Expert: Claes-Gustaf Nordquist, M.D. - 6/3/2007

Question
QUESTION: This morning, in the wee hours, I went to the bathroom, had no bowel movement even though I felt like I needed to.  When I wiped I noticed a very slight amount of feces along with what appeared to be pink on the toilet paper.  So being curious I took another sheet of TP and without wiping I just held the TP to the anal opening with a little pressure. When I looked there was a bright red spot of what appeared to be fresh blood about the size of a pencil eraser.  This really scared me because that's never happened before.  About 10 minutes after that I felt the urge for a BM.  Before I went I held the TP to the opening with some pressure and it came away clean.  After I went I inspected the feces which was very light brown in color and well formed but kind of oval shaped instead of round but it was still firm.  I saw no signs of blood mixed in and there was no blood on the TP after wiping.  There was a slight burning sensation afterwards that I can still feel several hours later, no bad but just enough to notice.  I have gone to the bathroom once since then but no BM and no blood.  Several hours after the episode I noticed a small drop of blood, about half the size that I found on the TP, on my bed sheet.  It looks dark red probably because it's been there for several hours.  After noticing this I wiped around the anal area with a wet white wash cloth that came away slightly pink.  I do have a history of chronic bowel problems for several years.  My stools are frequently soft and mushy, kind of feathery and not formed at all and usually not dark in color.  I also frequently experience diarrhea shortly after eating certain foods.  When I do have a "normal" BM it's usually kind of oval shaped not round.  I did have a bout with constipation about a month ago. I did not have a BM for 4 days and had to take a laxative.  When I did go it was runny.  There was no blood.  A couple of days ago I did have a bout of diarrhea  after eating spicy food.  I do have a history of external hemorrhoids, and I did notice some bulging after that bout with constipation but there is nothing there now and like I said there has not been any bleeding before today and just that one episode only, even though I've gone to the bathroom twice since then.  I surfed the net and found all this stuff about colorectal cancer and it really scares me.  I am a 46 year old female with a history of a high fat diet and I rarely eat fruit and vegetables.  I have also read that is a rick factor for colon cancer.  I am working to change all that and I have recently started eating more healthy.  I just hope it's not too late!  Do you think that is something I need to worry about?  What could have caused the blood I saw this morning but not since?  Do you think it could be caused from this cancer?  I do plan to see a doctor, but in the meantime I am really panicked about this!

ANSWER: If you do have external hemorrhoids the blood could very well come from them. BUT we do not know that! So I strongly suggest that you let a dr. check you! The best way to find or exclude a colon cancer is by a colonoscopy! Good luck!


---------- FOLLOW-UP ----------

QUESTION: So you mean that it could be colon cancer even though the blood was only on the TP before I had the BM and there was no blood in the BM?  I don't have any external hemorrhoids right now but couldn't I have one inside?  I've still not had any more blood, or another BM, but all day ever since that incident there has been kind of a burning, stinging, sore feeling there along with the feeling like there's something there.

Answer
You may have internal hemorrhoid too that may cause this. The burning sensation may come from a small rift in the intestinal mucosa inside your rectum (lowest part of your colon). That may be the reason for your bleeding too. Only an examination by a dr. can tell us what the cause may be.