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GI Discomfort/Small Bowel Cancer?
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GI Discomfort/Small Bowel Cancer?

28 year old male. I have had no major medical history with the exception of a GERD Dx.

Around 1 week ago, I began having some abdominal discomfort after eating. Within an hour of eating, I get crampy, bloated, colicky, gas pains that come and go. My stools have been occasionally solid, but occasionally diarrheal in nature. Often foul smelling and yellowish.

I have lost around 7 pounds in the past week, perhaps due to loss of appetite.

Obviously, these symptoms are non-specific and can have many causes. I haven't noticed any particular dietary pattern that's triggered the GI symptoms.

Diagnostic tests:
8/13 - CBC - all values normal.
8/13 - CMP - all values normal
8/13 - C Reactive Protein - 0.8 mg/l - low end of the normal range
8/14 - CBC - all values normal except for slightly elevated basophils (8 with a reference range of 0-7)
8/14 - Pancreatic Enzymes - all values normal
8/14 - Complete Abdominal Ultrasound (liver, bile ducts, pancreas, spleen, kidneys, gall bladder, aorta) - all normal and unremarkable

My concern is small bowel cancer, and in particular small bowel lymphoma. My GI thought the suggestion was ludicrous (and I imagine he had a rational foundation for thinking so). In the first place, I am aware that small bowel malignancies are rare. I am also aware that they are especially rare within my age group. And I am further aware that lymphomas of the small bowel within a person of my age group would be exceedingly rare. He also added that it would be even more unlikely still that there would be no abnormality on any of the lab work, in particular the CRP. Still, I have anxiety about this.

In the past, I have had several CT studies performed 5 years ago that I believe may have triggered a carcinogenic process that could have led to this. However, from all of the medical literature I've read, leukemias are far more likely to result from radiation exposure than lymphomas, and lymphomas (if they manifest at all) are more likely to manifest decades later.

Anyway, he proffered the explanation of IBS--but I am bothered by the sudden onset of symptoms.

Any insights you could offer would be greatly appreciated.
Avatar_dr_f_tn
Hi, understand your anxiety. If your symptoms are due to leukemia, the blood counts would be abnormal. And if your symptoms are due to lymphomas, then the enlarged lymph nodes would have been picked up by the CT scan. Also, the other groups of lymph nodes in the neck and axilla would have been enlarged. Your symptoms could be due to IBS. IBS is a diagnosis of exclusion. If all the tests to rule out other disorders are done and found to be negative, then the diagnosis of IBS is made. IBS is diagnosed when a person has abdominal pain or discomfort at least three times per month for the last 3 months without other disease or injury that could explain the pain. The pain or discomfort of IBS may occur with a change in stool frequency or consistency or may be relieved by a bowel movement. Regards.
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