Oncology (General Cancer)/rectal bleeding,

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Question
QUESTION: dr highby,this might be your field of expertise,but I would appreciate if you help me.im 80 and a big hyponcondract.3 years I had a sigmoidscope, the dr found internal hemorrhoids.im constated from all the medicine I take.i usually have to strain to produce bowel movement.once in a while from straining I see a stringy brown mucus with a little red blood on it.there is never any bright blood in toilet or on stool,just the worm like brown thing with blood on it.could it be the rectal lining from straining.im not concerned about cancer,just the straining from hemorrhoids.the sigmoidscope got a good look and all he saw was  hemmrhoids.no colonscopy please I wont take it

ANSWER: From what you are saying, I suspect it isn't cancer;  people with hemorrhoids and constipation frequently have varying degrees of blood in their stool.  I don't understand why you won't have a colonoscopy; I've had several and while unpleasant, they are bearable.  There is a "virtual colonoscopy" you can have in which you swallow a very small camera which looks at your colon (after you've cleaned yourself out) but if something is found you still need to have a regular colonoscopy.  That might buy you some peace of mind.  However, I think you just have internal hemorrhoids and constipation.  

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QUESTION: thank you for the answer.you are a gentleman.another expert would have said cant answer see your doctor.most people today are taking sigmoidscope instead of colonscopy.only 33%of people with blood in stool go to doctot.as part of myother question is it not a good sign if bleeding from rectum has no visible blood on stool.

Answer
The amount of blood and the "visibility" of blood doesn't tell us where the blood is coming from or why.  Obviously if there is a lot of blood that poses a different danger, namely, becoming anemic.  I've taken care of patients with severe anemia who had nothing more than untreated hemorrhoids.  And I've taken care of patients with colon cancer who had no blood in the stool at all.  However, on the whole occasional minimal amounts of blood in someone with hemorrhoids and constipation is probably benign.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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