New Here: Having Extended Panic Attack over Rectal Bleeding/Colonoscopy

[Gizmo12]

After suffering from anxiety/hypochondria for as long as I can remember, I think this is the worst it's ever been.

I am male, 33, who began having intermittent episodes of rectal bleeding two years ago. 3-4 times over the course of a year, it would be two days of looking like I poured cranberry juice in the toilet, and then I'd be fine. First GI I went to suggested a colonoscopy (naturally). I've never been sedated, and that was a crippling fear of mine--so I bailed on the test even though I had gone through the prep.

Second doctor I saw (colorectal surgeon) gave me a thorough rectal exam and announced I had internal hemorrhoids that were not inflamed at the time. Still, to be absolutely sure, he recommended the scope. I bailed on that one, too.

The bleeding went away for 8 months, and the third GI I saw (I had sufficiently pissed off the second) said not to worry unless it returned. Well, it did, and naturally he suggested a scope. Realizing the definition of crazy is doing the same thing three times, I more or less begged and pleaded to have a virtual (CT) scope done instead. He agreed, and the scan was all clear.

A year without symptoms, and the bleeding returned last week with a vengeance. Instead of two days, it was 6, and on the last day I was dripping so much blood into the toilet that I had a meltdown and ran to the ER. Five hours later: perfect blood work, no anemia, and another physician verifying I had an internal 'rhoid. Not only that, it hurt when he poked it ("a good sign," he said) and had a streak of blood on it. I know they can bleed profusely, but rational thinking doesn't really work when you look down and see totally red water.

That was last Thursday, and it kind of broke me mentally. I've been in a steady state of panic ever since: trouble sleeping, eating, sweating, fatigue. I feel like colonoscopy is inevitable if I want to put my fears to rest once and for all, but the idea of sedation is truly terrifying. I like being in control. On the other hand, I feel as though I'm dying.

I do have other indicators for a serious issue: my stools have been thin, and my alkaline liver level is high. While my physician wasn't concerned about it, to me it's a sign the colon cancer has moved to my liver.

I just feel absolutely trapped. Doing nothing means anxiety. Getting the scope means acute anxiety. I'm confident the CT exam would've picked up any threatening mass, but then I Google the radiologist who read it and see he was recently sued for malpractice--missing a spinal fracture. He had to settle. In my brain, that means he could be incompetent and missed a huge tumor.

This year has just been terrible. My mother died, my father moved away, and my HA went into absolute hyperdrive. I've already gone through a rabies scare, an anal abscess, a skin infection, an antibiotic rash I was sure would turn necrotic, fears of sepsis, and God knows what else I'm forgetting. This is the first time, though, that I feel completely out of control. My best friend is a physician--that can come in handy, admittedly--and she's confident it's harmless. But no one can say FOR SURE without a horrible, invasive test.

I just don't know how to deal with this.

[marc]

Welcome to anxiety zone. Many years ago, I had a horrible episode of rectal bleeding where the
entire toilet was filled with blood and the toilet paper was covered with blood. I flipped out and went to the
ER and nothing was found. I had a flexible sigmoidscopy which was clear. Over the years I have had issues of
blood in my stools, and minimally on the toilet paper. I have to date had 7 upper endoscopy's (I did have an
esophageal ulcer in June 2005) 5 colonoscopy's, 2 flexible sigmoidscopy's, 3 abdominal and pelvic MRI's with and
with out contrast. I personally would get the colonoscopy done (My last one was in May 2009) as the sedation now
used is really safe, with little side affects. In fact, it is the best sleep I have ever had. Odds are however, that if your
virtual colonoscopy was normal, than you should be OK. I was told by a colorectal surgeon and by my GI physician that
colon and rectal cancer take a long time to grow.(I have been to so many GI visits, that I have lost count).

[catastrophizer]

Hi Gizmo, Sorry to hear about your mom.  It sounds like there's been a whirlwind of events that's put you on the path to land you here at anxiety zone.  I'm new here myself (relatively) and just wanted to let you know that there are some great people on this forum with a lot of great advice.  It sounds like you have taken all the steps you need to take, minus the scope.  The sedation isn't really that bad and if you're that anxious about it, you can always ask them for a lower dose of it.  I knew a nurse who was allergic to just about everything in the book and she asked to do the scope without sedation!     I'm sure that was an unpleasant experience, but just goes to show what we're capable of doing when we put our minds to something!  Sedation is more of a twilight effect.  You can still respond to instructions and answer, you just won't remember doing so.  I know what it's like to want to be in control at all times, but sometimes we have to let that go to get the answers we're looking for.  Hemorrhoids are notorious for bleeding just as you described.  I'm sure if your initial scan was clear you've got nothing to worry about.  If it's still causing you loss of sleep, then do the scope for reassurance.  Please come back and update us with your decision!      

[Slangevar]

I can't believe you went through the prep & missed the colonoscopy - the prep is the worst part!

Seriously - the rest goes like this: You check in; they get you ready; you go into the room; the nurse gives you this absolutely gorgeous drug through your IV, and you watch, all calm and dreamy, while they project a giant image of your colon on a TV in front of you. I was totally awake for the whole thing and frankly calmer and happier than I am on most normal days.

