Anal bleeding- doctor says it's no big deal?

I had something similar (not bleeding all the time, just bleeding when I went to the bathroom) and the result was the doctor did a colonoscopy, which found a hemorrhoid. He wanted to rule out cancer, which is the wise way to go.

I would get a second opinion were I in your situation, just to be on the safe side.

Did you have a difficult bowel movement? Has it been going on for days and weeks, or just this one time? If you are 50+ years old, you might as well get a colonoscopy, because you should have one at 50 anyway. If you are younger and the bleeding persists you should probably go to a gastroenterologist for a better exam. Assuming you just went to your GP? Do you have pain on your side? Most likely left side, but can be right side?

Eat things that will help you be regular for the next few days like raisins or prunes. Avoid raw veggies, nuts, and seeds. See if you heal up.

If your concerned, get a second opinion as @Seelix says.

How do you know it’s anal bleeding and not from higher up in your digestive tract? Was the doctor able to see where the blood was coming from? Are you just having bleeding when you have bowel movements or all the time? If you don’t know for sure where the blood is coming from, see a gastroenterologist for a colonoscopy. It could be a form of inflammatory bowel disease.

I have a similar issue. If the anal bleeding is fresh red blood, it is most likely a hemorrhoid or anal fissure, particularly if the bleeding occurs following a difficult bowel movement. Changes in your diet can help and increasing your fluid intake. If there is any history of colon cancer in your family, I would suggest a colonoscopy.

I agree that you should get a second opinion. And when you go the the second doctor, ask him a few questions.

Can you be sure it is just anal fissure? If so, how are you making that determination?

Could I have hemorrhoids? If so, what treatment is available for that? What lifestyle changes can I make to avoid this problem?

Would you reccomend a colonoscopy or other type of test to check if there are any problems further up inside of me? Why or why not?

What should I look for that might be something serious? Blood in the stool? Blood in the urine? Throwing up blood? Pain? What else should I be concerned about?

Does the color of the blood help to make the determination? Dark blood may mean something different than regular bright red blood.

What other situations would cause anal bleeding? Ulcer? Cancer? Internal Injury?

It is likely that the first doctor was correct, but it is too bad that he didn’t tell you how he came to that conclusion to give you some sense of confidence. Let us know how the second opinion goes. Feel better : )

P.S. In the meantime, you might want to get yourself some baby wipes instead of using toilet paper. It will be much less harsh on that sensitive area.

I’m 19, so I think the GP was pretty much assuming colon cancer was out.
This has been happening for a couple months now, it only happens when I have a bowl movement. No, I am not straining any harder than normal, which is why I’m concerned that it might not be just a hemorrhoid. Perhaps I’m just being paranoid though. No, the doctor was unable to determine where the bleeding starts from, another reason I’m more than a little bit concerned. The blood is bright red, so it can’t be from too much higher in my intestinal tract. I think I will ask for a colonoscopy though, just to be sure.

@hesaidshesaid Are you eating things that might tear you up like raw veggies and nuts?

I eat a lot of apples, but that is pretty much my veggie/fruit intake, unless it’s cooked in the foods I eat. I eat quite a bit of meat and pasta, no, no nuts for me though.

@hesaidshesaid Sorry to tell you, but bright red blood can also be from bleeding in your colon. I’m not saying it’s likely, but it would be smart to cover your bases and push to get a colonoscopy. That ought to tell you with certainty whether or not it’s anything to worry about. Sorry for the awkward questions but are you having diarrhea with this? Also keep an eye out for dark stools (like black). This doesn’t look like blood, but can be either old blood or blood from much higher up in the digestive tract.

There are a lot of innocent explanations for this, so don’t freak out, but you don’t want to mess around with possible IBD either.

How long do you spend on the toilet? If you sit there longer, it raises your chances for hemorrhoids. If your blood is bright red, according to my doctor, it’s not something that he worries about. It’s just uncomfortable. If the blood is dark, then it is clotted or something and comes from higher up and could well be a problem.

He also said that he doesn’t think you should do much about hemorrhoids. There is some kind of surgery, but he didn’t seem to think it was worth it. So, I live with it. Everyone once in a while, my stool is pretty hard, and I have to strain to get it out. That’s not good. It encourages the growth of hemorrhoids. But what can I do? I gotta push.

