometimes bloody only on the toilet paper; sometimes a little blood in the bowl;
-rectal discomfort after a bowel movement that lasts maybe 30 minutes - only when I go frequently
-a lot of gas; many bowel movements are just releasing gas; but there is usually a "squishy' sound when I release gas as if there is mucous in my rectal area; even when this occurs there is no blood many times.
- bowel movements have changed; now I have very small pieces of stool that are evacuated with the gas; I don't have one large stool per day.
- after I either release gas or have a mini- bowel movement, immediately after there is still an urge to evacuate, which goes away after about 15 seconds.
Seems like it could be internal hemorrhoids except I can't explain the change in bowel movement and the excess gas.
This is more a follow-up comment. When ever I had a colitis flare-up in the past, I would feel uncomfortable throughout the day to some extent. I would either feel very gassy or my abdominal/intestinal area would feel tight or slightly sore. This didn't go away until my flare-up started to subside, With my current situation, there are long periods during the day where I feel absolutely fine and would not even know I have an issue, Usually later at night, I tend to become more gassy and will tend to run to the bathroon more often than I would during the day. That's when my rectum starts to feel sore. The gassy nature of the problem makes it a very urgent situation. That is, when I feel the sudden urge to go to the bathroom, sometimes I almost have to run to the bathroom.
I noticed I entered the incorrect email address on my account. The email address should be:
YYYY@YYYY
-occasional rectal bleeding; most times not bleeding at all; sometimes bloody only on the toilet paper; sometimes a little blood in the bowl;
-rectal discomfort after a bowel movement that lasts maybe 30 minutes - only when I go frequently
-a lot of gas; many bowel movements are just releasing gas; but there is usually a "squishy' sound when I release gas as if there is mucous in my rectal area; even when this occurs there is no blood many times.
- bowel movements have changed; now I have very small pieces of stool that are evacuated with the gas; I don't have one large stool per day.
- after I either release gas or have a mini- bowel movement, immediately after there is still an urge to evacuate, which goes away after about 15 seconds.
Seems like it could be internal hemorrhoids except I can't explain the change in bowel movement and the excess gas.
This is more a follow-up comment. When ever I had a colitis flare-up in the past, I would feel uncomfortable throughout the day to some extent. I would either feel very gassy or my abdominal/intestinal area would feel tight or slightly sore. This didn't go away until my flare-up started to subside, With my current situation, there are long periods during the day where I feel absolutely fine and would not even know I have an issue, Usually later at night, I tend to become more gassy and will tend to run to the bathroon more often than I would during the day. That's when my rectum starts to feel sore. The gassy nature of the problem makes it a very urgent situation. That is, when I feel the sudden urge to go to the bathroom, sometimes I almost have to run to the bathroom.
I noticed I entered the incorrect email address on my account. The email address should be:
YYYY@YYYY
Brief Answer:
less likely to have internal hemorrhoids
Detailed Answer:
Hello,
I apologize for late reply.
I understand concern towards your present symptoms and also appreciate level of awareness towards symptoms.
1) When was last colonoscopy was done? What were the findings in that colonoscopy?
2) From my point of view, this occasional fractional bleeding episodes are not due to internal hemorrhoids. Hemorrhoids are classified based on location (internal or external). Internal hemorrhoids are located completely inside anal canal and they are very small. Bleeding episodes in hemorrhoids are directly proportional to size of hemorrhoids thus it is rare for internal hemorrhoids to bleed.
3) Did any of colonoscopy mentioned diverticuli in rectum or colon? This are prone to develop in colitis and might be reason for bleeding
4) Another possibility (based on your overall symptoms) is flare-up colitis with bleeding for one of intestinal ulcer. This also confirms hemorrhoids (although not primary investigation for hemorrhoids)
I suggest you to undergo repeat colonoscopy to evaluate and find reason for bleeding.
Hope I have answered your question. If you have any further questions I will be happy to help you.
Have a good day!
less likely to have internal hemorrhoids
Detailed Answer:
Hello,
I apologize for late reply.
I understand concern towards your present symptoms and also appreciate level of awareness towards symptoms.
1) When was last colonoscopy was done? What were the findings in that colonoscopy?
2) From my point of view, this occasional fractional bleeding episodes are not due to internal hemorrhoids. Hemorrhoids are classified based on location (internal or external). Internal hemorrhoids are located completely inside anal canal and they are very small. Bleeding episodes in hemorrhoids are directly proportional to size of hemorrhoids thus it is rare for internal hemorrhoids to bleed.
3) Did any of colonoscopy mentioned diverticuli in rectum or colon? This are prone to develop in colitis and might be reason for bleeding
4) Another possibility (based on your overall symptoms) is flare-up colitis with bleeding for one of intestinal ulcer. This also confirms hemorrhoids (although not primary investigation for hemorrhoids)
I suggest you to undergo repeat colonoscopy to evaluate and find reason for bleeding.
Hope I have answered your question. If you have any further questions I will be happy to help you.
Have a good day!
Above answer was peer-reviewed by :
Dr. REMY KOSHY
My last colonoscopy was 6 months ago (May, 2016). The colonoscopy did not show any signs of diverticuli that I am aware of. The reason I didn't think it was a colitis flare-up was that, compared to any flare-up I had before, this time:
- the onset of the situation was totally different; with a flare-up I would first experience gas, then loose bowel movements and then blood - and the blood wouldn't go way until the flare-up was under control; this time I noticed blood first and then there were days when I didn't have any blood. I still do not have diarrhea, which was always a given with a flare-up.
- my rectum internally feels sore and inflamed after several bowel movements; I don't recall that with a flare-up
- I don't feel bloated with gas all the time like I did with a flare-up; many times during the day I feel normal. That was never the case with a flare-up.
If you still feel it might be a flare-up I'll talk to my doctor about another colonoscopy.
- the onset of the situation was totally different; with a flare-up I would first experience gas, then loose bowel movements and then blood - and the blood wouldn't go way until the flare-up was under control; this time I noticed blood first and then there were days when I didn't have any blood. I still do not have diarrhea, which was always a given with a flare-up.
- my rectum internally feels sore and inflamed after several bowel movements; I don't recall that with a flare-up
- I don't feel bloated with gas all the time like I did with a flare-up; many times during the day I feel normal. That was never the case with a flare-up.
If you still feel it might be a flare-up I'll talk to my doctor about another colonoscopy.
Brief Answer:
Still suspicious about flare-up disease in rectum with ulcer development.
Detailed Answer:
Hello,
I apologize for late reply,
Yes still I have suspicion for flare-up with specific involvement of rectum and development of rectal ulcer on background of inflammation.
I am sure about that this is not relate with internal hemorrhoid because
1) Internal hemorrhoids are small in size and they never bleed spontaneously.
2) Internal hemorrhoids are painless and they not have any GI tract related symptoms.
3) If internal hemorrhoids big enough to bleed then you might feel foreign body sensation in anal region with peri-anal pain also.
I would recommend to consult your gastroenterologist for colonoscopy.
Still suspicious about flare-up disease in rectum with ulcer development.
Detailed Answer:
Hello,
I apologize for late reply,
Yes still I have suspicion for flare-up with specific involvement of rectum and development of rectal ulcer on background of inflammation.
I am sure about that this is not relate with internal hemorrhoid because
1) Internal hemorrhoids are small in size and they never bleed spontaneously.
2) Internal hemorrhoids are painless and they not have any GI tract related symptoms.
3) If internal hemorrhoids big enough to bleed then you might feel foreign body sensation in anal region with peri-anal pain also.
I would recommend to consult your gastroenterologist for colonoscopy.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
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