wife with colon cancer symptoms

[scoobysnacks]

My wife has had the following symptoms presented, chronically, for the past 3 months. She had an abdominal CT scan on Friday after a three week wait to see the gastroenterologist to whom she was referred for a consultation from her new PCP.

1. chronic constipation
2. narrow, low volume stools
3. sensation of incomplete elimination during bowel movements
4. sensation of abdominal 'fullness' and bloating
5. sensation of pressure on the rectum
6. a palpable tender area (which under thoracic pressure responds by bulging) on her right abdomen, approx 2" below her last rib, and six inches to the right of her belly button.
7. Increasingly irregular menstruation, including two periods within 15 days, bright red from the vagina after sex, and periods that start/stop/start.

In addition to these chronic symptoms, she has been nauseous for the past three days.

Of course we are waiting for the results of her CT scan.

My question is the following:

If this were your wife, in addition to the CT scan, what tests would be indicated, and aside from colon cancer, what possible causes would you be screening for?



Thanks in advance for your reply.

[lizziecee]

Until the doctor responds thought I would say hi.
Your wife's symptoms could be due to many diseases, gall bladder, inflammatory bowel disease, diverticulitis, coeliac etc.  I have had Crohn's for some 38 yrs, in both small intestine and colon, and currently have symptoms just like your wife's but also severe weight loss, some 14 lbs in past 4 weeks. I saw my gastro last week and he has ordered a CT scan of pelvis,abdomen,liver and pancreas, 26 June and an upper GI endoscopy under sedation 9th July. I was dx by MRI last Nov with 2 strictures in the small intestine, but was asymptomatic then. I suspect my problems are either pancreatitis or the narrowed strictures. I don't feel it is a Crohn's flare, as I have been on injections of methotrexate for 7 yrs, and a flare feels quite different.

Could of course, be colon cancer, especially since my father died of this disease when he was 59 yrs, and Crohn's patients are more susceptible to colon cancer than the general population. No point in second guessing the dx, until scan results come back but you might ask the gastro about scopes of the small intestine and colon. That way, he has a complete picture.
I do hope your wife gets a definitive diagnosis soon, and appropriate treatment. It will be interesting to see what Dr. Pho thinks - his quite brilliant.
Liz.

[Kevin Pho, MD]

I agree with the CT scan.  At this time, a colonoscopy is needed.  This can exclude colon cancer, as well as a variety of lower GI conditions like inflammatory bowel disease or colitis.

With the bloating and fullness, an upper GI workup may be warranted.  This can be done with an upper endoscopy.  Further tests can include a 24-hr pH study (looking for GERD), and a gastric emptying scan (to exclude delayed gastric emptying).

Sending the stool off for culture and analysis for malabsorption can also be done.  I would also do blood tests to exclude celiac disease.

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

[lizziecee]

Glad you are on your wife's case... don't have clue as to how old she is, I was 24 yrs when diagnosed with Crohn's, now 63 yrs and counting hopefully. Sopme of our local Crohn's and Colitis Assocn members have children as young as 6 yrs dx with this insidious disease.  It took 9 minths to dx me, no scopes in those days, just some nuclear B12 absorption medicine test and the rare Schilling test,= at a major teaching hospital in London, UK. the fifth hospital I was in, not anorexic as I could eat, but weighed some 60 lbs. Like a skeleton with my bones protruding.   I ended up having a laparatomy of my lower abdomen  Some 38 yrs later there are so many new diagnostic tests for GI diseases, that no-one these days has to succumb to that barbaric surgery. And...there are so many new meds to bring the disease into remission. I was on steroids for 30 yrs, which have played havoc with my bone density so on bisphosphonates now, but been on self injected methotrexate for 7 yrs, except for a 4 month lapse for breast cancer FEC chemo,Thought I had it all sussed out, but got big problems at present, possibly due  to two strictures dx on MRI last November, but asymtomatic then. Getting a CT scan 26 June and an upper GI endoscopy 9 July to try and figure out current problems.
Your wife is truly blessed with such a caring husband....my 2nd husband, now 79 yrs and disabled has been my rock...but I have always had to do my own research for the best treatment on socialised medicine in England as I figure I am my own best advocate.

Wish you both well...let us know how you get on, as your information is invaluable to other posters on here, and our Community Site, where I now the leader for Crohn's. Could be your wife has other gi problems, but always helpful to other posters.
Take care,
Liz.

[zoomistic]

rectocele is possible, also does she have black tarry stools or are they normal color?

[scoobysnacks]

Thanks for the post, Liz. I have only been doing research on her condition for two weeks. I have a list of anticipated dx's including diverticulosis and the set of inflammatory bowel conditions, including enterosis, and crohn's. While colon cancer is in my list of anticipated dx's, her odds are so extremely low at her age (99.9996% chance against).

Your experience- highlighted in your post- is very helpful. I look forward to hearing Dr. Pho's comments.

We anticipate hearing results from the CT scan by mid week at the latest. I will post back.

Thanks
scoob