Step 4: Read and complete the decision guide to learn more about your symptoms.
The most likely diagnosis to explain your bleeding is hemorrhoids. Because you are approaching the age when cancer risk increases, you should confirm that your bleeding is coming from a hemorrhoid or another benign problem, or else you should be examined for polyps or cancer. Your bleeding should only be attributed to hemorrhoids if hemorrhoids are visible during a doctor's examination and if they are actively leaking blood during your doctor's inspection. If your doctor sees actively bleeding hemorrhoids beneath the surface of your rectum, then most experts would agree at your age, you may not require further testing. Further testing may be required in the future if your symptoms persist or you develop additional symptoms that are concerning for polyps or cancer.
An inspection of your anus and rectum will be necessary to confirm your diagnosis of bleeding hemorrhoids. A lubricated hollow cylinder called an "anoscope" may be used by your doctor during your examination. This hollow tube is approximately the diameter of a normal bowel movement. It can be pushed gently against your anus and inserted four or five inches into your rectum so that your doctor can view your rectum.
If hemorrhoids are not visible and actively bleeding at the time of your examination, you should have a more thorough evaluation to check for colon polyps or cancer. A colonoscopy is the test that is most likely to be recommended for this purpose.
Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some do cause pain, particularly if a blood clot forms, creating a "thrombosed" hemorrhoid.
Colon polyps are bulges of intestine tissue that dangle or protrude into the hollow of the colon. They often bleed. Polyps need to be removed because they may form cancers if they are left within the intestine.
Colorectal cancer is the second most common cause of death from cancer in the United States. It is preventable, if colon polyps are discovered and removed. Colorectal cancer can be cured by surgery if it is found at an early stage.
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