Brief Answer:
colonoscopy alone can't rule out GI-bleeding..

Detailed Answer:
Hello Dear , Welcome back and thanks for following up,

I've gone through your query and understand this trouble some period that your passing now..

Yes passage of blood and blood clots can indicate GI bleeding for sure , now the source is needed to be narrowed down in order to establish a proper management..

Well to be specific, I need to tell you that the standard Colonoscopes (the device be it rigid or flexible) can only pass through up to a certain distance in our colon , the upper point of distance is the Sigmoid colon and / Recto-sigmoid junction..

If the source of bleed is above that, then the colonoscope can't capture it, so that's why when you're on the preparation, you passed those blood clots..

The same principle applies for Upper GI endocopes as the scope can't pass after a certain point of our Duodenun, so in between these two procedure there's quite significant distance of the gut which is left uncovered by these two..

Mostly these two procedures cover up the maximum and most common regions of bleeding but as obvious , nothing's prefect !!

So there are other techniques available to detect those regions, i.e. MR-angio of abdomen , CT-Angiography of Abdomen and the widely popular Capsule Endoscopy - with these also, not all those parts are perfectly covered but at least the most of them are..

Haemorrhoids are different as they also cause bleeding but always in Fresh form (bright red color) so it's quite unlike that those clots are due to any haemorrhoids..

So I hope now you understand why there's so many possibilities of bleeding, and for them different investigation modalities are available, you can discuss this with your Gastro-enterologist in details.. I certainly hope he'll provide the best suitable option for you..

Well Gluten free pizza dough is available on request at selective outlets , you need to specify it to them at the time of ordering, but the main culprit here is the Cheese which can aggravate your IBS, so my advice would be to avoid them for the time being..

Even if your doctor had taken biopsy during the procedure , still it's quite unlikely that'll cause bleeding after so many days (unless you're on any kind of blood thinners or having any bleeding disorder, Do You ??)

Don't worry and go ahead with the discussion, let me know how it goes..

Take Care
Kind Regards

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Brief Answer:
Nothing to worry, however routine and timely follow-up to continue..

Detailed Answer:
Welcome back Dear,

Since your not aware of any bleeding disorders, then most likely they are not causing this, and thyroid problem has no role in this, so relax..

It's good that the due physical this time will come handy..while doing physical , make sure they include a LFT, Coagulation profile along with the usual Haemogram ..

Well, Lower GI bleed , if persists for a longer duration, can contribute to significant loss of Hemoglobin and other complications, to avoid them , I'd definitely advice to book appointment to your GASTRO at the earliest..(you can understand that smaller amounts can get certainly bigger and much alarming, so it's always wise to control it before that situation even arrives..)

Proctologists generally deal with the lower GI-part and the surgical approaches, so it's better to get assessed by the Gastro and he feels like , he himself will refer to either GI-surgeon or Proctologist..

Best part of those tests are, none of them are too invasive !!

In CT/MR Angio, they'll push a XXXXXXX through a small IV line in you(after confirming that your kidney function is intact ), and all you have to do is lie down in side the scanner while it'll capture those images..

In Capsule endoscopy , you need to swallow a small capsule(just like any regular capsule ), containing wireless camera will pass all the way down while capturing images and you wearing a belt ..this needs an overnight preparation like other endoscopic procedures, but not all centers have this so you may need to search for it ..

Also the decision for a suitable investigation is exclusively based on your specialist, they'll do what they feel suitable for you, so just let them choose for you in the beginning and after hearing their decision, you can put forward yours..

It can be polyps(which is again quite treatable depending on various factors), but at your age, it's quite unlikely to be cancer (I can understand the concern, but there are several factors- age,family history,smoking,alcoholism,few genetic inheritance,some particular food habits etc. needed for one to actually get cancer)..

So don't worry and get investigated thoroughly at first ..

Let me know how it goes..

Kind Regards
Take Care

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Brief Answer:
not necessarily ..

Detailed Answer:
Hello Dear , Welcome Back,

Well I've seen your colonoscopy report done 7 yrs back , it was suggestive of benign growth so nothing to worry..

I believe it's the same Gastro who performed it 7 yrs back , in that case he's even more thorough with your findings..

So during Colonoscopy if the doctor gets any finding , he'll definitely take sample for biopsy but if there was nothing significant or suspicious then he won't..

So you can simply ask him about the findings and whether he has taken the sample for biopsy or not , you'll get to know..

Like I've said , not to worry , just be clear with your doctor and he'll definitely clarify all of your doubts..

Let me know how everything goes in the due course..

Take Care
Kind Regards

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Brief Answer:
not necessarily ..

Detailed Answer:
Hello Dear , welcome back ,

Yes , like I've explained previously, if the findings are normal or they don't find any thing suspicious then there's no need to take any biopsy..

Once again, I'm telling you that the cause of bleeding can be multifactorial and varies widely depends on different locations .. It can even be a combined effect of some other pathology high above in the intestine along with the Large Hemorrhoid..

So just schedule the appointment and have a detailed discussion regarding the next course of investigation and let me know if you need any kind of clarifications..

Take Care
Kind Regards

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