QuestionHello Dr,
Not long ago I had asked about rectal bleeding periodically. To refresh, I am a 37 yr old white male. 5'11" 244 lbs.
Starting this year, I had a few times when there was blood in the bowl and on the paper in the am. I am regular and every morning is my routine. Each time, I had something relating to pepper the night before (i.e. crushed red pepper flakes, black pepper, red pepper sandwich spread etc). It happened about 5 times in January, in the am movement, and after the first time, I purposely ate the pepper to experiment. At other times and watching to not eat pepper items, I had no blood whatsoever. I always had No pain, no itching, nothing abnormal, no straining. I'm just very regular. Along with the food the night before, most of the time I had beer also, but this didn't seem to affect anything since other times I had beer and no pepper items and had no blood in the morning movements.
Upon advice, I went to my Dr (internist), who took a look that day and did the DRE which he felt nothing. So, they shceduled me for a sigmoidoscopy a week later and I went in the office for that. He said it would go in 60cm or about 2 feet. The end result was that he said I had a normal healthy looking colon, rectum and anus with only a minor bit of irritation at the anus opening. He attributed this to the insertion of the probe, but may have been some slight irritation pertaining to a fissure/hemorroid.
In the last few months, I've had several times where there was blood in the morning movement and recalled the night before contained some sort of pepper in it. The last few days, it has been a common occurrence in the am to see this. I do, however, feel like a very minor bit of itching/feeling just inside the anus, but only very slight and only very sporadic. Because nothing was found during the sigmoidoscopy, does that mean it has to be a fissure/hemorroid of some sort, even though I don't feel anything or strain or anything out of the ordinary? I do feel better knowing that the first 2 feet of my insides are healthy, but why do I still get bloody water in the am frequently? Maybe I need to cut out pepper from everything.
I apologize for this being so lengthy, but needed detail to explain. And I appreciate your advice. Thank you.
AnswerI am not sure why you had the sigmoidoscopy and not the colonoscopy... but bleeding from the anus implies that it is hemorrhoids.... first would be food avoidance, like the peppers, and also if there is any constipation, take some low dose miralax (over the counter) daily to keep any strain off defecation Then, if it persists, you need the full colonscopy Hope this helps
