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What is the cause and treatment for recurrent rectal bleeding?

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Internal Medicine Specialist
Practicing since : 2004
Answered : 364 Questions
I have a internal Hemerroid that bleeds it seem when I exersise or strain. I use suppositories and it does stop with in a few hours and I am now trying Hem -Relief. I will have a normal bowel movement size ,color in the morning no blood then late have to go again and the stools are thinner and a little trace of blood on them. Then i use a suppositore . I have had external radiation for Prostate which now is PSA .02 I have ITP and take Nplate injections which work for the most part. . They bring my Platelets up to over 200 at times and the bleeding is lessened a lot. . I had to go to the Emergancy one night because I thought I was bleeding a little to much. They gave me a CBC and said my Platelets were down,but my HGB was good. . They kept me two days giving Platelets which XXXXXXX my count up a some and the bleeding stopped . They wanted to give me a colonoscope but my Platelet count never got high enough. I went home . My hemo doc gave me a Nplate shot and it went up to 250. they still wanted to give me a colonoscope . When my Platelets stabilized . Well I had another bleeding and went back to the ER this XXXXXXX e the DR used I guess it was called aanoscope and said I had a internal Hemerriod and he could see that is wher eth ebleeding was coming from. They gave me a enama and I spent then tnight took a CBC an it was still low Platelets but my HGB was normal. . I saw a Gastro. Dr. he said that he wanted to give me a colonoscope. He said he did not deal with Hemerroids. and that the proctoligst as per Kaiser policy would not see me until I had a colonscope. What I don't understad is they know the bleed is coming from the Hemmerroid so why don't they just fix it then give me the colonscope to see what elese is going on if anything. I do have IBS and Diviticlosis in my entire colon. Please excause my spelling any advise as to what to do next
Posted Tue, 18 Mar 2014 in Digestion and Bowels
Answered by Dr. Enrique Molina 2 hours later
Brief Answer: get the colonoscopy first Detailed Answer: i understand your concern, and the fact that you are having recurrent rectal bleeding and want the problem fixed. I can't stress how important it is to get a colonoscopy, particularly if you have never had one before. I have seen many patients that come with rectal bleeding "from the hemorrhoids", and when they get their colonoscopy are found to have a rectal or sigmoid cancer, which not necessarily would be seen on anoscopy or imaging studies. Missing a cancer is the main concern, but also other lesions may be found, that can be treated accordingly. If you have had a colonoscopy within the past 5 - 10 years, then you may get away without having another one, but it depends on the findings on that past colonoscopy, and the quality of the views (if you had a clean colon or not during examination). Diverticula in the colon can also bleed, and that could require surgery, which is another reason to get a colonoscopy, to see if hemorrhoid intervention is really needed. Hopefully that answered your concerns, Let me know if you have any further questions or concerns
Above answer was peer-reviewed by
Follow-up: What is the cause and treatment for recurrent rectal bleeding? 11 minutes later
GREAT ADVISE! My only concern is the prep for the colonoscopy and the bleeding it could cause. I had a berium enama which was clear and a CT scan which showed the Diverlicula. I will check back with my Dr and when my Platelet count is up proceed to get the colonoscopy. Having retcal bleeding is very stressfull. Any sujestion on how to prepare for the prep.
Answered by Dr. Enrique Molina 11 minutes later
Brief Answer: prep is not that bad Detailed Answer: the prep from the colonoscopy should not make anything to bleed more. you may wash out whatever blood might be in the colon, but prep is not an irritant and itself is not XXXXXXX There are many ways to "prep" the colon, and it all depends on your gastroenterologist preference. Ideally you will be on a "clear liquid diet" the entire day before the procedure. you will need to take a laxative the day before the procedure. Timing of the laxative will depend on the time your procedure is scheduled the following day. The more compliant you are with the instructions given, the cleaner your colon will be, and a better job can be done by your gastroenterologist. The fact that you have had a barium enema and a CT scan is good, and it would be less likely for your to have any big tumor, but again "flat lesions" can be missed. Also keep in mind that in your case, having had radiation to the prostate in the past, places you at risk for developing "radiation colitis", which are abnormal vessels that can bleed, and these can form years after you have finished radiation. Good luck and good health!
Above answer was peer-reviewed by
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