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The most likely diagnosis to explain your bleeding is hemorrhoids. However, your age means you have a higher risk for cancer or colon polyps. Your colon needs to be carefully inspected to ensure that you do not have cancer. A colonoscopy is the test that is most likely to be recommended.
Hemorrhoids
Hemorrhoids are veins just beneath the inside surface of the rectum and anus. Hemorrhoids can become overfilled and bulging, particularly when straining to push out a bowel movement repeatedly interferes with normal circulation out of these veins. A bulging hemorrhoid can develop a weak area that can allow small amounts of blood to spill into the rectum. Hemorrhoids can cause itching or can soil or moisten your underwear. Most hemorrhoids do not cause pain, but some do cause pain, particularly if a blood clot forms, creating a "thrombosed" hemorrhoid.
Your doctor will try to identify hemorrhoids during an office visit. An inspection of your anus and rectum will be necessary to confirm your diagnosis. A lubricated hollow cylinder called an "anoscope" may be used by your doctor during your examination. This hollow tube is approximately the diameter of a normal bowel movement. It can be pushed gently against your anus and inserted four or five inches into your rectum so that your doctor can view your rectum. Even if hemorrhoids are found on your examination, you need to have additional testing to ensure you do not have colon polyps or cancer.
Colon polyps
Colon polyps are bulges of intestine tissue that dangle or protrude into the hollow of the colon. They often bleed. Polyps need to be removed because they may form cancers if they are left within the intestine.
Colorectal cancer
Colorectal cancer is the second most common cause of death from cancer in the United States. It is preventable, if colon polyps are discovered and removed. Colorectal cancer can be cured by surgery if it is found at an early stage.
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