many problems zero answers

in august 2003 my husband was severely anemic and diagnosed w/ angiodysplasias. According to the gastroenterologist, quote" he was bleeding everywhere", all were cauterized except one small one in the small intestine. He has been on 1000mg. ferrous sulfate for over a year. The last ferritin test in july 04 ferritin level was 42 on scale of 20-380 ng/ml. Also colonoscopy in august 03 removed adenomatous glands that displayed low grade dysplastic features. Current symptoms which have been for several months, abdominal pain left lower side, weakness, fatigue, pain worse when sitting or lying down, more severe some days than others, urge to go frequently w/o results, but is having bowelmovement daily. latest ct scan nov.04 shows diverticula in sigmoid colon and inguinal hernia. EPO is elevated 3.5 points, hemaglobin and hemocrit was elevated 2 weeks ago HMG 19.1, HCT 54.3 on scale of 13.2-17.1,38.5-50, RBC 5.97 on scale of 4.20-5.80, but has come down HMG.19.2 on scale of 13.5-18, HCT 56.5 on scale of 41.5-57, RBC up 6.22 on scale of 4.50-5.50. Hemotologist thought elevation due to smoking even though arterial oxygen saturation test was within normal limits. Alkaline phosphatase at times within last couple of years has been elevated as much as 50 points, presently only 3.5 above normal.We are unable to even get an appt. w/gastroenterologist until jan.24,05. We are very concerned that diverticula may be confused w/ colon cancer, does ct scan definetly show positive difference between diverticula and colon cancer? We also are concerned he may have started bleeding again,we never saw blood in his stool even when he was severely anemic. Maybe of importance, 1 year ago cardiologist report, pulmonologist report, liver tests, all okay. Please give us any help you can.

[Kevin Pho, MD]

A CT scan cannot tell the difference between diverticula and colon cancer.  The only way to definitively tell would be to take a biopsy of the suspected lesion.  This can be done via a colonoscopy.  

If the bleeding continues despite multiple attempts at cauterization, then surgery to remove the affected bowel would have to be considered.  

Regarding the elevated HCT, I would suggest following up with the hematologist.  A bone marrow biopsy would give a more definitive answer as to what is causing the elevation.

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.

Kevin, M.D.
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