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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I want a gastroenterologist to answer this and NOT a

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Dr. Ratnakar Kini

Gastroenterologist

Practicing since :1996

Answered : 1873 Questions

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Posted on Tue, 1 Jan 2019 in Digestion and Bowels
Question: I want a gastroenterologist to answer this and NOT a general practitioner!!! I have hemorrhoids for over 40 years. Last Wednesday, for the first time in my 66 years of life, I saw three round spots of blood stuck on an otherwise normal color and consistency stool. No blood was in the toilet or on the toilet paper. I have never had a colonoscopy because I am deathly afraid of them, and I want to know if this symptom warrants such an invasive test as a colonoscopy. I never saw the blood again. My fecal test and blood work in XXXXXXX was normal. I had two gray stools in November and never again. I am very healthy and don't need pills for anything yet.
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Follow up: Dr. Ratnakar Kini 0 minute later
I want a gastroenterologist to answer this and NOT a general practitioner!!! I have hemorrhoids for over 40 years. Last Wednesday, for the first time in my 66 years of life, I saw three round spots of blood stuck on an otherwise normal color and consistency stool. No blood was in the toilet or on the toilet paper. I have never had a colonoscopy because I am deathly afraid of them, and I want to know if this symptom warrants such an invasive test as a colonoscopy. I never saw the blood again. My fecal test and blood work in XXXXXXX was normal. I had two gray stools in November and never again. I am very healthy and don't need pills for anything yet.
doctor
Answered by Dr. Ratnakar Kini 3 hours later
Brief Answer:
Yes

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

Blood streaked stools could be due to anal fissure.
You need sitz bath and stool softeners.

Taking your age in to consideration, colonoscopy should be done. This has to be done after seeing whether anal sphincter is not under spasm because of probable anal fissure.

I hope that answers your query.
Regards,
Dr.N
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Yes

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

Blood streaked stools could be due to anal fissure.
You need sitz bath and stool softeners.

Taking your age in to consideration, colonoscopy should be done. This has to be done after seeing whether anal sphincter is not under spasm because of probable anal fissure.

I hope that answers your query.
Regards,
Dr.N
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ratnakar Kini 33 minutes later
Stool softener? I wasn't squeezing. I have IBS and hardly ever am constipated. My bowels move easily. Why suggest a softener? So are you also saying I don't have polyps or cancer? What about a sigmoidoscopy?
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Follow up: Dr. Ratnakar Kini 0 minute later
Stool softener? I wasn't squeezing. I have IBS and hardly ever am constipated. My bowels move easily. Why suggest a softener? So are you also saying I don't have polyps or cancer? What about a sigmoidoscopy?
doctor
Answered by Dr. Ratnakar Kini 23 minutes later
Brief Answer:
Answer given below

Detailed Answer:
Thanks for the additional information.

My opinion was based on the information that you have hemorrhoids ( which is commonly associated with constipation) and the symptom of blood streaked stool and I do not have the option of doing a rectal examination.

If your bowel movements are fine and you do not pass hard stools, then other causes lower GI bleed should be looked in to that includes polyps, diverticulosis and malignancy.

If the blood was bright red in color, then the source is probably in anorectum and lower left colon. If it was dark red in color, the source could be probably in the proximal colon.

If the blood was bright red color, you can go for sigmoidoscopy.
Otherwise I would suggest examination of the entire colon with colonoscopy.

Let me know if you have any more questions.
Regards,
Dr.N


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Answer given below

Detailed Answer:
Thanks for the additional information.

My opinion was based on the information that you have hemorrhoids ( which is commonly associated with constipation) and the symptom of blood streaked stool and I do not have the option of doing a rectal examination.

If your bowel movements are fine and you do not pass hard stools, then other causes lower GI bleed should be looked in to that includes polyps, diverticulosis and malignancy.

If the blood was bright red in color, then the source is probably in anorectum and lower left colon. If it was dark red in color, the source could be probably in the proximal colon.

If the blood was bright red color, you can go for sigmoidoscopy.
Otherwise I would suggest examination of the entire colon with colonoscopy.

