Rectal Stump Bleeding: Seeking Advice

Hello, I'm a new member and hope to get some help. In my 5th year after bowel cancer and all my MRI and CT scans and blood tests are good.
Since 3 years, I have sometimes had bleeding from my rectum, and my doctor advised me to irrigate water (special) daily with a plastic injection. Sometimes it's okay after one day, sometimes after 2 days. But it was never a lot. Since 4 days ago, I have had daily blood coming out and I'm not sure what to do. I went to the GP for a blood test, but all is perfect.
Not sure what to think about it. Can anyone help, please? Gabi

Hello Gabi.

Sorry to hear that you are having this sort of problem and I am disappointed that your GP has not given you an adequate explanation for your bleeding. Bleeding  can be caused by a whole host of different things, so it is best to have a medic  investigate it and give you an acceptable explanation. If you don't get that, then I suggest you ask for a second or third opinion. If the bleeding is not serious then at least you will have peace of mind, which is very important in these matters. 

I occasionally have bleeding from my anus but it usually stops in a day or two. If you are irrigating, then it could be that you have slightly damaged the tissue either internally or, more likely just at the entrance. These minor lesions soon heal up on their own. However, it is as well to identify what has (or may have) caused them, as you might be repeating the problem. Sometimes the irrigation tools /catheters get very slightly snagged and those snags can be sharp enough to do damage. Also, it is always a good idea to make sure your fingernails and cutical skin  are well and smoothly manicured.   The smallest of tears can cause quite a lot of blood.

Also, I find that the colour of the blood will give me some clue as to where the damage might have occcured, If it is bright red, then often the damage will be near the external surface ( I can usually confirm this by using a soft tissue to dab the areas where I think it might be). If the blood is darker or globby, then it is more likely to have been internal and there for some time before coming out. These incidents seem more concerning because they could mean something more serious than simple surface damage. I sometimes suffer from an anal prolapse which is not always noticeable as it can go back in on its own. However, damage can easily be caused by the soft tissue being abrased by clothing, and if it then disappears back into the body, I woud not know what was causing the trouble, if I had not identified it as having happened before. 

Like I say, these problems need to be properly identified by someone who knows what to look for.  I saw one or two doctors  who said there was nothing wrong- then I met one who asked me to squat - standing on the rim of the toilet so that he could get a better look. He immediately diagnosed a prolapse, which would only be noticeable in this squatting position (which incidentally is also the sitttng position). When I simply laid down for an examination it hadn't showed up and when I stood up, it went back in.  I was simply glad that I had found a doctor that knew what to look for and how to find it.  The explanation made perfect sense and now I can take precautions based on some sensible advice. 

I hope you find a solution soon as these 'bloody' problems can be quite worrysome.

Best wishes

Bill      

Dear Bill,

Thank you so much for replying, and I will take your advice to talk to another doctor. Your answer has given me a little more freedom and not be so worried. My blood is very light and not at all dark. It could be that I damaged the rectum when entering, but I will check it out more. Thank you very much.

Kind regards,

Gabi

Hi, Gabi - and welcome to this site!

I had a proctocolectomy with end ileostomy in August of 2017, related to ulcerative colitis, not cancer.

For about 1 1/2 years after the procedure, I would intermittently pass B-shaped surgical capillary clips through the anus. I noticed brief, very light bleeding followed by the passing of one or more of the titanium capillary clips within about a day. I also experienced heavier mucus production at these times, I believe due to irritation of the mucosal tissues by the loose clip(s).

Perhaps the bleeding you experienced early on after your surgery could be explained by capillary clip expulsion, perhaps not. My experience doesn't sound like your current issue, however, and I agree with Bill that your seeking a second or third medical opinion is very wise.

Wishing you the best!

Lily17

Hi Gabi, maybe I missed it but what kind of ostomy do you have? I had the J Pouch which is now disconnected. The pouch and rectum are still there. I use a steroid foam sometimes to bring down inflammation in the rectum area, just inside. The smallest applicator is way too big and rough to put up there, inside without scratching the sensitive delicate flesh inside. When I use it now, I put some on my finger and spread it inside as much as possible without the applicator nozzle. Bill pointed out the need for fingernail trimming and scrubbing if you do this. A tiny scratch can leave you open to a very painful infection. A scope of my J Pouch scratched me inside and gave me a huge abscess just inside....3 weeks in the hospital because sterile "packing" is required to recover. An abscess or a scratch can ruin your whole month!!

If the blood is bright red, then it has not been through your digestive system and the problem is close to the exit. Darker or black (occult) blood means that the problem is further up the line, stomach or intestines. A few applications of the steroid foam works great for me and a course of Flagyl for a week.

If you put your bare fingers anywhere inside or around the opening, make sure they are scrubbed clean...better again use latex gloves. An abscess will put you out of action...flat on your back...for a couple of weeks. I personally have never felt pain like you get with an abscess, exceptionally painful.

I hope you went straight to your doc about the bleeding. Usually harmless but you need to know. At a pouch scope attempt that failed, the examiner said that the inside rectal area looked like raw chopped liver!!! And felt like it!! See your doc.

Eamon

Thank you, Lily. I now have an appointment next week to see a specialist.

Gabi

Thanks Eamon

Will get that cream and try it. Booked for next week a specialist and hope to get more answers.
Gabi

Hi Gabi, the foam comes in a small compressed gas tube (4 inches). The full name is "Colifoam". Just a little dab goes a long way. I found Flagyl to be fantastic for this also because of an infected scratch. As I say, the way to avoid scratches or nicks is to use a gloved finger. Amazing stuff.

I have never heard about those internal surgical clips coming loose and out the butt!! I saw an X-ray and I have more than you could count!! Never had one come out of me!!! Happily!!

Eamon

Hi Eamon

I looked around on the web but this is not available in the UK. Can't find anything similar.
Hope when I see the doctor next week he can tell me more. Thanks for coming back to me

Gabi