Hemorrhoids Question -- Aubrey? Van?

[Guest guest]

I've looked through the archives and cannot find an answer to my

particular question. A few days ago I was suddenly introduced to the

" joys " of hemmorhoids. I understand the whys and wherefores of them,

but I have one small problem .... they won't completely stop bleeding.

It's just a tiny seepage of blood but it's enough to keep me on edge.

Yes, my INR and PTT are above normal, but not drastically so. I bruise

spontaneously and had a recent episode of spontaneous bleeding on one

leg (looked like I had skinned my knee badly), and I heal very slowly

these days.

Is this continuing seepage typical at all?

Is the bleeding likely to increase without warning?

Do I need to call my GI?

I'm assuming it needs banding. Is that procedure painful?

Does this indicate that there are probably esophageal varices beginning

also?

Thanks everyone!!!

Regards,

Carolyn B. in SC

[Guest guest]

>I've looked through the archives and cannot find an answer to my

particular question. A few days ago I was suddenly introduced to the

" joys " of hemmorhoids... but I have one small problem .... they won't

completely stop bleeding. It's just a tiny seepage of blood but it's

enough to keep me on edge.

Carolyn -

Sorry, I'm not Van or Aubrey... just Joanne! And I didn't see if

anyone responded to your post from yesterday. My thoughts would be

that if you are oozing or seeping... absolutely you need to be seen -

either by GI or surgeon or start with your family doc or internist.

Please let us know if you have stopped bleeding today or how all is doing!

Take care.

Joanne

(, Ca., mom of , UC/PSC 2-06; JRA 2-98)

[Guest guest]

As you note this is common and a recognised complication of PSC. It may

not stop bleeding because of increased pressure and irritation during

defecation. You may need to have it banded or thrombosed. Usually

you'll get a local and general anesthesia (one or both) for this

procedure, although sometimes it's done without any meds because it can

be done pretty quickly and then you'll get some pain meds to take

afterwards.

In all likelihood this means you also have other varices. And because

your INR is elevated you should be examined for esophageal varices

either by endoscopy so larger ones can be banded or by MRI or Doppler

US (to look for portal hypertension). I'd call my GI/Hepatologist and

get on this soon. It's not an emergency but should be dealt with for

your own peace of mind and comfort.

Aubrey, MD

PSC '81, UC '90, LTX '98, Recurrence '05

[Guest guest]

Aubrey wrote:

>

> As you note this is common and a recognised complication of PSC. It may

> not stop bleeding because of increased pressure and irritation during

> defecation. You may need to have it banded or thrombosed. Usually

> you'll get a local and general anesthesia (one or both) for this

> procedure, although sometimes it's done without any meds because it can

> be done pretty quickly and then you'll get some pain meds to take

> afterwards.

> In all likelihood this means you also have other varices. And because

> your INR is elevated you should be examined for esophageal varices

> either by endoscopy so larger ones can be banded or by MRI or Doppler

> US (to look for portal hypertension). I'd call my GI/Hepatologist and

> get on this soon. It's not an emergency but should be dealt with for

> your own peace of mind and comfort.

Thank you, Dr. Aubrey! That's pretty much what I was thinking, but

wasn't sure. I very much appreciate your taking the time to clarify

this for me.

My dr. has already said, quite some time back, that he felt I already

had the portal hypertension due to the extent of splenomegaly. I see

him every 4-6 weeks and his first question every time is whether I've

had any bleeding at all.

General anesthesia is out for me (total pseudocholinesterase deficiency)

and so I hope local will be sufficient. I'm not exactly eager to get a

needle there, that's for sure!!

When my dr. gets back to the office on the 20th, I'll give him a call

(and keep praying that I won't need him before then!). This is a very

large GI practice and most of the other drs. are great, but there are a

couple who won't listen to a word you tell them (and that includes one

of the nurse practitioners!).

Thanks again!!!

Regards,

Carolyn B. in SC