Expert: Claes-Gustaf Nordquist, M.D. - 3/23/2007

Question
QUESTION: Hi Dr,
About a month ago I noticed bright red blood in the bowl, on the stool, and on the toilet paper. It was not a huge amount. I went to the doctor and he checked and found 2 large internal hemorrhoids. He gave me cortisone suppositories and the bleeding did stop, although it seemed to have stopped right before I started using them anyway. I then realized that my stools had been 'thin' for a while now...not pencil thin but sort of 'crescent-shaped' if looked at via a cross-section. So then I feared about that, and started taking psyllium after reading about it. It seemed to help and make the stool more round and normal, although I still get the occasional crescent poop. I was feeling ok with all this until I got the stomach flu (or something like it) for 2 days, with yellow watery diarrhea, stomach cramp/gurgling, and fever...my wife got it too so I think it really was some sort of stomach bug. This was gone in 2 days but my first solid poop was very fiber-y but with strange reddish streaks in it. Not on the surface, but in it...and I'm not sure if it's blood because it wasn't bright but not very dark either...and when I picked at it (with a utensil, not my finger!), the reddish material appeared sort of solid and translucent, almost like raw meat. Since this, I've become convinced I have colon cancer and am scared to DEATH. I am trying to schedule a coloscopy but it is taking a while, and in the meanwhile I had my hemorrhoids ligated and a small little growth removed from my anus (which the doc says doesnt look like cancer).

The strange red 'things' have happened once more, and I am again unsure if it is blood. I am confused and am hoping you can give any sort of observation about this. The doc doesnt seem too concerned but I havent really been able to talk to him about the strange red occurrence.
ANSWER: I see no reason to fear colon cancer. But in order to be sure I think a colonoscopy is a good idea. Have it done soonest in order to get rid of your worries! Good luck!


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

QUESTION: Thanks Dr. At the risk of sounding like a complete obsessed poop freak, what is worrying me the most at this point is the strange reddish stuff. The hemorrhoid explanation made sense to me until this started happening. It seems to occur in fiber-y poops, mixed in, and it happened again this morning. It looks like blood, but when picked at and spread out it becomes a more translucent red/orange color...almost as if the dark red appearance at first is due to the 'depth' of the stuff. Sorry to give such a detailed poop description, but do you think this sounds like blood? If it was blood from higher up (higher than the hemorrhoids), would it possibly have these qualities? Or would it be different? Thank you so much.

Answer
Colon & rectum cancers only produce red blood in the stools just like hemorrhoids and anal fissures do while blood from higher up (esofagus, stomach and duodenum) usually is black due to chemical changes from the mixture of hydrochloric acid from the stomach into it. I have no idea what it is you have been studying but it does NOT sound like a colon cancer symptom to me! Especially not when your age is considered too. Your dr. should with rather simple tests be able to make sure if there is blood in your stools or not and a colonoscopy should be able to prove or disprove the existence of any colon cancer rapidly with a high degree of certainty! Good luck!