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Hemorrhoid bleeding versus colon cancer
Feb 7, 2005

Hello again, Recently have been diagnosed with HIV,low CD4 count, high VL. On Sustiva/Combivir. This is embarassing but I am too scared to get things checked out as I don't want anymore bad news at this point. Last year I got a thrombosed hemmoroid that got dealt with after I was on holidays. I have a history of chronic constipation. Since I have been on meds and diagnosed I have been eating healthy and drinking lots of water and as a result been "regular" (totally new for me). No diarrhea but have noticed bright red blood in my stool. Just a little but also noticed the Hemmroid has come back probably got irritated. I am sure this is all it is. But I have not been diagnosed with an OI and am now scared I have colorectal cancer? With a low CD4 count this could be possible? I know I need to go get it looked at but what are the chances of it being cancer? I have an appointment with my specialist on the 17th. I rather her check things out than my GP as my GP has panicked ever since my diagnosis. I live in a remote area and have to be flown to my specialist so I can't just see her. Do you think it can wait two weeks if it is cancer? I had a colonoscopy a year and half ago and at that time everything was okay. I am also going on holidays and do not want to deal with this right now I just want to relax and not think of what could happen.

Scared again,

Response from Dr. Pierone

With a history of known hemorrhoids and recent colonoscopy (1.5 years is considered recent, thankfully) the chance that the bleeding represents colon cancer is just about zero. The natural history of colon cancer involves a good number of years for polyps to generate, grow, and then transform into cancer. Most gastroenterologists would not repeat a scoping at this point, but treat with standard hemorrhoid measures. You should relax and enjoy the holiday and simply have this checked on a routine basis.



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