For the past 8 months or so, I've has some blood with nearly every bowel movement. The first 5-6 months there was a terrible scraping/cutting feeling right near the anal opening. I went to a walk-in in Novemebr who looked and saw hemorrhoids. I saw my regular doctor a months after that who did an anoscope but didn't really see anything and recommended a sigmoidoscopy. Had that done a months ago and everything looked good other than hemorrhoids. He basically said he can't explain my bleeding. It's just a drop or two when I wipe, and only once or twice have I seen it in the toilet bowl. He did recommend a colonscopy but mainly because I'm almost 50. I KNOW I have hemorrhoids; but everything I read says only internal ones bleed, and the sigmoidoscopy didn't show internal ones. Can external ones bleed too? For eight months?? The scraping/cutting feeling has gotten much better, and with stool softeners I can manage one or two poops a week that don't bleed. It just bothers me that two doctors can't figure it out. If I definitely knew for sure it was just hemorrhoids I could stop worrying. It sure feels like it. I'm beginning to lose faith in doctors...

Hi Ocularsinistra,

My understanding is that internal hems bleed, but are not painful, and external ones can be painful but don't usually bleed.

The bleeding sounds like a fissure to me, but I'm not a doctor. I think you should see a proper CRS, because I'm not sure a regular doctor could diagnose a fissure, even with an anuscope.
And I don't think the sigmoidoscopy would show a fissure. I know I specially asked them to look for a fissure when I had my colonoscopy, and they did not see it.

Signs of a fissure:
- BMs painful, sometimes like passing broken glass or gravel.
- Sometimes painful spasms, or a feeling of burning pain starting 30 mins- 1 hour after a BM and sometimes lasting several hours.
- A skin tag (called a sentinel pile) on the outside of the anus at the site of the fissure. Do a web image search for sentinel pile. Preferably NOT when you are at work or in a public place
- sometimes there is blood, but often there is not any blood.

It's great that you have controlled the pain and bleeding to some extent using stool softeners. You can also work on your diet, getting the right amount of fibre (enough but not too much), and drinking lots and lots of water. But if you have a fissure, the CRS can prescribe medicines that will help you heal faster.

Also, as you've probably read here, you can try sitz baths, or take whole-body baths to relax the anus and help heal it. Heat therapy in general is very good for fissures. Just don't overdo the heat, because it can irritate the area. A nice warmth is best.

Good luck and let us know how you get on.

I do have the skin tags; about 2-3 of them. Every symptom I have sounds EXACTLY like a fissure, but 2 doctors managed to not find one. One of them did see what he referred to as a "mild abrasion" just inside the sphincter. Maybe it's too small to see? Like I said, it's improved greatly, but there is still a minor scraping feeling and blood nearly every time. I probably will be having the colonoscopy within the next 6-8 months just to rule out anything else but I highly doubt there's anything going on higher up on my colon as the blood is bright red and appears to be coming from right where that scraping feeling is. Just would like to know if it's that uncommon to bleed like this for this long?

I don't know how common the bleeding is. Some people do bleed. I never bled at all. I hope others who read this will tell you more about the bleeding. I would say the bleeding sounds like internal hems, but if haven't got those, then it's a mystery!
Wish I could be more helpful, sorry!