Let me know if you have any more questions.
Regards,
Dr.N


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ratnakar Kini 9 hours later
So if I go to a gastroenterologist, they will first examine me, my rectum, and see my hemorrhoids, how far up they are, also if I have an anal tear, which I would think healed by now, and then they may suggest a colonoscopy? What are my chances it is cancer, since I only saw the blood one time, last Wednesday, after all the bowel movements I've had since then? What about the gray stool I talked about having twice in November? You didn't answer that. Thank you.
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Follow up: Dr. Ratnakar Kini 0 minute later
So if I go to a gastroenterologist, they will first examine me, my rectum, and see my hemorrhoids, how far up they are, also if I have an anal tear, which I would think healed by now, and then they may suggest a colonoscopy? What are my chances it is cancer, since I only saw the blood one time, last Wednesday, after all the bowel movements I've had since then? What about the gray stool I talked about having twice in November? You didn't answer that. Thank you.
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Follow up: Dr. Ratnakar Kini 6 hours later
Besides the above that isn't answered yet, my ultrasound of the complete abdomen and kidneys O took Saturday was completely normal except because of gas tge pancreas isn't seen. Do I need a different type of test then?
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Follow up: Dr. Ratnakar Kini 0 minute later
Besides the above that isn't answered yet, my ultrasound of the complete abdomen and kidneys O took Saturday was completely normal except because of gas tge pancreas isn't seen. Do I need a different type of test then?
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Follow up: Dr. Ratnakar Kini 2 hours later
My blood work I did yesterday also came back totally normal! No inflammation in the body. Do I still need a colonoscopy? I haven't had an answer for over 8 hours. How long does it take for an answer?
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Follow up: Dr. Ratnakar Kini 0 minute later
My blood work I did yesterday also came back totally normal! No inflammation in the body. Do I still need a colonoscopy? I haven't had an answer for over 8 hours. How long does it take for an answer?
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Follow up: Dr. Ratnakar Kini 1 hour later
I forgot to tell you the complete abdominal ultrasound said I had a nonalcoholic fatty liver. IS that why I at times have a small achy feeling or soreness in that area if I eat garbage food or am nervous? I do have a minor case of IBS NOT IBD. Is that why?
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Follow up: Dr. Ratnakar Kini 0 minute later
I forgot to tell you the complete abdominal ultrasound said I had a nonalcoholic fatty liver. IS that why I at times have a small achy feeling or soreness in that area if I eat garbage food or am nervous? I do have a minor case of IBS NOT IBD. Is that why?
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Follow up: Dr. Ratnakar Kini 1 hour later
Where are my answers from any doctor??????
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Follow up: Dr. Ratnakar Kini 0 minute later
Where are my answers from any doctor??????
doctor
Answered by Dr. Ratnakar Kini 18 hours later
Brief Answer:
Answer given below

Detailed Answer:
Hi,
Sorry for the delay.
The occasional gray stool does not indicate anything significant.
Yes, your doctors may do a digital rectal examination and may suggest a colonoscopy.

The chances of cancer is less since you say you are hardly constipated and the bleeding was just once.

For your symptom of bleeding, the initial tests required are only digital rectal examination and colonoscopy.

Though the blood work was normal, I would still suggest a colonoscopy for two reasons.
1. Bleeding per rectum is not normal and the source has to be identified.
2. You are above 50 years of age

Nonalcoholic fatty liver with normal liver panel usually does not cause any symptoms.

IBS can cause spasmodic pain.

Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Answer given below

Detailed Answer:
Hi,
Sorry for the delay.
The occasional gray stool does not indicate anything significant.
Yes, your doctors may do a digital rectal examination and may suggest a colonoscopy.

The chances of cancer is less since you say you are hardly constipated and the bleeding was just once.

For your symptom of bleeding, the initial tests required are only digital rectal examination and colonoscopy.

Though the blood work was normal, I would still suggest a colonoscopy for two reasons.
1. Bleeding per rectum is not normal and the source has to be identified.
2. You are above 50 years of age

Nonalcoholic fatty liver with normal liver panel usually does not cause any symptoms.

IBS can cause spasmodic pain.

Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 1 hour later
I wouldn't call what I have spasmodic pain. I never had pain. I have a soreness or achy feeling where the gallbladder is for the past two years off and on, but tests came back normal yesterday, and the doctor thought it was my IBS or fatty liver and to just watch out what I eat. This is why I wondered about a colonoscopy to see what is under the gallbladder area, the intestines there, but only a gastroenterologist suggests it and not any other type of doctor. Why is that?
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Follow up: Dr. Ratnakar Kini 0 minute later
I wouldn't call what I have spasmodic pain. I never had pain. I have a soreness or achy feeling where the gallbladder is for the past two years off and on, but tests came back normal yesterday, and the doctor thought it was my IBS or fatty liver and to just watch out what I eat. This is why I wondered about a colonoscopy to see what is under the gallbladder area, the intestines there, but only a gastroenterologist suggests it and not any other type of doctor. Why is that?
doctor
Answered by Dr. Ratnakar Kini 12 hours later
Brief Answer:
Answer given below

Detailed Answer:
I suggested colonoscopy only for the symptom of bleeding.
The soreness /achy feeling in the gallbladder area does not require a colonoscopy.
Let me know if you have any more questions.

Regards,
Dr.R.K
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Answer given below

Detailed Answer:
I suggested colonoscopy only for the symptom of bleeding.
The soreness /achy feeling in the gallbladder area does not require a colonoscopy.
Let me know if you have any more questions.

Regards,
Dr.R.K
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 7 hours later
I have been told repeatedly that for there to really be a problem that warrants a colonoscopy, rather then going on a fishing expedition in my body for no reason, I would need to see a few streaks of blood in the stool and a dark color blood not bright red and the stool would be more black in color and not normal brown and not a dot on it or in it, and also seeing this more than only one time, along with weight loss and fatique and loss of appetite. I don't have polyp symptoms either so nothing could eventually turn into cancer when polyps aren't there in the first place. Do you agree with that assessment? Sigmoidoscopies are not really done in the State of Florida, USA, from what I am told anymore.
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Follow up: Dr. Ratnakar Kini 0 minute later
I have been told repeatedly that for there to really be a problem that warrants a colonoscopy, rather then going on a fishing expedition in my body for no reason, I would need to see a few streaks of blood in the stool and a dark color blood not bright red and the stool would be more black in color and not normal brown and not a dot on it or in it, and also seeing this more than only one time, along with weight loss and fatique and loss of appetite. I don't have polyp symptoms either so nothing could eventually turn into cancer when polyps aren't there in the first place. Do you agree with that assessment? Sigmoidoscopies are not really done in the State of Florida, USA, from what I am told anymore.
doctor
Answered by Dr. Ratnakar Kini 51 minutes later
Brief Answer:
Yes

Detailed Answer:
Yes, I agree with that assessment.
Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Yes

Detailed Answer:
Yes, I agree with that assessment.
Regards,
Dr.R.K.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ratnakar Kini 1 hour later
So you agree I don't have polyp symptoms or polyps? I wanted to clarify that. Thank you.
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Follow up: Dr. Ratnakar Kini 0 minute later
So you agree I don't have polyp symptoms or polyps? I wanted to clarify that. Thank you.
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Follow up: Dr. Ratnakar Kini 2 hours later
I guess the answers don't come quickly?
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Follow up: Dr. Ratnakar Kini 0 minute later
I guess the answers don't come quickly?
doctor
Answered by Dr. Ratnakar Kini 8 hours later
Brief Answer:
Answer given below

Detailed Answer:
Hi,
Without a colonoscopy, I cannot say whether you have polyps or not. Because polyps can remain without causing symptoms also.
There are no symptoms specific for polyps.
But when there is bleeding polyps should be considered as one of the possible causes.

Regards,
Dr.R.K


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ratnakar Kini 0 minute later
Brief Answer:
Answer given below

Detailed Answer:
Hi,
Without a colonoscopy, I cannot say whether you have polyps or not. Because polyps can remain without causing symptoms also.
There are no symptoms specific for polyps.
But when there is bleeding polyps should be considered as one of the possible causes.

Regards,
Dr.R.K


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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