Colitis? Colon Cancer?

Hello,
I am a 30 year old male. I alwayd had some digestive problems, such as frequent diarheea and difficulty eating fruits and vegetables. Lately it seemed to become worse.  My stool is sometime  smalll and hard and sometime soft. My stool comes out in many pieces usually and seems to be rather flat lately.(I did buy one of those take home kits for detecting blood in the stool and it turned up to be negative). I do have a lot of gas and feel bloated most of the time.

Anyway, I had some lower abdominal pain lately, especially in the right hand side. Due to this symptom and my flat stool, the doctor send me to do a CT scan with contrast. Here are the main findings

- there are subcentimeter mesenteric nodes, none large enough to be considered pathological;
- the rectosigmoid colon is not filled with contrast:it does, however, have a somewhat tacked down appearance with a persistent narrow lumen throughout. The radiologist is concerned about possible pathology involving the rectosigmoid colon such as colitis.
- the rectum also gives the appearance of slight thickening of the wall though with the the absence of oral contrast filling that region, he cannot exclude that being completely artifactual
- there are some prominent inguinal lymph nodes present, the largest measuring approximately 8-9 mm in short axis

Now I read the report and I become really worried. Is it possible that I have colon cancer? It says that the lumen is narrow throughout the rectosigmoid colon, which is pretty long, so could that be a tumor? Or a tumor would look different at the CT scan and would involve only a smaller piece of the colon? Are colon tumors actually visible on a CT scan?

Also, does a colitis lead to a narrowing of the whole rectosigmoid colon? How about the slightly enlarged lymph nodes? Could they have anyrhing to do with something like colitis or is that a sign of cancer?

I am really concerned and I will see a GE in 2 weeks.

Thank you

[Kevin Pho, MD]

Large tumors can be seen on the CT scan.  However, that is not the best test to exclude colon cancer.

It seems you will need a colonoscopy - which will be the most comprehensive test.  Colitis can also be seen and biopsed for.

I would strongly recommend a colonoscopy in light of the CT scan findings.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com