The FDA has required Hoffmann-La
Roche to change their label for Accutane many times. The most recent label states
- Inflammatory bowel disease: Accutane has been associated with inflammatory bowel
disease (including regional ileitis) in patients without a prior history of intestinal
disorders. In some instances, symptoms have been reported to persist after Accutane
treatment has been stopped. Patients experiencing abdominal pain, rectal bleeding
or severe diarrhea should discontinue Accutane immediately.Pursuant to FDA Rules and Regulation, the reporting of Adverse Side Effects is on a voluntary basis. In other words, the doctor, hospital, or other medical person or facility are not required by law to report an adverse side effect from a drug. The FDA reported that perhaps only one in one hundred side effects ever get reported. One could only imagine about how many serious Adverse Side Effects there are from taking Accutane, that have never been reported to anyone!
Individuals with inflammatory bowel disease have significantly higher risks of colon cancer than in the general population!
Rectal bleeding is a sign that something is wrong. It is usually something minor that can be easily diagnosed, but not always. It is, therefore, important that the specific cause of rectal bleeding be identified so appropriate treatment can be started and the problem corrected. Even though rectal bleeding may not be serious, an individual should never assume this to be the case. Most importantly, rectal bleeding may be a sign of rectal cancer.
The Causes of Rectal Bleeding
Hemorrhoids - These are dilated blood vessels or veins in the anal or rectal area. They can occur on the outside where they are felt as small bumps when wiping. Or they may be on the inside where they are usually painless. They develop quite commonly with chronic constipation and especially with pregnancy. Hemorrhoids are usually treated with stool bulking agents that soften the stool and reduce straining.
Fistula - A fistula is an abnormal, burrowing channel that usually runs from the rectum to the skin around the anus. It often will drain a whitish discharge, but it can also bleed. While it is usually just a local problem, a fistula can be associated with chronic inflammation in other parts of the intestinal tract. This disorder is called Crohn's disease. Fistulas are treated with antibiotics and hot baths. If they persist, surgery is usually required.
Fissure - The passage of a hard stool or severe diarrhea may tear the lining tissue of the anus. This problem is similar to having cracked lips in cold weather. Nerve endings and blood vessels are exposed so that pain and bleeding occur with bowel movements. Frequent warm baths and bulking agents, used to keep stools soft, usually correct this problem. Sometimes surgery is needed.
Diverticulosis - Diverticula are pockets or sacs that project from the bowel wall. They balloon out over the years due to recurrent, high pressure spasm of the colon. Occasionally they can bleed. They usually produce a lot of blood, and it comes all at one time. It normally does not persist in small amounts with bowel movements over days or weeks. Serious, persistent diverticular bleeding usually requires hospitalization and, at times, surgery.
Proctitis and Colitis - Either the rectum, colon, or both, can become inflamed and ulcerated. There are a number of disorders which cause the inside surface of the bowel to become ulcerated and bleed. There may be rectal urgency, cramps or diarrhea associated with the bleeding. When the inflammation is restricted to the rectum, the condition is called proctitis. When the colon is involved, it is called colitis. It is important to identify the specific cause of the inflammation so that appropriate treatment can be started.
Polyps and Cancer - Of course, the greatest concern about rectal bleeding is cancer. Polyps are benign growths in the colon. When polyps reach a large size, they can bleed. And certain types of polyps turn into cancer. Colon cancer is usually curable when discovered early. It most often occurs in people over the age of 50, but is not unheard of in younger individuals, even in their 30's or younger. Because colon cancer is such a common cancer, it is always considered as a possible diagnosis.
Protrusion of the Rectum - Some older individuals will have weakened rectal support tissues. Part of the rectum then can project from the anus and bleed. This condition is called rectal prolapse. It can be felt as an abnormal bulging from the rectum when wiping. Surgery is the only effective treatment.
For additional information the Crohn's and Colitis Foundation of America, Inc., has regional and local chapters. It provides free educational materials, as well as educational activities, through local chapters in most parts of the country. The foundation may be found here . You may also visit the Mayo Clinic and search "rectal bleeding."