Many patients ignore minor rectal bleeding, because, they attribute it to hemorrhoids. The fact is, that rectal bleeding from a cancerous colon tumor, may not differ from that of hemorrhoids. If you experience rectal bleeding, please get examined. If on exam, obvious bulging hemorrhoids are seen by the examiner, then perhaps, no further tests need to be perfomred. Failure to visualize obvious bleeding or engorged hemorrhoids, warrants further investigation. Red blood, reflects bleeding from a source closer to the rectum, and could be investigated by flexible sigmoidoscopy. This is a simple office procedure, performed by the gastroenterologist, by a 56 cm flexible scope. Dark or black blood, reflects a source further away from the rectum, and requires a colonoscopy. Colonoscopy uses a 110 cm scope, requires a more complete bowel prep, is performed in the hospital, and requires sedation for comfort. Patients over 50 yrs, should be very suspicious of any rectal bleeding. Fear of uncovering cancer, should not cause you to delay evaluation. Colon cancer is very curable if caught early.

       Flexible endoscopy is the wonderful byproduct of fiberoptics. Besides the fiberoptic bundle for light, these scopes contain several conduits( pressurized air, vacuum, water, and empty channels to pass tiny forceps to biopsy and snare polyps, as well as perform cautery for minor
bleeding ).

       For patients over 50, the American Cancer Society  recommends: alternating Colonoscopy with Sigmoidoscopy every 5 yrs, and annual digital rectal exams, with stool hemoccult testing. Patients with a family history of colon cancer are advised to have a colonoscopy every 5 years.

       Ingestable Camera Capsule is now available for those patients who are unable to tolerate
endoscopy, or to examine the small bowel ( not reachable by any scope ). The Camera Capsule
is able to produce several thousand still pictures as it traverses the bowel. With more
experience we will learn the specific usefulness of this method. 

        Virtual Colonoscopy is a sophisticated Xray( a CT Scan )  which computes images of the Colon. This may be useful in patients who are too ill to undergo a Colonoscopy, but it is limited by its inability to detect small polyps or perform biopsies. Virtual Colonoscopy maybe slightly more detailed than Barium enema ( Lower GI Xray ), and easier for the patient ( less invasive ).