Oh. And the runs are pretty bad, too. All that wiping. I don’t wipe any more so much as blot. Wiping hurts too much. Blotting is ok. But just think! It’s one of the common joys of getting older. The more hemorrhoids you are, the wiser you are. Or some such.

Bright red blood can still be bad – I cannot emphasize this enough. It’s less bad! But please please don’t write this off – and don’t let any doctors write it off – just because the blood is bright.

I think it’s a good idea to get checked, but if you’ve been checked and you don’t like the result, what then? Do you want it to be bad news? This is the kind of thing that drives up health care costs without any increase in health. Sure, doctors are wrong on occasion, but that is really quite rare.

If the doctor looked and didn’t find anything, then, unless you enjoy being poked around there, I’d leave it at that. You can drive yourself crazy worrying about this and that. And I understand. That’s how I was when I first saw the crimson on the paper. I’m used to it now. I try to take care of myself, and in general, it seems to reduce the incidence of blood.

No I don’t want it to be bad news!
But there was an extreme lack of answers in his answer, which really bothers me. He didn’t find anything, so he assumes it must be a fissure. That really bothers me.
Again I’m a college student. 19. With a really high deductible. Please don’t suggest that I am doing this frivolously.

I am biased here, because I almost died because of a doctor thinking my symptoms probably weren’t “anything to worry about”

I just think that it sounds like what was done was not thorough. Sounds like he was just examined externally and the doctor didn’t see any indication that there was anything wrong externally – that would just give me more reason to believe that it could be a problem internally. A colonoscopy will tell you definitively, so the worry can end there if it is indeed unwarranted.

I agree though with what you had to say at the end @wundayatta – I will admit that I am a borderline hypochondriac, and there is something to be said about approaching these things with a more relaxed attitude.

just get scoped, man

@hesaidshesaid Don’t freak out. I frequently have the problem you are having. I have been scoped 3 times from the ages of 32 to 43. Twice I did have a mini small polyp, but the bleedng was not from the polyps. I have colon cancer in my family, so that is why I did the colonscopy. Even when I was perfectly clear of polyps I had bleeding off and on. Usually eating just pasta and meat might consipate people, do you have to strain at all? You are young so you might not have this problem. How long has this been going on, and is it every day? It can be many things including diverticulitis. The likelihood it is cancer is very very low, but of course even young people get cancer.

Go to a specialist so you can feel more reassured. Honestly I almost never go to a GP, I almost always just go straight to a specialist. Less expensive in the end and less time.

Are you being seen by a proctologist? If you’re not, that’s where your next appointment should be. 1) why am I bleeding? 2) what do I need to do to get it to stop?

I’m assuming that you think that you’re getting enough fiber and liquids, don’t have a constipation issue, and anal sex is not an issue, or you would have identified a cause on your own and not be posting here.

@hesaidshesaid But there was an extreme lack of answers in his answer, which really bothers me. He didn’t find anything, so he assumes it must be a fissure. That really bothers me.

This sounds like an issue of lack of communication. He must have had reasons for telling you what he told you, but he didn’t share them. He had the kind of “bedside manner” that is perhaps common of doctors who think they know better and don’t need to explain themselves to patients. Patients won’t understand anyway.

This kind of attitude is going away, but it’s still around. If this is the case, and it seems like he had no time for you, then I suggest you call and ask to speak to him and find out in more detail, what he saw or didn’t see, and why he thinks it isn’t a problem. Let him know you are still worried and hope that if he explains his diagnosis, you’ll feel better about it. If he has email, you could ask the question that way. It’s easier to get a doctor through email than over the phone.

Actually, @wundayatta makes a very good point. Many doctors believe patients just want to be reassured, and actually are loathe to give more detail as to why, because then more questions might come up from the patient, or a conversation might ensue that the doctor feels wastes his time. You might call as @wundayatta suggested to get details as to why the doctor is not concerned, which still will probably not satisfy you. I figure no matter what you will feel you need a second opinion. Maybe I am mistaken. I think doctors generally look to the most obvious answer, the docs on this thread can comment on if that is true or not. Most likely, statistically, you have some sort of small tear or inflammation. Doesn’t mean you are not part of the small mimority that has someyhing else wrong. Your chance of having colon cancer is less than 1% and you don’t have the other symptoms. See early symptoms on the same link I provided.

@JLeslie is correct. Anal bleeding in a 19 year old is almost never colon cancer and almost always anorectal verge bleeding (hemorrhoid, fissure, etc.).