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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18888
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hell I am a 29 year old healthy male with no medical issues.

Customer Question

Hell I am a 29 year old healthy male with no medical issues. The day before yesterday and yesterday I had a lot of spicy food and I got a little bit constipated. I went to the toilet and I was a bit forceful when using the toilet and when I wiped there was some blood bright red blood. I was a little concerned about this. Later on in the day I squated down to take a look with a light and a mirror to see if there was a fissure and when I squated the pressure from squating caused some small bleeding. I was a little concerned as to whether this might be cancer or if it could hemmroids or piles. I just wanted to have an opinion based on what I have written above. Thanks
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. D. Love replied 4 years ago.
Thank you for using JustAnswer. I would be glad to assist you today.

Although it is impossible to make a specific diagnosis over the internet, the most likely cause of this bleeding would be a small tear or fissure related to the passage of the constipated stool. It is also possible that there is an internal haemorrhoid, but this would usually take longer to develop. As an aside, piles is simply a layman's term for haemorrhoids.

A single episode of blood when wiping after a forceful passing of constipated stool is not worrisome. However, persistent or recurrent episodes would be more of a concern. At your age, it would be very unlikely to be due to cancer, unless there is a strong family history of an inherited cancer syndrome. There are some other worrisome conditions that can occur in this age group, primarily inflammation of the rectum (proctitis) or a local manifestation of a more generalized inflammatory bowel disease.

At this point, it is reasonable to see if the problem resolves. It is appropriate to continue to manage the constipation, such as with a stool softener. If the problem is not persistent or recurrent, then there is no reason for further concern or evaluation.

If you have any further questions, please let me know.

Customer: replied 4 years ago.
Thank you for your response I have some further questions. I do not have any family history of cancer. I also wanted to ask when you say recurrent episodes could be a little worrisome what would recurrent episodes indicate? What is the most common symptom of cancer of the rectum or colon? My stool patterns have been normal only yesterday I had to force a little when going to the toilet. I have been to the toilet today and there was no blood when wiping. I have experienced this in the past and there was a burning sensation and it felt as though the anal area was hot. Can spicy food irritate fissures or hemmroids. Thank you for your response?
Expert:  Dr. D. Love replied 4 years ago.
Most recurrent episodes are also due to haemorrhoids or fissures, but the worrisome condition would be proctitis or inflammatory bowel disease, as noted above.

The most common symptom of cancer of the rectum or lower colon are bleeding or altered bowel habits, but it is unusual for these symptoms to indicate cancer in someone of your age. If your were 59 instead of 29, the answer would be different.

Some people notice that spicy foods irritate anal conditions, but from your description, it is more likely to be due to the constipation.

Customer: replied 4 years ago.
Thank you for your response I still have some further questions . I only had constipation for the past day or so today I went to the toilet normally and there was not any bleeding. But I have had some itching in that area today. My bowel movements are normal and there have been no significant changes. Would you say this sounds like hemmroids or fissures? I know fissures are normally quite painful and I have not had much pain with this.
Customer: replied 4 years ago.
Hello I have still not recieved a response for the question below I am not sure if you received the initial question.
Expert:  Dr. D. Love replied 4 years ago.
I'm sorry for the delay, but I had stepped away from the computer when I hadn't received any follow-up questions after a while.

Itching is non-specific, as it can occur with any of the conditions noted above. Itching can occur during healing of many conditions, even if it does not occur as a primary symptom of that condition. If you have ever had minor surgery of the skin (such as removal of a mole), you may have experienced this, as many people experience itching as the skin heals.

Certainly, pain is common with tears or fissures, but a small tear or fissure frequently may only have bleeding.

Customer: replied 4 years ago.
Sorry to keep coming back with questions but would you say this sounds like hemmorhoids? You don't think there is a risk of cancer? What is the main symptom of colorectal cancer?
Expert:  Dr. D. Love replied 4 years ago.
I have already answered these questions above.

Customer: replied 4 years ago.
But you didn't mention what you feel could be the cause of this I am sorry of I am repeating myself but I just wanted to have some confirmation.
Expert:  Dr. D. Love replied 4 years ago.
Yes, I did. It is in my first answer.