33F with recurrent bright red rectal bleeding, chronic diarrhoea and pencil-thin stools
Age: 33
Sex: Female
Height: 163 cm
Weight: 110 kg
Location: Australia
Smoking status: Current vaper
Medications:
Vyvanse 30 mg
Fluvoxamine 50-100mg
Amitriptyline 20 mg
Yaz contraceptive pill
Medical history:
Gallbladder removal in 2025
Acute pancreatitis in 2025
Chronic diarrhoea and very soft stools for over 10 years
Two previous colonoscopies; polyps were found but I was told they weren’t concerning
Family history: My mum has diverticulitis and has had her internal haemorrhoids removed
Main complaint and duration:
I’ve been experiencing rectal bleeding on and off for years when having a bowel movement. The blood is bright red. Sometimes it’s just a streak on the toilet paper, but other times there’s enough blood to turn the toilet water red. The blood appears separate from my stool rather than mixed through it. It only happens when I poo.
My bowel movements are almost always very soft or liquid. When my stools are more formed, they’re still very soft but can sometimes be unusually thin, flat or ribbon-shaped, almost pencil-thin.
I’ve had ongoing bowel issues for over 10 years, including frequent diarrhoea and very soft stools. I haven’t been diagnosed with haemorrhoids or an anal fissure.
I’ve previously had two colonoscopies, during which polyps were found. I was told they weren’t concerning at the time.
Given the recurrent bleeding, chronic diarrhoea, occasional ribbon-shaped stools and my family history, I’m worried about what could be causing this and whether I need further investigation.
Questions:
Could internal haemorrhoids cause this amount of bright red bleeding, including turning the toilet water red?
Can haemorrhoids or other benign conditions cause thin or ribbon-shaped stools?
Could diverticular disease or another bowel condition explain these symptoms?
Given my previous polyps and ongoing symptoms, would another colonoscopy or other investigations be appropriate?
I understand that nobody can diagnose me online, but I’d appreciate advice about what I should discuss with my doctor.