What are the chances of this being something sinister?

[witchbitch22]

Posting here for traffic. NC but MN can confirm I'm a long term poster and not a poo troll.

Basically I've had bleeding from my bottom for several years. It's gotten worse in recent years and more often than not I see quite significant amounts of bright red blood on the paper after wiping. I've seen a GP about this naturally and they put it down to piles (which it probably is because I do have noticeable external ones since having my last baby). Prescribed cream and suppositories and sent on my way.

I did have a clear colonoscopy in around 2019 for this (and other bowel issues). I've always had irregular habits which I strongly believe is anxiety related. My anxiety and stress plays havoc with my bowels. It's ok when I'm chilling at home but as soon as I'm out of my usual routine like a holiday or a work presentation or something crops up they go crazy. I have a self imposed rule that I have to use the loo at least three times before leaving the house for these sort of situations which sounds bonkers but after years of having my brain and bowel conspire against me and getting caught short in some embarrassing places, I guess it's a way to feel more in control. Needless to say this hasn't helped the bleeding issue as sometimes I'm almost forcing myself to go.

Anyway I'm adding health anxiety into the mix now because even despite having a colonoscopy 4 years ago I can't shake the feeling that bleeding, irregular bowel habits, having to use the loo after I've just been could all be signs of something sinister. I've said this to my GP, they just make noises about me being too young for bowel cancer.

Do I accept this having had a clear colonoscopy not that long ago? Is it my anxiety that I really need to address here? I just want to feel normal. But I'm worried about everything - shitting myself in public and having some sort of bowel cancer being the main ones.

Anxiety can do amazing things to your bowels.

As you say, forcing yourself to go isn't doing any good as far as your piles are concerned.

You know you have health anxiety, you know you have piles - try to work on the things you know about.

You are not alone! I have irritable bowel that got waaaaay worse after having my gallbladder removed in my 30s. I, too, have issues leaving the house because my anxiety lives in my bowel, I say, not my head, lol. Childbirth also gave me external piles that have never gone away, despite lots of creams and meds. If you are bleeding that badly (and I do agree that bright red blood indicates piles and not something farther up the colon) and that often, talk to your doctor about doing something. I know there are rubber banding techniques and possible surgery. I think it would also be reasonable to tell doc you want another colonoscopy to rule out anything else as it has been 4 years since your last. And if it comes back all clear, as expected, then you and doc can hit the hemmorhoids on all fronts.

This sounds really difficult, OP. @MereDintofPandiculation is right about what anxiety can do. But no one can say with 100% certainty that nothing serious us wrong without examining you.

Have the symptoms been getting worse? Even if they have, the chances are that anxiety is driving this, but it would be prudent to make your GP understand this.

Worst case, if really worried I might save up for a private consultation possible colonoscopy, though I recognise not everyone can afford this. But to prevent this becoming a habit I would use part of the appointment to learn what to look out for in the future and how to break the worry cycle.

I would wager it’s anxiety/IBD. Statistically this is more likely. I wouldn’t panic, honestly.
Do ask them for more tests for your own peace of mind but I think the chances of it being sinister are extremely small.

I have a self imposed rule that I have to use the loo at least three times before leaving the house

You are almost certainly straining too much on a very regular basis and irritating your haemorrhoids.

Given your anxiety I think it's extremely unlikely.

You need to see a therapist, not a doctor. But if you feel like you need to, you could always pay for a private colonoscopy. I feel your money is better spent on a therapist though. Your anxiety is almost certainly impacting your bowel movements, and it sounds like from what you've said above you've developed obsessive/compulsive habits which are exacerbating separate physical symptoms (piles).

I have a very similar history- persistent diarrhoea, bleeding from my bottom, cramps. I had a clear colonoscopy in 2020. My symptoms gradually got worse since. My GP examined me this time last year and I had skin tags and ulceration around my anus then a positive FIT test not long after. I had a colonoscopy in January which clearly showed Crohn’s. I’ve been quite poorly on and off this year with it, in and out of hospital which has been a shocker after the clear colonoscopy a couple of years back.

I’d say it’s unlikely to be anything and from what you’re describing it could very well be related to anxiety.

I would push for some more tests/another colonoscopy though to be sure.

Also wanted to add that it surprised my GP. When I saw him this time last year he was adamant I wouldn’t have inflammatory bowel disease but agreed to further tests because that was what I was worried about. I saw him again in February when I was very poorly and he sent me straight to the hospital where I was admitted and said at the appointment that he was very surprised that I had indeed been diagnosed with Crohn’s. I think I was probably just unlucky!

Thank you for the replies. @elliesmummy19 my initial colonoscopy was to investigate the possibility of IBD as I'd had a positive FIT test ( that's the lovely one with the little spoon and test tube I believe). But I was discharged after the colonoscopy and given the all clear.

I think my age, the ridiculous NHS waiting times and the fact that bowel cancer tends to be slow growing so even though it was 4 years ago, it was still pretty recent by those standards...all these things seem to be stopping the GP from referring me again. And they probably think I'm neurotic too which I guess I am a little bit. No idea how much a private consultation or colonoscopy would be. Any ideas anyone? It's probably not necessary my symptoms are all red flags for bowel/rectal cancer even though logically I know they are probably being caused by other things.

I have had CBT for the anxiety. Tried medication (citalopram and beta blockers), mindfulness, yoga but I still can't seem to break that brain/bowel link, it's very debilitating.

Could you try having linseed every day with your breakfast. It softens the stool and helps keep you regular. The fact that your piles keep bleeding makes me think something like this would help.

After a lifetime of very dodgy upset bowels and stomach, I was prescribed Mebeverine last year.

And only because it was my adhd titration doctor, who was concerned about it (and my adhd meds make it a million times worse).

Mebeverine isn't perfect but helps.

Why don't you ask GP for another FIT test?

If I'm stressed anxious or worried I do what I call a rabbit poo. A worry poo essentially. If rabbits are scared they do a poop.

To me it sounds like you are anxious and that's causing the issue not any bowel cancer.
Do you have mucous in your poo?

Occasionally but this is another symptom of piles I think :-/

Another thing I should have mentioned is that sometimes I can go a few days without a BM and then when I do go I need to go again, urgently, quite soon after. It's like my bowels go to sleep and are inactive for a few days then they wake up and go into overdrive, which again doesn't do my piles and anxiety issues any good. Is this quite normal for IBS/IBD for those who've experienced them?

I know the only way to get answers is to see a GP again but each time im having to take unpaid leave for appointments just to get fobbed off, it makes me feel like it's not worth bothering with. And maybe it is all in my head.

I have the same issues as you, I had high calprotectin, so had a colonoscopy 2 months ago, the Dr's were saying it was likely crohns, but the colonoscopy was clear apart from 1 poylp which was removed! I have been referred to gastroenterology as my my diarrhoea flare ups are still bad. I've been prescribed amitriptyline now to see if that helps, Google IBS and amitriptyline and have a read and see if that is something your Dr would let you try.