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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12565
Experience:  Emergency Medicine and Family Practice for over 26 years
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Not looking for textbook information, Im looking for an answer based on your own obs

Resolved Question:

Not looking for textbook information, I'm looking for an answer based on your own observations in your practice. Please describe the typical manifestation of bleeding from colon cancer - have you observed it to be a one-time visible bleeding that goes away and does not return, or is it recurring and what are the frequencies of bleeds. If you do not have direct experience with colon tumors, please do not answer the question.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. David replied 1 year ago.
Hello, this is Dr. David. I have read your question and am ready to help.

I am a cancer doctor

colon cancer bleeding usually continues and does not stop. it is recurring if there is a cancer in your colon because the cancer continues to bleed until it is treated. not all colon cancer bleeding is visible however. you need stool occult blood testing to check for microscopic bleeding from colon which can also occur. that is why stool occult blood testing is often recommended on years you are not having colonoscopy.

Expert:  Family Physician replied 1 year ago.
Thank you for your question:

There are 2 types of bleeding that are typically seen (both in my personal experience over the last 30 years of practice and based on "textbooks") in colon cancer.

You have ongoing (chronic) small amounts of blood loss (microscopic) that can go entirely unnoticed without occult blood testing AND later in the disease process, you can have larger amounts of bleeding - sometimes massive rectal bleeding.

The occult/microscopic bleeding can occur for months or even years before the tumor has any other symptoms.
Customer: replied 1 year ago.


Thanks. Now another question: what about a one-time visible bleed that seems to have been correlated with an unusual physical stress (exercise, etc.). How does this correlate with tumors? Can a tumor be stressed into bleeding only once?

Expert:  Family Physician replied 1 year ago.
I don't believe that there is any specific evidence that "stress" directly leads to bleeding from tumors.

Isolated episodes of bleeding can occur with a number of conditions (including tumors). Examples include diverticulitis/diverticulosis, ulcerative colitis or Crohn's disease, bleeding disorders (low platelet counts, clotting disorders).
Customer: replied 1 year ago.


Is there any knowledge/studies on physical activity/mechanical stress and rectal bleeding? For example, an individual who has had a few isolated incidents of bleeding (yes they need to have a colonoscopy), that in every case occurs in conjuction with an unusual physical/strenuous activity.


 


If you would like to answer this I will "Rate to finish". If you would like a separate ticket for this question, that is fine too.

Expert:  Dr. David replied 1 year ago.
This is Dr. David

simple physical activity and mechanical activity will not cause bowel or rectal bleeding.

if you have trauma to your abdomen like if you are in a car trash, or you get hit severely in the abdomen and the bowels, you can have bowel trauma, and this can lead to bruising and bleeding of the bowel.

if you are constipated, or are passing large hard stools, this can cause trauma to internal hemorrhoids which can cause bleeding temporarily

if you have a bowel inflammatory condition, like colitis or inflammatory bowel disease, this can cause bowel bleeding

but just exercise, heavy lifting, strenuous activity will not cause bowel bleeding.
Dr. David, Board Certified Physician
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Expert:  Family Physician replied 1 year ago.
I'm sorry I was offline when you responded.

I would have to respectfully XXXXX XXXXX exercise can indeed cause gastrointestinal bleeding.
http://www.ncbi.nlm.nih.gov/pubmed/23548011

http://www.ncbi.nlm.nih.gov/pubmed/23075554

http://www.ncbi.nlm.nih.gov/pubmed/22410703

I hope these reference clarify the previous answer. Exercise could cause bleeding.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12565
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 8 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Thanks for the responses both of you. It's good to see debate and cited sources based on both people's experience and knowledge.

Expert:  Family Physician replied 1 year ago.
You're welcome. Please let me know if I can ever help you again. Have a nice evening.

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