[Gizmo12]

Slang,

Yep: prepped twice. Got cold feet both times. I don't mind that part: it's the altered state of consciousness that bothers me. I do not drink, use drugs, etc. A nurse hovering over me with drugs and promises of "feeling good" sends shivers down my spine. I want to feel like myself, have control over my body, etc. Being able to respond to commands yet still be "out" sounds terrifying. I'd sooner have Propofol, but I don't think any GIs here offer it.

My GI will actually do the scope unsedated--I had my wisdoms out without going under and he had his done without anything--but that's a whole other level of discomfort I'm not sure I'm prepared to handle. I know I need to get this done. Just a question of how.

Thanks to everyone who has replied so far. I'm hoping I'll keep it together emotionally until my gastro appt. in late October. Since the bleeding is bright red, I'm fairly confident it's lower in the colon, so I might be happy with an office sigmoidoscopy...except if that's clean, I suspect I'll have a few days of comfort before beginning to think there's a tumor further up. 

[29sillygirl]

You have had a horrific year.  Let's start there.  Serious life events.  Now the rectal bleeding...and fear of being 'put out'.  Makes sense in a way.
I am an anal cancer survivor: never feared much of anything health wise.  But worst part of colonoscopy for me was prep.  I was put completely out...way I like it...woke to happy faces and news that I was ok.  Well, I wasn't but it took a surgeon to confirm cancer...another topic altogether.

I can no longer 'enjoy' going to sleep (btw: my surgeon used the Michael Jackson drug...and I live in FL)....as colon is too brittle from radiation treatments...so believe me...whether you go to sleep or chose to be awake...(as I am now with barium enemas)...the worst is the prep.

I think if you focus on what doc can do while checking your colon...i.e. remove polops...maybe nip those roids..I dunno...you will feel less anxious.

Until then...chat with your doc friend...and us too if it helps....I would try to put it out of your mind until you Oct. appt.

Best...

[markinmaryland]

Man...you need to chill out....don't you see you are causing most of your problems. I know, I was there. I had my first colonoscopy a year ago at age 50, and was so nervous about it I was a zombie for several days beforehand. The prep was nothing, I couldn't care less about that, I was terrified of general anasthesia. Well, I got myself so worked up and my stomach full of acid that I aspirated during the procedure and got aspiration pneumonia for 2 weeks afterwards. Of course, the colonoscopy results were 100% clean. But I suffered for no reason.

Any website could have told you that bright red blood in the toilet means hemorrhoids and NOT colon cancer. It appears several doctors told you that, too, but you chose not to believe them.

You are going to drive yourself insane. Get the colonoscopy but tell them you were a nervous wreck and they will intibate you so you won't get what I got. Your colonoscopy will be fine and you won't have to worry anymore.

I also think you need to get to a psychotherapist right away and help them to help you. It helped me.

[Gizmo12]

Mark,

While it's true that bright red blood is less concerning than occult blood or black stools, it's still symptomatic of colon cancer. All the doctors I've spoken to consider it "unlikely" at my age, but all recommend the scope to be sure. I'm certainly not begging to have it done against their wishes, believe me.

I agree I'm my own worst enemy, for sure. Virtually everything I've ever worried about has been over nothing. That said, a toilet full of blood is a very unpleasant sight. The ER doc suggested Colace to soften things, but that gave me diarrhea, so  that's out.

It seems like I can't get much of a break anymore. Yesterday I woke up with a pimple-type thing on my shin; later in the day, I accidentally scratched it. Now I'm worried the pus is going into my bloodstream. There are days I literally don't even know what to agonize over first.

[Rainbeaufox]

Hello!
I have had bleeding intermittely like you.  I have had less but its mucousy and in my stool.  I went to a surgeon, he was pretty sure it was anal fissures and allowed me to have a CT scan which i get this Thursday.  I am reall scared I am going to get bad news.  He recommended a colonoscopy to rule out the "C" word.  Of course that terrified me.  I have decided to get my colonscopy wihout a sedative, as I hate those too.
Ive researched it and hear it wasnt painful, more like embarassing if youre awake.
I can personally handle the embarassment over my loathing of a sedative.  I like to be in my right mind.  Plus you can watch the moniter and ask questions, which I think is really fascinating!

Even if something is wrong (prolly nothing life threatening though)  look at it like this, worrying everyday wont change anything.  Being upset doesnt get the test results back faster or change their outcome.  Plus how upset would you be if everything wad fine (or not) would you be upset you spent everyday worried, anxious, and overall upset. 

[Alphamale13]

I have a story that mirrors yours see what you can take from it.  I had 2 instances of rectal bleeding about 2-3 months apart, very minor on TP only.  Of course my anxiety kicked into to 5th gear and my mind had taken over.  I was convinced I has colon cancer.  4 doctors later and with co-payments and prescriptions in the 350.00 dollar range finally I got my sigmoidoscopy today.  I prepped yesterday and that did indeed suck.  The colonoscopy and sigmoid are different in there is a sedative with the colon scope not the sigmoid like I had.  I will admit I have a zero tolerance of pain and a complete pansy with anything medical.  With that said I would have preferred the colon scope just for the fact they administer the sedative, the sigmoid was the single worst experience of my life.  Take the colonoscopy just for the sedative.  Take my word for it of course everyone is different.

