IBS and Rectal Bleeding

Digestive health
1

Hi All.

Just a quick question to you fellow IBS sufferers that I'm looking for thoughts and views on, hoping some of you can help.

I suffer with IBS-A (alternating), but during a flare up I sometimes get some rectal bleeding, and at the same time get what can only be described as gurgling / fizzy sensations anywhere in my lower abdomen. The flare ups last about a week, but the bleeding goes on for a few days after then stops. I usually go weeks to months before it happens again. During these bouts of bleeding I tend to feel more generally unwell. The blood is bright red, and usually after passing a stool (red blood on toilet paper, maybe a drop or two in the toilet bowl), but has been known to come out before passing one, and sometimes it can look like there are blood clots on the toilet paper when I wipe, however I do produce a lot of mucus with my IBS and wondering if this is a combination of loose stool, blood and mucus. I'm currently going through one of these bouts now, and experiencing IBS-D at the moment, and there isn't a huge amount of blood, but its there. The last time I had bleeding, I was going through IBS-C, and there was quite a bit of blood. This made me go to the doctor, who prescribed me suppositories for heamorrhoids, and at the end of the course of suppositories the bleeding stopped, this was about 6 - 8 weeks ago, but now I'm bleeding again. My doctor has referred me to a Gastroenterologist as he feels a colonoscopy would be wise. I did have a combined colonoscopy and endoscopy a couple years back and all that was found was that I had a very long and mobile sigmoid colon, and polyps which were removed and found to be benign, no other issues.

Sorry to have to be so graphic about my toilet habits, and I hope some of you can give me your thoughts and views on this, especially if you do suffer the same as I do.

Many thanks in advance.

2

You can get bleeding if you have fissures or haemorrhoids cause by straining from constipation.  Try a stool softener to make your stools easier to pass.  However, you are going the right thing seeing GI specialist to investigate the bleeding more since it is still going on..

3

Get the colonoscopy for sure 

4

Paul

I've passed blood like you describe a few years ago when I was suffering from constipation as a result of IBS. However it was only occasional ie fresh blood on paper and little drops in the toilet pan. I had a sigmoidoscopy and they found no issues but I did have inflamed internal hemmeroid.

You should take comfort that you only had colonoscopy a couple of years ago and it was all clear. I think it is unlikely anything serious can develop in that short space of time however it is best to get it checked out.

Good luck, hope things go well for you

5

Thanks for the useful advice Pippa, and I am swaying more towards the problem being a fissure or haemorrhoids, but the bleeding can happen when I'm constipated and straining, or passing loose stools with no effort at all. I'm also linking it to the fact then when I bleed, I feel noticeably more groggy than normal. I remember having a Sigmoidoscopy before my colonoscopy, and during that the consultant did notice slight signs of inflammation and bleeding on my colon wall, and did say to me that this was more than likely the reason for my bouts of feeling more ill than normal, but they never followed that up, and didn't seem too concerned. It's definitely something that needs further investigation to be sure.

Thanks again for the response

6

Definitely on the cards Dave!

7

Thanks for the reply Adam. I do take some comfort from the fact I had a colonoscopy a bit over 2 years ago, and nothing untoward was discovered, plus comfort from the fact that there has never been a history of any serious nasties in my family. My bleeding usually comes in bouts of a few days to a week, it almost always looks like fresh blood, and after passing a stool, I can dab my bottom and there will be blobs of fresh blood on the toilet paper, which indicates more to me that the bleeding is close to the opening of my bum and more than likely a fissure or haemorrhoid. Its just, as I mentioned to Pippa, the fact that I generally feel more unwell when these bleeding episodes occur. Are they linked or is it just coincidence, I don't know!! I have been diagnosed with Fibromyalgia, CFS/ME and Anxiety on top of the IBS, so maybe these bouts of feeling more ill are a combination of a number of my ailments. Definitely going to get it checked out, but I can almost guarantee that when the colonoscopy comes round, I'll be having one of my better bouts and they won't find anything. That'll be just my luck!

Thanks again for the reply and take care.

8

I think the signs of inflammation and bleeding in your colon should have been followed up just to rule other causes out.  Were any fissures or haemorrhoids found during the sigmoidoscopy?

9

Biopsies were taken during my sigmoidoscopy, I remember watching the consultant take them on the screen they use. I know they were going to do tests on them, but I never heard anything back so I'm presuming nothing was found. As for fissures and haemorrhoids, I had quite a weird experience during my colonoscopy. I don't remember a thing, other than the last few minutes when I think the sedative and pain relief were beginning to wear off, probably because I had a combined endoscopy / colonoscopy, and due to my very long and mobile sigmoid colon. I was in quite a bit of pain, but I'm pretty sure I asked the consultant if I had haemorrhoids, and I swear he said 'there's your haemorrhoids' as he was taking the scope out. Everything was a bit hazy during that part of my colonoscopy but I am quite sure that was what happened.

