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Gastroenterology (Expert Forum)
Possible Explanations? Colon Cancer?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Possible Explanations? Colon Cancer?
by Geaux, May 06, 2003 12:00AM
(No cancer history in parents of)...50 yr. old male, 5'8", 165 lbs. (unchanged in 10 years), non-smoking (smoked 20+ years in past but not for over 5 yrs and recent chest x-ray was very clear), light alcohol daily, has life-long history of single/daily/early-morning/fully-formed bowel movement. For the past 6 months, not a single solid stool; diarrhea each morning (at reg. time); multiple episodes within first hour of waking; includes greatly increased gas ("foul" odor), no blood and little if any stomach pain (occasional lower left quadrant but not daily). Diarrhea also some evenings after meals.
30+ year history of "heartburn," once diagnosed as acid reflux; ELIMINATED symptoms with Prilosec (for three years), but loss of insurance 5 years ago makes post-insurance treatment: 3 Zantac twice daily and several teaspoons baking soda in water when immediate relief required (perhaps 5/wk.). Could the diarrhea be related to the (currently, barely managable) acid reflux?
Also external hemmeroid problem, managable with 2.5% cortisone cream twice/day, several days every other week. Could this be a factor?
Other daily medicines include 5mg. hytrin/day for benign enlarged prostate (last year's annual checkup had negative blood test for prostate cancer(would this have shown colon cancer if present?).
I have a colonoscopy scheduled for next week (after last week's bloodwork showed nothing), but other than the diarrhea, I am healthy in every respect. Continue with sports (tennis, softball, golf) and have no desire to have colonoscopy if one of the above may be causing diarrhea problem, and if confirmation of that could be accomplished by a gastrointerologist, whom I will see for the first and only time at the time of the colonoscopy. Could I perhaps eliminate need for colonoscopy with a a pre-proceedure visit to explain above?
With diarrhea now as "regular" as past solid bowel movement history, I wonder what, other than colon cancer, the colonoscopy MAY find, and how serious this may be.
Thank you for addressing the above. Your site and your service are greatly appreciated.
30+ year history of "heartburn," once diagnosed as acid reflux; ELIMINATED symptoms with Prilosec (for three years), but loss of insurance 5 years ago makes post-insurance treatment: 3 Zantac twice daily and several teaspoons baking soda in water when immediate relief required (perhaps 5/wk.). Could the diarrhea be related to the (currently, barely managable) acid reflux?
Also external hemmeroid problem, managable with 2.5% cortisone cream twice/day, several days every other week. Could this be a factor?
Other daily medicines include 5mg. hytrin/day for benign enlarged prostate (last year's annual checkup had negative blood test for prostate cancer(would this have shown colon cancer if present?).
I have a colonoscopy scheduled for next week (after last week's bloodwork showed nothing), but other than the diarrhea, I am healthy in every respect. Continue with sports (tennis, softball, golf) and have no desire to have colonoscopy if one of the above may be causing diarrhea problem, and if confirmation of that could be accomplished by a gastrointerologist, whom I will see for the first and only time at the time of the colonoscopy. Could I perhaps eliminate need for colonoscopy with a a pre-proceedure visit to explain above?
With diarrhea now as "regular" as past solid bowel movement history, I wonder what, other than colon cancer, the colonoscopy MAY find, and how serious this may be.
Thank you for addressing the above. Your site and your service are greatly appreciated.
Doctor's Answer
by Kevin Pho, MD, May 07, 2003 12:00AM
, May 07, 2003 12:00AM
Hello - thanks for asking your question.
Diarrhea that persists more than 4 weeks is considered chronic diarrhea. It makes a viral cause (i.e. viral gastroenteritis) less likely.
Potention chronic causes includes cancer, inflammatory bowel disease, untreated parasite or bacterial infection, irritable bowel disease or malabsorption.
To answer your questions:
1) External hemorrhoids or acid reflux should not result in chronic diarrhea. I would investigate a seperate cause.
2) The negative blood test for prostate cancer (via the PSA - prostate specific antigen) would not have any bearing whether you have colon cancer or not.
3) As you are the age of 50, you should have a colonoscopy regardless of whether you have diarrhea or not. You are at the age where screening for colon cancer is recommended and the best test we currently have is the colonoscopy.
4) Other than colon cancer, a colonoscopy can evaluate for colitis, inflammatory bowel disease, polyps or diverticulosis.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Diarrhea that persists more than 4 weeks is considered chronic diarrhea. It makes a viral cause (i.e. viral gastroenteritis) less likely.
Potention chronic causes includes cancer, inflammatory bowel disease, untreated parasite or bacterial infection, irritable bowel disease or malabsorption.
To answer your questions:
1) External hemorrhoids or acid reflux should not result in chronic diarrhea. I would investigate a seperate cause.
2) The negative blood test for prostate cancer (via the PSA - prostate specific antigen) would not have any bearing whether you have colon cancer or not.
3) As you are the age of 50, you should have a colonoscopy regardless of whether you have diarrhea or not. You are at the age where screening for colon cancer is recommended and the best test we currently have is the colonoscopy.
4) Other than colon cancer, a colonoscopy can evaluate for colitis, inflammatory bowel disease, polyps or diverticulosis.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
If you are going in to check your colon, you might as well have them scope your upper GI as well. Not a lot of doctors push for that, it seems. But it's a good idea, and it can be done at exactly the same time, with you being sedated and not bothered by it in the least. It would provide some good information for your doctors to help profile your entire condition, which I understand is not just involving bowel habits but a long long history of heartburn and taking medication to suppress it. Heartburn is not always just heartburn. Scope the upper GI...you could have a tumor or some other condition which is causing some of the symptoms.