Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Rectal Bleeding
Question: I am having some minor rectal bleeding and from time to time small dark clots.
I went to Dr. and went into hospital for the night for colonoscopy prep.They did CBC and said my Platelets were to low 41k they had me do the prep anyway and in the morning took another CBC still with low platelets and said my blood otherwise was ok bleeding probably from Hemorrhoids or radiation proctitis . So they sent me home very frustrated.Since the bowel prep the bleeding is still going on I feel the prep made it worse.I take Nplate to increase platelets once a week 1000 cm and it still is not high enough. I have ITP and CLL .I am going to start some Chemo this week.. pLus still take the Nplate.I wS GIVEN 25 MG SUPPOSITORIES. They seem be at a losss of what to do. One DR. told me the bleeding is minor and not to worry,but that's not right.. So I guess I am stuckbetween a rock and a hard place.
I went to Dr. and went into hospital for the night for colonoscopy prep.They did CBC and said my Platelets were to low 41k they had me do the prep anyway and in the morning took another CBC still with low platelets and said my blood otherwise was ok bleeding probably from Hemorrhoids or radiation proctitis . So they sent me home very frustrated.Since the bowel prep the bleeding is still going on I feel the prep made it worse.I take Nplate to increase platelets once a week 1000 cm and it still is not high enough. I have ITP and CLL .I am going to start some Chemo this week.. pLus still take the Nplate.I wS GIVEN 25 MG SUPPOSITORIES. They seem be at a losss of what to do. One DR. told me the bleeding is minor and not to worry,but that's not right.. So I guess I am stuckbetween a rock and a hard place.
Brief Answer:
needs complete clinical correlation
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. I am sorry for your troubles . Immune thrombocytopenia purpura and CLL combined are affecting your platelet lines due to too much destruction. Prepping for colonoscopy should have been delayed till the platelet counts have been above 80 thousand at least. Your hemorrhoids are worsening the rectal bleed and ITP making it more prone to. Nplate alone does not help, you need corticosteroids to help with ITP, some other immunosuppressants like rituximab. Splenectomy ( removal of spleen ) can be considered too if all medical measures fail.
Nutshell, mainstay of management here is focussing ITP and chemo for CLL. Colonoscopy and prepping of colon can wait. Minor bleed from hemorrhoids can be managed with supportive care. Soft fibrous bulk stool forming diet with plenty of fluids intake will help for a while. If hemorrhoids grades are higher, they can be surgical corrected as well.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
needs complete clinical correlation
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. I am sorry for your troubles . Immune thrombocytopenia purpura and CLL combined are affecting your platelet lines due to too much destruction. Prepping for colonoscopy should have been delayed till the platelet counts have been above 80 thousand at least. Your hemorrhoids are worsening the rectal bleed and ITP making it more prone to. Nplate alone does not help, you need corticosteroids to help with ITP, some other immunosuppressants like rituximab. Splenectomy ( removal of spleen ) can be considered too if all medical measures fail.
Nutshell, mainstay of management here is focussing ITP and chemo for CLL. Colonoscopy and prepping of colon can wait. Minor bleed from hemorrhoids can be managed with supportive care. Soft fibrous bulk stool forming diet with plenty of fluids intake will help for a while. If hemorrhoids grades are higher, they can be surgical corrected as well.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
