23 years old with polyp and strange GI symptoms

I just had a colonoscopy at the age of 23 and a single polyp was found. The doctor said it was very unusual for someone my age to have one, and recommended genetic testing after my endoscopy scheduled in a few weeks. I tested negative for Crohn's and Celiac's Disease, and also for ulcerative colitis. I'm going to give you my symptoms and family history to be as thorough as possible and help you determine what could be the source of the problem.

My mother had colon cancer at 50, breast cancer at 42, and skin cancer at 48. My grandfather on her side died of lung cancer, and her uncle died of colon cancer about 20 years ago.

I started noticing my symptoms while traveling the world last year. One month into my trip, I was in Germany and had bowel movements with thick, yellow mucus, 3 times greater in volume than my stool. I had this about 15 times in 2 days. I went to the hospital, and was told to get a colonoscopy when I returned to the US. The symptoms disappeared for a few months until I was in China where I developed severs GI problems that lasted 2 days, and increased in severity each week. I had a fever, severe diarrhea (pale and watery), and dizziness at first. My last week in China I also had vomiting, an irregular heartbeat, and diarrhea every 30 minutes. I was flown home to the US a week later and recovered. My doctor tested me for parasites and found nothing, but proscribed Flagyl just in case.

Since I returned, I've had constant diarrhea and foul smelling stools and gas with diarrhea at least twice a week. I was more gassy than usual and still am. I also noticed localized chest pain right behind my breast plate that sometimes radiates to my back. However, it doesn't travel up my esophagus and doesn't always occur after I eat spicy foods. I also have pain under my rib cage, to the left and bottom where my stomach is. This is also localized and I noticed it tends to worsen with coffee or alcohol.

[Kevin Pho, MD]

I agree with all the tests done thus far, including the colonoscopy and the tests to exclude Crohn's disease and celiac disease.

I would also obtain more specialized tests, like breath tests to evaluate for lactose intolerance and bacterial overgrowth.

Sending the stool off for analysis and culture to rule out an infectious cause, as well as various types of fat malabsorption, can be done as well.

Furthermore, chronic pancreatitis can lead to mucous-filled stools.  Obtaining blood tests to evaluate the pancreatic enzymes, as well as imaging the abdomen with CT scan can be considered.

These options can be discussed with a GI physician, preferably at a major academic medical center.  

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.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd