Rectal bleeding confusion: endo/haemorrhoid/rectal cancer?

[Hana98]

I have been having haemorrhoid symptoms and occasional rectal bleeding for 5 years.After a first colonoscopy I was diagnosed with internal haemorrhoid.

I had a child.all natural bowel issues after labour.

So this is now the fourth month I have rectal bleeding while I am period.( Had very little one in middle of month too)I am referred to two departments. Colorectal and Endometriosis.

When the colorectal surgeon saw me last she said she can't feel any haemorrhoid and asked to come back on my next period when I am bleeding so she can see if there are leakage.( I had a coloscopy last year that showed piles).I could not go as I had no one to take care of my child.

The Endometriosis appointments are still one or two moths away.

The rectal bleeding is only when I have Bowel movement. The blood is bright red. My BM is not painful. I take fybogel and have a diet to keep stool soft. Some times during the month ( not period times),I get a very sharp pain in my rectum that lasts few minutes and then goes away.If go for a fast walk,I rectum ( on the left side) gets painful.

Questions:

I know endometriosis clinics also have colorectal specialist. Do they usually look in to haemorrhoid to rule it out?

Is that colonoscopy a year ago enough o rule out cancer?like ractal cancer?

Do I have to push for 2 week referral from my GP or just sit and wait until it gets worse?

I am just so confused about what is wrong.

[Nicole_GCCA Partner]

Hi Hana98 ,

Thanks for posting here and I'm sorry to hear about your symptoms and we understand how worrisome it can be to see blood when having a bowel movement.

It really varies from where you live/what hospital or doctor's practice you go to - but we have many people who have also had rectal bleeding and doctors have discussed/investigated to see if endometriosis is involved.

When you have multiple doctors that are seeing you for different symptoms, it is important that they are consulting with each other and keeping each other up to date on what tests they are performing, and also speaking to you about this as well.

If you are experiencing symptoms now, they may want to do a colonoscopy to see what is going on now, because images from your colonoscopy last year will not tell them what is going on with you today.

It sounds like you have clear directions from the doctor to see her when you are on your period - do you know when that will be? Is that appointment scheduled yet or do they want to call them when you start your period?

I know it can be frustrating to not know what is going on and to be waiting for an appointment.

If you ever are having extreme pain remember to contact your doctor or seek immediate medical attention.

~Nicole, GCCA Staff Member & Colon Cancer Connected Site Administrator.

Just a reminder - this group is here to offer support, share experiences, and offer our thoughts - but this is not medical advice, and you should always consult your medical professional(s). Additionally, for all emergencies, seek urgent medical care, never delay.

[Hana98 in reply to Nicole_GCCA]

Thanks for your great advice Nicole. I lost one appointment on my last period ( again with rectal bleeding) as it happened earlier than I expected so now I am booked again for the day I think I will period again next month. I hope I get my period on that day.It is Hard to exactly guess.So far the colorectal surgeon thinks I don't need another colonoscopy as I had one last year. Is it something I can ask for? and if they say no, do you think if I suggest a sigmoidoscopy it would be a good suggestion?

I still have not seen the endometriosis specialist but before I see him ( I might see him private), do you think I can get the notes from colorectal surgeon to show endometriosis doctor? Are doctors allowed to just print their notes for you to take to another specialist?

So far,I am fine in terms of pain and bleeding between periods. Can I go to A&E is there is pain and bleeding?

[Nicole_GCCA Partner in reply to Hana98]

Most importantly - if you are in severe pain, you should always seek emergency medical care. For people who experience frequent rectal bleeding, they will discuss with their doctor at what point is the amount of blood an emergency. This can be hard to measure but when in doubt, seeking medical care is very important.

Regarding the colonoscopy, see what the other tests they perform show, but it is totally reasonable to ask for another colonoscopy since your last one was a year ago.

For patient rights regarding your records - this may vary depending on which country you reside in. In the U.S., there is a law called HIPAA, which is the Health Insurance Portability and Accountability Act. Under HIPAA, patients do have the right to request a copy of their medical records. The only information that may be withheld is psychotherapy notes.

In regards to your doctors consulting about your case, again, depending on where you live and if the doctors are part of the same practice, you may need to fill out a form to provide written authorization for your two doctors to discuss your case.

Patient portals that are online and have the ability for patients to view and print test results are really great, and if your doctor offers this service, we recommend that you do use it. You could print several copies and keep in a binder that you bring to all appointments.

Regarding your period - if you should get your period early, do call the doctor and let them know, perhaps they will be able to see you earlier. Or if you haven't gotten your period yet and you are supposed to go to the dr.'s office that day, you may want to see if they can move you a day or two later.

We know how stressful it can be to work with multiple doctors, advocate for tests to be performed, and also ensure that your doctors are speaking with each other about your tests and the plan for moving forward.

Please keep us posted and we'll be thinking of you!

~Nicole @ GCCA