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Abdominal pain, bleeding in rectum with normal COLONOSCOPY.

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I went to the hospital about 12 days ago with lower abdominal pain that I suddenly woke up with. They did a CT scan without contrast, and told me my sigmoid colon was inflamed. I went home a few hours later with a ten day supply of Cipro and Flagyl, which I have finished.I followed up with my own doctor, who looked at my scans and told me they could not determine whether I had colitis or diverticulitis. They did a rectal exam in hospital that showed a trace of blood, but my blood work was fine.I followed up with my own doctor, who repeated blood work. Again, my WBC was fine-a 5 or 7, but my ESR was elevated-33.He repeated the rectal exam, and I still showed a trace of blood, which he said was likely due to the infection. I suffer from constipation-pass dry, hard stool. I have been told to take Metamucil, but don't stick with it. I am 54, female, menopausal, good health, already had 2 colonoscopies-normal findings, except they could not finish second one because I have a tortuous colon and woke up during procedure. The doctor got about 75% of the way through-but found nothing-no polyps. I have also had an upper endoscopy-all within the last 6 years- that was normal too. The doctor wants to repeat the colonoscopy and take biopsies. I am SO scared I have developed an inflammatory condition.Do you think this episode was a one-time thing?
Thank you, please help!!!

Category: Gastroenterologist, Medical

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Category: Hepatologist
 19 Doctors Online

Thanks for posting your query at

I am Dr.R.K and I am pleased to assist you.

Since you have history of constipation and the sigmoid colon is inflamed the most likely cause for your lower abdominal pain is diverticulitis. It looks like a milder form of diverticulitis which is why your doctor treated you with oral medications.

Diverticulitis is a complication of diverticulosis which in turn is a complication of long standing constipation. Diverticulosis is outpouchings in the colon which usually remain without symptoms unless they develop complications like diverticulitis.
This is not a one time thing. You can get repeated attacks if your bowel movements are not good.
So continue taking metamucil, high fiber diet and drink lot of fluids to ease your bowel movements.
I hope that answers your question.
Let me know if I can assist you further.


Patient replied :

Thank you so much, doctor. I would like to add that I have never smoked and do not drink alcohol, and rarely eat red meat. I am concerned about my ESR reading of 33 and the trace blood the doctor found when he did the rectal exam. Can you give any opinion on this? Do you think I need to worry about colonoscpy? I am so confused about what I read regarding IBD. Can this hit a person suddenly, without warning? I do not feel pain when I have a bowel movement. Thank you in advance. My CT scan showed normal vascular flow and no blockages. All other major organs were fine.

Thanks for getting back to me with more questions.
Yes ESR is slightly on the higher side. It indicates that there is some inflammatory process going on somewhere in your body (provided you are not anemic).
Some of the causes for rectal bleeding are hemorrhoids, fissures, IBD, diverticulosis, polyps and malignancy.
You could be having any one of these.
A colonoscopy has to be done to find which of these is the reason for your rectal bleed.
You can have IBD symptoms without warning.
But as I said , there are other causes as well which are to be ruled out by getting a colonoscopy done.
I hope that answers your query.

Dr. Ratnakar Kini
Category: Hepatologist
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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