What is the Cause of Seeing Fresh Blood When You Go To Toilet in a 50 year old?
Seeing fresh blood when you go to toilet can be caused by alot of factors.
But at that age of 50 years and above colon or rectal cancer must be ruled out completely.
Colon/rectal cancer is a strong differential diagnosis in this age group.
Case study: Mrs xyz, a 51 year old woman. She presented with bleeding through the anus which started about one year ago. The bleeding started very gradual and later became serious. There was associated pain anytime she goes to toilet. It was also noticed that she has lost weight. <p>When she was examined, a bleeding mass was found inside her rectum. A tissue from the mass was taken to the lab for analysis to find out if it is cancer or not. The result of the lab came out as a rectal cancer. But she was lucky, it has not spread to other organs. So she was booked for surgery. The rectum containing the tumour is going to be cut out and the remaining part of the colon joined to the anus. </p>
What is colorectal cancer?

Cancer means when there is abnormal, uncontrollable growth of the tissues. When the cells of your colon grow without control, cancer results.
The colon is the large intestine responsible for digesting and absorbing foods you eat.
Other symptoms of colon/rectal cancer include:
1. Feeling of always wanting to go toilet even when there is not faeces in your colon.
2. You constantly have constipation (hard feces) or diarrhoea or alternating constipation and diarrhoea.
3. Pain in your abdomen
4. Weight loss
5. Sometimes, you may not have any other symptoms especially in the early stages.
When to see the doctor
Bleeding from the anus when you go to toilet is an ominous sign. You need to see your doctor as immediate as possible.
Your doctor may need to do a colonoscopy .
What is colonoscopy ?
Colonoscopy is the use of a tube with a light source to view the inside of your colon and rectum, to see what’s going on there.
It may cause you some mild discomfort, but some drugs will be given to you to prevent pain.
With colonoscopy, your doctor will see inside of your colon and tell you if there is any tumour inside there or not.
Other Tests that could be done are:
1. Barium Enema: Here a dye is injected into your colon and an X-ray taken.
This will outline the inside of the colon, and delineate any mass inside.
2. CT scan / MRI of the abdomen: This is the imaging your abdomen. It will show any mass inside the abdomen.
Other Possible causes of fresh Bleeding from the Anus when you go to toilet include:
1. Haemorrhoids (Pile) : Haemorrhoids occur When the veins in your anus are engorged with blood. This makes them swell up and protrude through the anus.
Haemorrhoids are treated by surgery – haemorrhoidectomy .
2. Anal Fissures : Apart from bleeding Anal fissures can also present with severe pain during defecation. Anal fissures are tears in the Anal canal.
Anal fissures are treatable with examination under anaesthesia where tumour is ruled out first and the Anal sphincters relaxed to allow the fissures to heal.
3. Diverticulum of the colon: Diverticulum of the colon occurs when there is an outpouching of the lining of the colon. This can cause bleeding through the anus.
4. Peptic ulcer disease : This too can give you bleeding through the anus, especially when it is massive.
Conclusion
The age of 50 and above is very delicate for things like this. In case you are seeing blood when you go to toilet, you need to report as soon as possible.
The woman in the case study above noticed her own about one year ago. But she could not report to appropriate hospital. According to the brother-in-law she reported to one hospital like that, and she was falsely reassured that it was haemorrhoids. Only for the thing to escalate up to this point.
This also has its own lessons. You should know type of place you go in the name of hospital. Many persons claim to be doctors but they are not.
Even doctors have areas of specialization. You should be sure of where the doctor you are seeing specializes. If you are not satisfied you may go to a teaching or general hospital.
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