Reason for concern?

I will see my gastroenterologist about this, but he's now on vacation.

I'm 29, male, non-smoker, and have no family cancer history.

Nearly a year ago, I noticed a small amount of bright red blood on (not in) my stool one time when I went to the bathroom. This has never recurred, but a few times I've found small amounts of bright red on the toilet paper. This has been very infrequent, the amounts have been small and it's generally been after repeated/deep wiping. I know I should have gone to a Dr. -- but I didn't.

Then, a month ago, I woke up feeling very sick -- nausea/vomiting, stomach cramps, food intolerance, abdominal discomfort, and, after a day of this, an awful acidy feeling in my throat. I went to Dr. -- who sent me to a gastroenterologist.

The GE did an endoscopy and said I had GERD and gastritis. He prescribed Aciphex, and did blood work and sent for a biopsy -- neither turned up anything unexpected. I told him about the blood and my colon cancer fear; he didn't suspect colon cancer and said blood was probably a hemorrhoid -- which we could follow up on it after adressing the GERD and gastritis.

Now, acidy feeling is gone and appetitie is fine. The problem is abdominal discomfort/cramping. I've felt "sick" to my intestines since this started, but sometimes seems to be in/around stomach too. It comes and goes -- no link to eating -- and I sleep fine. Now for the last 2 weeks, I get bad cramps when I run. At first, they seemed closer to stomach, but now they're near the hips, on both sides. I run on an empty stomach and it's not side stitches.

I've also been gassy & get gurgling in my lower abdomen. Can't tell if bowel habits have changed; don't have pure diarhhea, but stool is usually soft/feathery and I have to wipe A LOT to get clean. But could be dietary, and it might have been this way for a long time (never paid attention until recently).

I'm panicked that this is colon cancer. I'd really appreciate your thoughts. Thanks.

[Kevin Pho, MD]

A lower endoscopy should be considered if colon cancer is suspected.  The most comprehensive test would be a colonoscopy, but given your age and clinical picture, a flexible sigmoidoscopy can be considered as well.

If the diarrhea continues, I would continue to recommend a lower endoscopy, but add on stool tests to exclude malabsorption or infection.  Blood tests can be done to evaluate for celiac disease.  

If the tests remain negative, irritable bowel syndrome can be considered for treatment.

These options can be discussed with your personal physician.

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.
www.kevinmd.com
www.twitter.com/kevinmd

[atb1980]

Thanks for the quick reply. I actually went to a new GE this morning (don't want to wait another week) and am now scheduled for a colonoscopy this Thursday, so I guess that will give me a definitive answer.

The GE didn't seem too worried about colon cancer -- but this was based only on my age (29), it seems. So that didn't really put me at ease, given how many people under 40 I've read about who get this. He also didn't find any hemorrhoids, although he said there could still be internal hemorrhoids.

So I'm still panicked, just because I can't imagine what else could cause the blood and abdominal symptoms I've been having.

[atb1980]

Sorry -- my follow-up question apparently got cut off....

I'm just wondering if there could be a connection between the Gastritis I experiened last month and any potential colon blockage/cancer. I can't seem to find much written about this, but I'm wondering if a blockage from colon cancer could "back up" my system and produce gastrits. Is this even possible? (It's the theory I've developed as I worry about having colon cancer.)