A. PILES/HAEMORROIDS

Question 1

Why do I have blood in my stools?

Answer 1

I fully understand why you are worried about your bloody stools. The blood in the stools may be fresh blood and will appear bright red in colour. This happens due to bleeding from haemorrhoids, anal lesions or anal fissures. On the other hand, if the stool is mixed with dark red blood, it can be caused by diseases involving either the small intestine or the large intestine (colon). Among the most prevalent diseases are polyps, cancer, inflammatory bowel disease, diverticular disease, infections and diseases of the small intestine. If the stool is black in colour, it is caused by bleeding from the stomach, duodenum and small intestine.

Haemorrhoids are usually not painful and bleeding occurs after a bowel movement. It can be known when applying the tissue at the bottom or seeing droplets of blood on the toilet bowl. Pain when passing stools is normally caused by anal fissures. This condition can occur at any age.

If bloody stool is followed by symptoms such as dramatic weight loss, anaemia, abdominal pain, stool characteristics change with excessive mucus, other more dangerous causes need to be identified such as colon cancer (usually among those aged 40 and above), inflammatory bowel disease (usually of all ages and children) and diverticular disease (usually at age 50 and above). If there is fever and diarrhoea, it is probably due to infection of the gastrointestinal system.

What do you need to do now?

We would like to advise that you go and see a doctor or gastroenterologist as soon as possible. The doctor will first inquire about your medical history and then perform a medical examination which includes rectal examination using a gloved hand and proctoscopy in which a device which looks like a short telescope will be inserted into the anus.

You may also need a blood test.

After proctoscopy, you may also need to undergo further examination by colonoscopy to find out the causes of bleeding from the colon. For this procedure, you need to take laxative to clear the bowel one day before the procedure. Endoscopy specialist will insert a flexible instrument (colonoscope) through your anus. Colonoscopy will be conducted to examine the condition of the large intestine. Air will be pumped in and you may feel a little uncomfortable. Sedatives are usually given to reduce the discomfort. The procedure is usually safe and the risk of bowel tear during the procedure is only 1:1000.

To conclude, it is important to find the actual cause of such bleeding. Please see a doctor or gastroenterologist as soon as possible.  

DIRTY URINE

Question 1

When I was passing urine, I noted that my urine is yellowish orange which I think is not normal. Currently, I am having my period (menstruation) too. However, I have missed my period last month. Is it normal?

Answer 1

Changes to the colour of urine may occur in several situations as follows:

1. Dark yellow colour if there is a lack of water in the body (dehydration)
2. Light yellow after drinking large amount of water
3. Plain tea colour if there is blood in the urine
4. Red colour in cases of obvious bleeding in the urinary system involving the kidneys or bladder

From your question, it is most likely that changes in colour of your urine is due to the mixing of urine with the menstrual blood. One week after your period is over, please take note the colour of your urine. If it has returned to normal, you are not having any medical problem but if it does not, you need to check your urine at the nearest clinic.

The menstrual cycle can be interrupted once in a while when there is a fluctuation of hormones in the body. This can happen if you are under stress or having overweight problem. However if this occurs very frequently, then you should seek advice from a gynaecologist.

  C. NUMBNESS OF HANDS AND FEET

Question 1

I frequently have numbness of my hands and feet. I have sought treatment from the clinic and was given some medication but I still have not recovered yet. Result from blood tests was reported to be normal.

Answer 1

The symptom of numbness in both the hands and feet normally indicate possible problems in the peripheral sensory nervous system (i.e. the nerve that helps us to feel). As the numbness that you are experiencing involved both your hands and feet, it indicates that more than one nerve is being involved (‘polyneuropathies’). The processes which can cause damage to the sensory nervous system include inflammation, injury, pressure on spinal nerves, excessive alcohol intake over long period of time, and lack of vitamin B12 and minerals such as calcium and magnesium.

However, numbness of hands and feet is also a symptom often experienced by diabetic patient who is suffering from the complication of peripheral neuropathies. When there is obstruction of blood supply to the hands and feet due to atherosclerosis that often occurs in diabetic patients with high blood pressure and smokers, it can then lead to numbness.

Since you still have not recovered even after being treated with medicine, you should see the doctor again for further investigation to identify the actual problem you are experiencing so that appropriate treatment can be given. It would be advisable if you see a neurologist to do a detailed assessment to identify the cause and nerves that are being affected.

Last Reviewed : 30 January  2012