10

I would keep calling your doctor to find out the results of those tests.  They would always tell you if the scan should norhing.

11

I will question this again, but I think I have already and he didn't say that there were any issues found. I also had my polyps tested and they were found during my Sigmoidoscopy, and removed during my colonoscopy. They were found to be completely benign.

However, I'm pretty sure that I have troublesome haemorrhoids or a fissure going on. My stool this morning had a thin streak of bright red blood on it, and a couple drips of blood after. From what others have told me this is a typical sign of haemorroids / fissure. I think the groggier feelings are more of a coincidence than linked to bleeding, my IBS is quite uncontrollable and flares up frequently, as does my Fibro and CFS/ME.

I'll go through the motions of getting it checked out though, always better to be safe than sorry.

12

Have you been prescribed anything for the haemorrhoids? You can get cream or you could try ice to shrink them.  Haemorrhoids and fissures can occur with IBS because of constipation.  Your groggy feeling may be linked instead to your IBS, Fibro and ME since you have a combination of things going on.

13

I got given Anusol suppositories last time I bled, and by the end of the course the bleeding cleared up. I'm pretty sure my doctor would prescribe them again if needed, but compared to the last time I was bleeding, this time it's far less. Are creams any good for internal haemorrhoids?

14

I think you can use creams for both external and internal haemorrhoids which are effective.  However, if the suppositories helped before, ask your doctor to prescribe them again if the haemoorhoids keep causing trouble.

15

Will do. Thanks for all your advice Pippa, much appreciated!

16

Hope it does the trick.

17

Have you already got colonoscopy done this time? If yes, what were the results? I am very corious because I have similar stuff going on as yours, I mean, occasional rectal bleeding and discomfort in my lower abdomen which begins right after I start bleeding. At the moment I am waiting for sigmoidoscopy to be done, so still worried what all that can be.

18

Hi, sorry to hear about your problems, it can be very worrying I know.

I couldn't go for my colonoscopy, I had a bad Fibromyalgia, CFS/ME flare up during the week I was supposed to start my bowel prep, I just physically didn't have the energy to go through with it and was in a lot of pain as well. I'm glad I didn't have it though, as on the day I had to call an ambulance out as I was having excruciating abdominal pain, I thought I had appendicitis or something. After giving me a good check over the paramedics said I was likely having a bowel spasm caused by my IBS. I was dubious about this diagnosis but after reading other peoples IBS experiences, some are left writhing in agony. I know this was probably caused by me trying to cut down on taking Mebeverine, which is an anti-spasmodic drug, for a few days prior to this happening.

I did have a sigmoidoscopy followed by a colonoscopy a couple of years ago and all that was found was very slight inflammation of a section of my colon wall (biopsy taken, no issues found), rectal polyps (removed and found benign) and that I had a very long and mobile sigmoid colon (? volvulus (colon twist / blockage) in the past, not that I can remember).

After paying attention to my bowel movements I am pretty sure my bleeding is caused by straining to pass stools due to constipation. I had an experience last week where I hadn't been for a couple of days, the next day I had an urge to go, but nothing happened, so had to strain quite hard to pass anything. After passing a stool I was bleeding. If my stools are easy to pass I don't get any bleeding, but if they are hard or difficult to pass then I bleed, typical constipation, hemorrhoid and/or fissure symptoms. I can't rule out the pains I get from being part of my Fibromyalgia, CFS/ME and IBS, but I do feel less illness and pain when I go through bouts of constipation, than I do when I am experiencing IBS-D. This doesn't mean I'm not going to try and get it checked out still, I have a doctors appointment next week and will discuss this further with them.

When is your Sigmoidoscopy? Are you bleeding red blood? Is it lots or just some on the toilet paper and/or a few drops in the toilet bowl (bearing in mind a little blood can go a long way)? Does it happen after every bowel movement? What discomfort do you feel? Do you have any other symptoms (bloating, burping, flatulence, nausea, etc)? Answers to these questions can reveal a lot.

Try not to worry too much, I'm sure, like me, it won't be anything too serious. This has been happening to me for a long time and I'm still here and fighting fit (sort of). Would be interested to get more of a background of your problems though.

19

Though I haven’t been diagnosed “formally” with IBS, I HAVE had past bouts with hemmorhoids, and experience similar with bright red blood on my TP, along with some mucus.

       I’ve personally found that my diet has A LOT to do with these symptoms. After 15+ years of incorrect diagnoses and treatments, I was told a couple years ago that my issues are likely caused by an overgrowth of Candida, along with some food allergies.

     For me, going on a STRICT anti Candida diet (no sugars, no carbs, no grains, nothing processed-  basically lean meats, leafy greens, quinoa and berries- strawberries, raspberries, blackberries, blueberries) along with cutting out all nightshades (tomatoes, white potatoes, eggplant, peppers, etc) has a profound and nearly immediate benefit to my symptoms, including bleeding.