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Strips of red outside the stool on straining hard. Have fissures and hemorrhoids. Colonoscopy clear. Reason?

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I strained and had two stripes of red (or maybe maroon) blood on the outside of my stool. I have a known fissure (very small) and some XXXXXXX hemorrhoids. The only bleeding I've had before is clearly from the fissure (just a tiny bit of pink blood. I had a colonoscopy 5 years ago that was completely clear.

I went to the gastroenterologist who says it's hemorrhoids and does NOT advise another colonoscopy. Does this make sense? I thought blood always indicated the need for a colonoscopy.
Posted Thu, 13 Jun 2013 in Abdominal Pain
Answered by Dr. Jorge Brenes-Salazar 2 hours later
Dear friend,

Thanks for your health concerns. I agree with the gastroenterologist with the information provided; if there was a normal colonoscopy 5 years ago, the chances of bleeding related to a malignant cause is quite low; on the other hand, anal fissures and hemorrhoids are the most common cause of bleeding while straining. A conservative approach with special detail to prevent constipation appears reasonable.

Hope this is helpful wish you the best health

Dr Brenes Salazar MD
Mayo Clinic MN
Department of Medicine
Division of Cardiovascular Diseases
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