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What Causes Soreness Of The Rectum And Constipation?
Question: I have a sore rectum that started about 2 months ago as an itch. Now it seems to stay sore and my stools are very small around and lately I'm constipated. Blood appears to be on the toilet paper after I wipe, but there appears to be no blood in my stool. I'm 72 years old and my younger brother died in 2003 of colon cancer, however, I've had several colonoscopys and they were all clean except 5 years ago I had to have a benign gist removed from the area outside my colon. 4 years ago I had to have a heart valve replaced and am currently taking the blood thinner Xarelto. Also I have a pace maker. 2 years ago I had a thyroidectomy performed and am taking medicine for it.
Brief Answer:
Treat constipation and consider sigmoidoscopy; xarelto might cause bleeding
Detailed Answer:
Hello,
Thank you for asking at HCM.
I carefully read your question and understand your concern.
There are a few reasons for the rectal bleeding you are experiencing. Especially related to constipation is hemorroids. The typical clinical appearance in these cases is blood when wiping and sometimes can be clear bright blood in the toilet. Sometimes it might be blood with stools but mostly around the stool and not mixed with them. If the bleeding is not intense you might just notice blood when you wipe. The external hemorroids, which are those close to the anal canal entrance can also cause discomfort. Constipation makes them worse and more painful.
To help with these it is important to treat constipation. Having extra fiber in diet and sometimes lactulose syrup one table spoon 1-2 times a day might help. If much anal pain than a steroid cream with lignocaine locally can help.
Another cause to consider is bleeding due to the blood anticoagulant you are having. It is very likely not the case but is always good to consider the dose and speak with your doctor if it might be the cause of it.
If you have family history of colon cancer it might be good to have at least a sigmoidoscopy done which is an endoscopy that checks the last part of the bowel and is not so invasive as colonoscopy.
So to conclude I would suggest:
1. make sure you take extra fiber like Psillium in diet daily (you can buy it in supermarkets, it is over the counter), if not much help might add Lactulose syrup 1-2 table spoon a day
2. local anal cream with steroid/lignocaine twice a day can help with pain if it is really bothering a lot
3. Consider having a sigmoidoscopy done to rule out cancer or other masses like polyps of the last part of the colon; might be a good idea to do this test and it is not so invasive. It would also visualize hemorroids easily
4. talk with your doctor on the need to adjust the dose of xarelto as it might cause bleeding as side effect
I hope this is helpful and answers to your questions but please feel free to contact me in case more clarification on this is needed.
I wish you well.
Kind regards
Dr Antoneta Zotaj
Treat constipation and consider sigmoidoscopy; xarelto might cause bleeding
Detailed Answer:
Hello,
Thank you for asking at HCM.
I carefully read your question and understand your concern.
There are a few reasons for the rectal bleeding you are experiencing. Especially related to constipation is hemorroids. The typical clinical appearance in these cases is blood when wiping and sometimes can be clear bright blood in the toilet. Sometimes it might be blood with stools but mostly around the stool and not mixed with them. If the bleeding is not intense you might just notice blood when you wipe. The external hemorroids, which are those close to the anal canal entrance can also cause discomfort. Constipation makes them worse and more painful.
To help with these it is important to treat constipation. Having extra fiber in diet and sometimes lactulose syrup one table spoon 1-2 times a day might help. If much anal pain than a steroid cream with lignocaine locally can help.
Another cause to consider is bleeding due to the blood anticoagulant you are having. It is very likely not the case but is always good to consider the dose and speak with your doctor if it might be the cause of it.
If you have family history of colon cancer it might be good to have at least a sigmoidoscopy done which is an endoscopy that checks the last part of the bowel and is not so invasive as colonoscopy.
So to conclude I would suggest:
1. make sure you take extra fiber like Psillium in diet daily (you can buy it in supermarkets, it is over the counter), if not much help might add Lactulose syrup 1-2 table spoon a day
2. local anal cream with steroid/lignocaine twice a day can help with pain if it is really bothering a lot
3. Consider having a sigmoidoscopy done to rule out cancer or other masses like polyps of the last part of the colon; might be a good idea to do this test and it is not so invasive. It would also visualize hemorroids easily
4. talk with your doctor on the need to adjust the dose of xarelto as it might cause bleeding as side effect
I hope this is helpful and answers to your questions but please feel free to contact me in case more clarification on this is needed.
I wish you well.
Kind regards
Dr Antoneta Zotaj
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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