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Why Multiple Bowel Movements In A Short Period Of Time With Hemorrhoids?

Posted on Fri, 28 Jun 2024

Question: Background. I had borderline anemia five years ago. I also had a positive fbot test but my dr never called me with those results. I changed dr a couple of weeks later and had bloods redone and the anemia was gone. In the past five years I have had 7 blood tests all were normal until this past September when I was borderline anemic again. I did a fbot test since I’m 47 now and all 3 of those were negative and I also did 6 at home fbot tests the kind where you put the tissue in the water and all of those were negative. My question is, is it possible to have bleeding from the colon for six years and not have visible blood in my stool and for it to go undetected and not get worse over that time and never show to be anemic just until seven months ago? I have had blood on the toilet paper before. I have had this happen since I was a teenager and it was never on the stool just the paper, but that usually happens if I have multiple bowel movements in a short period of time. I also have hemorrhoids. Two years ago they were so bad it hurt to walk.

Thank you

Follow up: Dr. Ramesh Kumar (8 hours later)

I also forgot to add I have had multiple negative fobt tests. My dr had me do 3 at my last appointment and I also have done 10 at home tests in the past two years. They were the EZ Detect brand when you use the tissue in the toilet.

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
Please go through detailed answer.

Detailed Answer:
Hello,
Have seen the details and blood report sent by you,
You have Hemorrhoids and most common cause of blood seen on tissue paper is hemorrhoids.
With a history of 4-5 years,Any bleed from colon would have been easily seen in stools.
You stool test is negative for blood.
Your problem is related to hemorrhoids and I don't think that colon is related to it,However if any one in your family has history of colon carcinoma then a colonoscopy can be done for prophylaxis.
Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (3 hours later)

Thank you. My dr said my mild anemia was not concerning since I had no symptoms. He told me to look out for change in bowel movements and black tarry stools which I have not had. Could I also assume that if I had a bleed from the colon for 5 years my anemia would of gotten worse? I consulted another DR on line and he said I wouldn’t have colon cancer for that long but it’s possible I could have tested negative on all 12 of my fobt tests for the past two years but still had bleeding polyps.

Follow up: Dr. Ramesh Kumar (5 hours later)

My Dr also said my high bilirubin might cause my mild anemia. I have been diagnosed with Gilbert’s Syndrome and my bilirubin will get as high as 2.6 or 2.8 at times.

Answered by Dr. Ramesh Kumar (4 days later)

Brief Answer:
Follow up.

Detailed Answer:
Hello and thank you for follow up and sorry for a late reply,I had a covid infection and so can't reply,
See blood from colon would have a black tarry charcoal like appearance.
Yes having a benign polyp could be a possibility but it's benign as you have it from 4-5 years,
So 99% it's from Hemorrhoid and 1% from colon polyp. XXXXXXX could be a possibility but again patient remains asymptomatic so nothing is required to be done.
However to be on a very safe side a check colonoscopy can still be done to make things 100% clear.
Please feel free to follow up n regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (4 days later)

Sorry to hear about your infection. Since we last spoke I did take a couple of over the counter stool tests. I took 6 of the kind with the tissue paper in the water all negative. I also took two 3 fit tests over the counter the first two were negative but the last one was positive. All of these tests were from different specimens. I booked an appointment with my dr he ran labs on me and all of my values were better than last time. RBC were a bit below normal and HGB was normal and HCT a bit below again. He ran an iron panel and all was normal including a sed rate test which was also normal. He did refer me for a colonoscopy but over the past 7 months I have taken probably a total of 20 stool tests including the 3 fit tests from my DR in September and 19 have been negative. He thinks my chances for something something serious is very small and thinks I had the positive fit due to my hemorrhoids. Would he be correct in his assessment? So a polyp would be bright red and colon cancer would be more like a tarry blood?

Answered by Dr. Ramesh Kumar (11 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Your colonoscopy will be normal.
Mild anemia is due to hemorrhoids.
Don't worry,
Plus don't worry about numbers. We treat patients and not numbers.
You have Hemorrhoids and some time the test is positive for blood due to hemorrhoids only.
Don't worry your doctor is absolutely correct.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ramesh Kumar (2 hours later)

Thank you for answering my questions. I hope you feel better I have had covid twice. Very minimal symptoms both times. I guess I can attribute that to being vaccinated and boosted.

Follow up: Dr. Ramesh Kumar (22 hours later)

I was curious about my borderline anemia. My rbc and hct were still low albeit just under the low reference range but my iron panel and ferritin are all normal. I assume that rules out iron deficiency anemia since iron is normal? My hgb and mcv are also normal. My values also do not support anemia of chronic inflammation. Any idea why my rbc and hct counts are consistently low or near low and everything else is normal?

Thank you

Follow up: Dr. Ramesh Kumar (24 hours later)

My dr just called me my and my reticulocyte count was high at 5.7. I have had borderline RBC and HCT now on my past two lab tests while HGB has been normal. And my MCV is also normal, but I have a high MCHC and slightly elevated RDW. I have high bilirubin. All my iron tests are normal. My dr has referred me to a hematologist. What do you think might be causing this? I am concerned about chronic blood loss, but woudnt that cause a drop in my iron levels? And I do not have that.

Answered by Dr. Ramesh Kumar (24 hours later)

Brief Answer:
Follow up.

Detailed Answer:
Thank you for follow up,
Reticulocytes are immature RVC.
Whenever you loss blood body starts producing reticulocytes in bone marrow.
Actually thing is that as a doctor I can't treat numbers rather I treat symptoms...In easy words there are atleast 1000 parameters in your blood and even the fittest person on earth won't have all those parameters in normal limit ...because there is nothing called normal...normal limit means that you fall under 95% of people ..Suppose if a test is done on 100 people and 95 of them has value of hemoglobin in range 14-18 then books label this as normal hemoglobin level ...but what about the 5 people who don't fall in this category...
Hope you are getting what I mean to say.
Unless you are symptomatic these things mean nothing( slight variation of some parameters)..
Hope this clears your query.
Please feel free to follow up.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar