Dr. Vandana Andrews
General Practitioner
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Patient's Query
Hello doctor,
I have been suffering from constipation for almost two years now. I need laxatives to assist me in having bowel movements. About eight weeks ago, for about five or six days, I experienced some light bleeding. Only a few spots were visible with close inspection. I am very health conscious at the minute. I consulted a GP (general practitioner) and did a QFIT (quantitative fecal immunochemical test), which was at a level of 14 mcgHb/g Stool. The GP told me he was not worried about it. He did a rectal examination and found only a skin tag. I was referred to a gastrologist, and he did a rectal examination a few days later and found external hemorrhoids. He said he did not expect any significant pathology as I had a recent colonoscopy last summer and a CT (computed tomography) scan of the bowel last winter and that the bleeding was possibly due to external hemorrhoids. How can some doctors find hemorrhoids and others cannot? However, in the interim, I was feeling very constipated on a few occasions, and on one of the days, I passed a large amount of stool with some bleeding. I did not have to strain much but had slightly more than the previous bleeding. Is this normal with being constipated? About a week later, I was feeling very constipated again, and I passed a hard stool, but the pain in it was terrible. It was sharp but eased when I got rid of the stool, accompanied by a small amount of bleeding. I know that this can happen when passing a hard stool. Could this be an anal fissure even though the pain disappeared when I got rid of the stool? I have undergone a rectal area examination, and some areas of the skin around the rectum feel rough. Could this be a sign of proctitis? Please help.
Thank you.
Hi,
Welcome to icliniq.com.
I have read the query, and I can understand your concern.
Based on your symptoms and medical history, you may have developed hemorrhoids, which are swollen veins in the rectum or anus that can cause bleeding, itching, and pain during bowel movements. Hemorrhoids are a common condition, particularly in people who are constipated or strained during bowel movements. The bleeding you experienced a few weeks ago could be related to hemorrhoids, as external hemorrhoids can bleed when they become irritated or inflamed. The fact that the bleeding was light and only a few spots suggests that it may have been due to small hemorrhoids. The rectal examination performed by your GP (general practitioner) and the gastrologist may not have revealed the presence of hemorrhoids, as they can be difficult to detect during an examination if they are not large or symptomatic. Some people may not experience any symptoms from hemorrhoids and may not be aware that they have them. The pain you experience when passing a hard stool could also be related to hemorrhoids, as the pressure put on the rectum during bowel movements can cause discomfort and pain in this area. However, it is also possible that you have developed an anal fissure, which is a small tear in the anal canal that can cause pain and bleeding during bowel movements. The roughness around the rectum could be a sign of proctitis, an inflammation of the rectum lining. However, it could be related to hemorrhoids or other factors, such as constipation or irritation from frequent wiping. If you are concerned about your symptoms or if they persist or worsen, it is suggested that you consult with a gastroenterologist for a proper diagnosis and treatment plan. They may recommend lifestyle changes, such as increasing fiber intake and staying hydrated, as well as medication or therapy to help manage your symptoms and prevent further complications.
Some doctors may find hemorrhoids, and others may not. It could be due to several factors. The size and location of the hemorrhoids may make them more or less visible during an examination. Some people may also be more prone to developing hemorrhoids due to factors such as genetics, diet, or lifestyle habits. Additionally, some doctors may be more experienced at detecting hemorrhoids during examinations than others. It is always important to communicate concerns about your symptoms with your healthcare provider so they can provide appropriate care and guidance based on your needs.
I hope this will help you.
Thank you.
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General Practitioner
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