[markinmaryland]

Giz---

For years I was a hypochodriac like you----for just about any little thing I would zoom the webmd.com and check symptoms. Fortunately, I am past that now. But I had red blood on the toilet paper and some blood in the bowl, bright red, and it really didn't take me long to realize it was internal hemorrhoids. Eventually, during a regular physical the doctor told me that's what it was. Only once did I really have a hemorrhoid problem that was significant, a big blue one that bled out, but I learned exactly how to handle that, and it hasn't been a problem since. I still get some blood on the TP after a hard 0103, but who doesn't. Of course, now I keep a box of pop up baby wipes by the toilet and wipe with them--so much better!

Anyway, you are avoiding the issue here. You need some therapist help, and I have no idea why you are waiting on this. Find a good psychologist or psychiatrist (a referral from your doc would help) and explain the situation to him/her. I know once you are on some anti-anxiety meds you will feel so much better.

Do it now!

[Slangevar]

I can't imagine doing a colonoscopy unsedated... it would be like the worst gas you've ever had in your life (times five). Even on Versed, they had to stop at some point because I was aware of the pain.

Does full sedation with propofol sound better?  I wanted to be awake for the procedure, so I could see everything for myself, but everyone's different.  I will say, I had a great experience with Versed. I felt calm and happy and didn't feel any hangover afterwards. I did get a little of the "amnesia" they talk about (i.e. where you can't remember the procedure), but that only applied to the pain. I do remember seeing the procedure on the big flatscreen TV. Colons are beautiful!

[Gizmo12]

Mark,

Most everyone I speak to--family and docs included--has indicated I need some medication or therapy, no question. I've been on Zoloft for several years and my primary thinks a bump in dosage is needed--but I'm already so emotionally blank that I'm afraid any more of the stuff will turn me into a total zombie.

I tried therapy and behavioral counseling, but it didn't seem to do much for me: and at $300/mo. (no insurance), it's also expensive.

Also, re: "handling" the bleeding hemorrhoids, any advice? I've read that diosmin/hesperidin can significantly decrease symptoms, but a recorded side effect is gastritis. I really don't need to be bleeding from my stomach at this stage. Just talking Benefiber right now with some Fiber 1 at night, and trying to limit cheese/heavy foods, which has been easy: I've burned off about 7 pounds over the past ten days because of my panic.

[Slangevar]

I had a friend on Zoloft who complained of digestive issues... I wonder if digestive issues and hemorrhoids are possible side effects?

[AOKAY]

First, my condolences on the death of your mother.  You have good reason to be a wreck. 

I'm a Crohns (inflammatory bowel disease) patient and have experienced the "bowl full of blood".  Panic is a normal instant reaction.  But you need to get to the bottom (no pun intended) of the problem and, in your case that means a colonoscopy.  I'm betting they find hemorrhoids and nothing worse.

If you are afraid of the test, ask the doctor to give you a dose of Xanax to take with a sip of water after the prep but before you head out the door for the test.  That will at least keep you from skipping out and freaking out.

I have had at least a dozen colonoscopies; two without ANY medication.  I recommend you accept all the meds they offer you.  My doctor uses two intravenous medicines, Versed, which is just a form of Valium, to calm you down and relax your muscles, and Demerol, a pain killer to deal with the cramps.  One time I wanted to be fully awake, so I asked just for the Demerol and I do NOT recommend that as it makes the doctor's job more difficult getting the scope around the bends of your intestine since you are not relaxed and the cramping is even worse, even with the Demerol.  The great thing about the Versed is that while you are actually fully awake and cooperating with the doctor, you have no memory of it, which is fine.  Who wants to remember searing abdominal cramps.

I am also a control freak and hate the idea of being "put under" and "losing control".  Just know that with Versed you do NOT lose control.  You are fully awake and aware of what is happening and what you are doing and saying; you just don't remember it.  That seems like an impossibility, but is absolutely true.  Try it and I think you will understand and agree and be sorry you waited so long.  You will be fine.

[markinmaryland]

Perhaps you would be better off on something other than Zoloft. There are so many better handled anti-anxiety meds out there--Wellbutrin, Lexapro, etc. Perhaps one of those would be better.

We could go on until we are blue in the face about the colonoscopy. Just do it. It will make you feel better. Personally, hemorrhoids are not the end of the world, sometimes they bleed, sometimes not. It is pretty routine in the medical world. It is not clear why you are worrying about them and then not willing to find out what the real story is.

As for the colonoscopy---go to a doc who uses propofol, it's great. Tell him that you are a nervous wreck and maybe they should intibate you. You shouldn't have any problem and I, like the others who have responded, am sure you will be so much better after you know that all you have is some hemorrhoids.