I bleed after straining to pass stool. Should I go for a colon check-up?
Colonoscopies are recommended for patients who have had rectal bleeding and are above the age of 50.
Q. I am a 51-year-old woman. Once in March and once in April, I noticed there was blood in the toilet bowl after my bowel movements.
I had strained to pass hard stool but I do not suffer from piles.
I drank prune juice and was able to clear my stool the next day. Things seem to have been well since then.
I wonder if I should go for a thorough colon check-up. I had a full body check at a clinic six months ago which included blood, urine and stool tests and I was certified well.
A occasional rectal bleeding is not uncommon, especially in times of constipation, when one has to strain to pass stool.
Bleeding on these occasions is often related to minor injury to the haemorrhoidal cushions (vascular structures in the anal canal which help with stool control), even if piles is not a problem.
This is the most common cause of rectal bleeding.
The injury is superficial and should heal on its own.
Constipation can be eased by taking food containing fibre, for example fruit and vegetables, and drinking plenty of fluids throughout the day.
The recommended daily fibre and fluid intake for an adult is 20 to 35g and 1.5 to 2litres respectively.
There are several other causes for passing blood in the stool, including polyps and rectal or colon cancer.
Colon cancer is now the most common cancer in Singapore. Every year, 1,500 Singaporeans are diagnosed with it.
As the risk of developing colon cancer increases with age, we usually recommend colonoscopy to screen patients who have had rectal bleeding and are above the age of 50.
Dr Bettina Lieske
Associate consultant at the division of colorectal surgery at National University Hospital
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