Worried about blood in stools

Q: I am in my early 20s. Two years ago, there was blood in my stools so I saw a doctor at a polyclinic who referred me to a specialist.

I did some research first and found that one symptom of colon cancer is having blood in your stools. At that time, I had no family history of cancer. However, last year, my father had a polyp in his throat. He was successfully treated for it. Recently, blood (very red) reappeared in my stools. Should I see the specialist again?

A: As you are in your early 20s, common causes of rectal bleeding would be haemorrhoids (piles) and anal fissure (tear in the lining of the anus). Given your young age and the absence of a family history, colon cancer would be less likely.

Colon cancer usually occurs in people older than 50 years of age, with rectal bleeding as one symptom, as you have rightly pointed out. However, tumours can be found in younger people.

When you first saw your specialist, he would have taken a detailed history regarding your rectal bleeding and conducted a physical examination (including a scope examination) to determine the cause.

Your father's discovery of a throat polyp will not predispose you to colon polyps or cancer. Only a specific family history of colon polyps, particularly in a close relative, is a significant risk factor.

Generally, bleeding from haemorrhoids (cushions of blood vessels in the anus) is painless. Sometimes, protrusion of a lump at the anus may be experienced. In contrast, bleeding from an anal fissure is associated with moderate-to-severe pain.

You should see your specialist to seek his advice on your recent rectal bleeding. Appropriate treatment, depending on the cause, may be needed to prevent its recurrence.

Dr Wong Kutt Sing

This article was first published in Mind Your Body, The Straits Times.