DEAR MAYO CLINIC: I was diagnosed with diverticulitis six months ago. I received antibiotics and have been feeling fine since the diagnosis. But over the past week, I've had blood in my stool. Could this be from the diverticulitis, or something else?
NSWER: Diverticulitis usually does not cause the type of bleeding you describe. Particularly if you're not having any other symptoms, it's unlikely that the bleeding is a result of diverticulitis. However, many other medical conditions can lead to rectal bleeding. Make an appointment to see your doctor to have your situation evaluated.
As people age, it is common to develop diverticula -- small, outwardly bulging pouches within the digestive tract. Although they can occur anywhere along the digestive tract, diverticula are most often found in the large intestine, or colon. Many people who have diverticula are not aware of it because they typically don't cause any signs or symptoms.
In some cases, however, the diverticula can become infected or inflamed, a condition known as diverticulitis. Common signs and symptoms of this disorder include sudden, severe abdominal pain and tenderness, changes in bowel habits, fever, nausea and vomiting. Although rectal bleeding can sometimes be associated with diverticulitis, it's not a common symptom. When bleeding is associated with diverticulitis, it usually does not occur without some other sign or symptom.
As in your situation, antibiotics are often prescribed to treat diverticulitis. They can help kill the bacteria that are causing an infection. In many cases, antibiotics are all that's required to eliminate diverticulitis. The fact that you've been symptom-free for six months seems to indicate your condition was effectively treated with antibiotics.
Although the chances are low that your bleeding is due to diverticulitis, you do need to see your doctor to find the underlying source of the bleeding. In some cases, diverticula can bleed without diverticulitis. This is usually painless and could be the cause of the blood you're seeing. But rectal bleeding can be caused by a wide range of other possibilities, too. Some of these are benign conditions, such as hemorrhoids or constipation, while others are more serious, such as colon cancer. When you have rectal bleeding, it needs to be evaluated.
To determine the cause of the bleeding, your doctor may talk with you about your medical history and ask you about any other symptoms you've noticed. A physical exam along with blood tests may be necessary. In some cases, imaging exams, such as X-rays or a CT scan, can be useful.
Using a scope to examine your colon and rectum, a procedure called a colonoscopy, may also help your doctor uncover the cause of the bleeding. During a colonoscopy, a long, flexible tube, called a colonoscope, is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon. If necessary, polyps or other types of abnormal tissue can be removed through the scope during a colonoscopy. Tissue samples, or biopsies, can be taken during a colonoscopy, as well.
Once the cause of your rectal bleeding has been found, your doctor can develop a treatment plan, if necessary, to address the problem. Because rectal bleeding can sometimes point to a serious underlying problem, it should not be ignored. It's important that you make an appointment to have this condition assessed soon. -- Michael Picco, M.D., Ph.D., Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Fla.
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