Frequently Asked Questions

Why am I seeing blood in my stool, toilet bowl, or toilet paper?

There are many reasons for seeing blood. Your anal opening is the final exit of your entire intestines (20 to 28 feet) so it can be anyone's guess where the bleeding may have originated. However, we know that the majority of bleeds are categorized under lower (vs upper) intestinal bleeding which is the colon, rectum, and anus. By far the most common causes of lower intestinal bleeding are:

Diverticulosis
Anorectal (i.e. anal fissures, hemorrhoids)
Intestinal ischemia

You could make an educated guess based on your symptoms such as pain, timing of bleed, and associated activity during bleeding. But it is almost impossible to know for certain without a detailed examination by a specialist in the office.

I have pain in my rectum. Does this mean I have hemorrhoids?

Hemorrhoids are blood vessels inside the walls of our anal canal--so technically everybody is born with hemorrhoids. Hemorrhoids become a problem when they enlarge by persistent pressure and irritation in the form of hard dry stools and prolonged periods of sitting on the toilet.

We all have internal and external hemorrhoids. In general internal hemorrhoids do not cause pain, while external hemorrhoids can cause extreme pain if they develop a blood clot underneath the skin.

Pain does not automatically mean you have a hemorrhoid problem, as it may be from other problems such as anal fissure, abscess/infection, fistula, pelvic muscle spasm, or even cancer.

What's the difference between diverticulosis vs diverticulitis?

Diverticulosis is the condition of having naturally weak spots that outpouch (diverticula) the wall of your colon. It is common in the sigmoid colon but can be located anywhere. These weak areas stretch out from the pressure inside your colon over time. These areas are weak because that is where the colon wall allows for the blood vessels to go through like plumbing going through a wall.

Diverticulitis is when the outpouched weakened colon wall (diverticula) rupture and cause spillage of stool outside your colon wall, causing an infection of your colon and the surrounding area. Mild cases may just require pill antibiotics, while more severe cases may require emergency surgery and creation of a colostomy bag (stooling out your abdomen).

Can I prevent diverticulosis/diverticulitis?

There is no single measure you can take that would be a 100% guarantee of preventing diverticular disease. However, studies have shown that there are certain things that correlate with diverticular disease. Factors that have correlated with increased diverticular disease include:

Eating fatty foods, red meats, processed foods
Age (particularly after 40)
Being male
Smoking
Use of NSAIDs (Non-steroidal anti-inflammatory drugs)
Obesity

Factors that have correlated with decreased diverticular disease include:

Exercise
Fiber intake (fruits, vegetables, supplemental)

Do I need surgery if I've had diverticulitis?

Typically after a case of complicated diverticulitis, surgery will likely be required. Complicated diverticulitis is defined as an episode that involves any of the following:

Free perforation (leakage of stool inside your abdomen)
Fistula (abnormal connection from your colon to another part of your body)
Abscess
Stricture or narrowing of your colon
Colon obstruction

Uncomplicated diverticulitis is a case that does not involve any of the features mentioned above. Typically these cases resolve on their own or with the help of antibiotics and dietary restrictions. Depending on the number of episodes you have had and how these episodes impact your life, the decision for surgery requires a thorough conversation with your surgeon.

About Katy Colorectal

Urgent Evaluations

We are available for in-office checks to care for your urgent alarming needs such as acute pain, bleeding, or sudden changes

Hemorrhoid care
Infections
Anal fissures
Bleeding
Burning
Itching

Office Procedures

We are equipped to perform procedures without requiring hospital admission

Rubber band ligation (RBL) of internal hemorrhoids
Excision of thrombosed external hemorrhoids
Incision and drainage (I&D) of abscess

Consultations

See a specialist with expertise to diagnose and treat your problems. One who has dedicated his career to colorectal health and well-being

Cancer of the colon, rectum, and anus
Colon screening
Crohn’s disease/Ulcerative colitis
Diverticulitis
Hemorrhoid care
Pilonidal disease

About Dr. Kim

Colonoscopy

Up to 40% patients have colon polyps. Polyps are abnormal growths inside your colon and rectum and that transform into colorectal cancer over time. Stay up to date with your colon screening to put your mind at ease.

Learn More

About Dr. Kim

Education and Training

Dr. Woihwan (Woi) Kim received his medical degree from the University of Louisville. He completed residency training in general surgery at Albany Medical Center, then went on to complete a fellowship in Colorectal Surgery at UT Health Science Center at Houston. He joined UT Physicians with the Colon and Rectal Clinic (CRC) in 2024.

Background

Dr. Kim is from the Republic of Korea and is fluent in Korean and English. He has been on many mission trips in the past to countries including: Kazakhstan, Ukraine, Haiti, Ethiopia, and Togo. He hopes his career would help patients both locally in the greater Houston area as well as globally.

What is a Colorectal Surgeon?

Formerly known as a proctologist, a colorectal surgeon is an expert in both surgical and non-surgical treatments for colon, rectum, and anal pathologies. They are able to perform complex surgeries like colectomies or abdominal perineal resections in addition to hemorrhoid care. They are also specialists in performing colonoscopies for colon screening which can detect polyps and cancer.

A colorectal surgeon is fully trained and board certified in general surgery. After this they undergo additional training and board certification to practice colorectal surgery.

Colorectal Health

Colorectal surgery

Frequently Asked Questions