Colon Cancer - should I worry?

[clarksigman]

I can't get the C-word out of mind. Can anyone out there share some insight with me?

GI SYMPTOMS/HISTORY

1. For over a year (and possibly longer), a typical bowel movement will take place as follows: several normal-looking pieces of stool, always on the soft-side, followed by a torrent of very soft, sticky “sludge” like stool that has the appearance of pudding or soft-serve ice cream, and will often pile up into a mound. Rarely flushes away without leaving residue in toilet bowel. Most stool breaks apart when flushed. Color ranges from light-brown to yellowish-orange. Overall, very regular, and BMs followed by feeling of “completion.”

2.In 2001, hemorrhoid first appeared. Fresh blood would frequently appear in toilet. Late 2009, hemorrhoid caused difficulty again, but was resolved in about 10 days with OTC meds and prescription steroids.

3.In September 2010, started noticing slight tenderness and discomfort in lower left quadrant. Not painful, nor any change in bowel habits. Attributed to gas, drinking too much beer, or “nervous bowels” (as I was considerably stressed at the time).

4.In October 2010, started noticing flu-like symptoms (body aches, weakness, general malaise, extreme fatigue, no fever) and anticipated the arrival of a cold or other infection. Bowel habits began to change: much looser and more frequent stools, tenesmus, palpable cramps in lower-left quad not relieved by bowel movement. Symptoms would worsen and then plateau around mid-November, and still persist today. Blood panel (CBC, liver, pancreas, vitamins) revealed nothing unusual.

5.In the last 3 weeks, have experienced alternating bouts of constipation and diarrhea, extreme bloating, and ever-increasing lower-left quad cramps/discomfort. Bouts of constipation have been somewhat relieved by fiber laxative, but sensation of incomplete emptying remains. Solid stools will be extremely loose and segmented, will often float, and are accompanied by mucous-y fluid. Hemorrhoid has flared up again, and fresh blood in visible in most bowel movements.

6.Both maternal and paternal grandfathers diagnosed with colorectal cancer. Both treated and recovered fully. Mother had polyp removed about 8 years ago. Paternal uncle suffered from chronic diverticulosis.

Any help or advice anyone can share would be greatly appreciated. As I said, so far blood panel looks good, and abdominal ultrasound revealed nothing unusual.

Thanks!

[clarksigman]

I actually just returned home from an Abdominal CT scan. The GI doc wants to play things safe and do the scope (I'm scheduled for later this month).

I perhaps overstated, or least put a little too much emphasis, on the blood in the stool thing. It's only happened twice, and the blood would spill (almost squirt) into the toilet before the BM arrived. This was accompanied by sharp, tearing pains in the anus, and the hemorrhoid (which has been positively diagnosed by my PCP in the past) could be manually palpitated. You're right, it could be some far more serious (quite literally, "the tip of the iceberg) and will not be overlooked.

My EBV hunch originates from the fact that I did test positive back in 2001. I enjoyed a clean bill of health up until late in 2008, when I caught what I thought then was a flu/cold, but the symptoms wouldn't let up for nearly 12-16 weeks. My doctors were perplexed, as was I, and never though to probe deeper on EBV angel (that is, antigens were not tested for). Again in Fall 2009, I would have another bout, this one lasting only about 5 weeks.

Which brings us to today (well, mid-October) and the same set of symptoms came about, and haven't really lifted since. My bowel distress would come about 2-3 week into the latest EBV crisis (we'll just call it that). The wrench in the whole diagnostic process right now is it seems we have war on 2 fronts, and one set of symptoms may be responsible for the other, and vice versa. It's quite possible these GI problems might be the result of an underlining condition that might cause the flu-like aches, fatigue, and malaise. Or...it's entirely possible these are two completely independent syndromes, not influencing one another at all.

Once the GI front is clear (and let's keep our fingers crossed), I think it's safe to assume there's an immunological issue in play, and I'll be seeing an immunologist who specializes in CFS, MS, and EBV-related cancers and syndromes. I'm happy to report - bowel issues aside - constitutionally I'm feeling much better, which might be consistent with the EBV flare up finally running it's course.

It's all very complex, maddening, and ultimately tragic when one comes as preoccupied with one's own body as I have at the expense of everything else. Thank you for your continued concern and advice.

We'll be in touch. I'm sorry about your liver situation and hope that gets resolved swiftly. As for your doctors, as Hunter S. Thompson said "Don't take any guff from those swine." We'll reach a point someday where patients and doctors can find synergy in together: in their years of education and experience and with our intense, intimate understanding of our own bodies and our advocacy for our own well-being. Until then, we just have to keep fighting.

Take care.  

[oona]

Where are you at with this? Have you had any blood tests or scoping done yet? It really sounds like you should be seeing a GI specialist, if you haven't already set this in motion. The blood thing concerns me slightly and should definitely get checked out, even if your suspicion is that it's "just hemorrhoids".

Have you tested positive for EBV? I've been having some confusion around this, as well.  I did test positive for a number of the antibodies, but the GI doctor that I'm seeing said that EBV will not reactivate (which I kind of think is baloney, but I guess that's besides the point). In any case, I'll be getting a colonoscopy soonish, which is scheduled for Feb. 1st. In the meantime, I also have a abdominal CT in two days to investigate a liver hemangioma (tumour, apparently benign), to be sure that that is exactly what it is. I had to beg 5 different doctors to follow up on the liver mass, all of whom have said that it's no big deal.

I guess I should answer your question, though. I have heard that bowel upset can be a symptom of reactivated EBV. I'm not sure about the others, I've not looked into that. However, I've never read about fresh blood being a factor. So, my advice is the same, get a colonoscopy or at least some further investigation with a GI specialist. I highly doubt that CFS/ME, MS or Fibromyalgia would be causing what you've outlined above. It's just not one of the primary symptoms, to you have a symptom tracker or a profile, or are there other things going on that make you think that what's happening here is more complex than the problem with your bowel?

Good luck and do let us know if you're seeing someone about this :)

[clarksigman]

Does anyone out there know anything about the presentation of the symptoms I've listed (see above) and certain autoimmune disorders such of CFS/ME, MS, Lyme, EBV, Fibromyalgia. The literature I've come across hints at a striking concurrence of these types of syndromes and IBS (irritable and inflammatory).

Anyone have an experience or read up on anything that might shed some light on this?

[clarksigman]

I know, I know. It's just that when you have weird stools for so long, and are asymptomatic otherwise, you chalk it up to individual variation ("Well, this is just how I poop, so what?").

Does anyone else have an inkling as to what this could be (excluding IBS or celiacs)?

[mammo]

You should have seen a Gastroenterologist before now, so I'm happy that you have an appt. with one.  This is their specialty and will get right to the source of your problem. The scopes not bad, you'll be asleep before they even begin. Keep us posted and take care!

[clarksigman]

Thanks for the comment.

I'm getting in to see a GI specialist soon. It seems the only true way to rule out the worst is the dreaded scope. Thanks again for your input. I'll keep everyone posted.

[oona]

Are you seeing a GI specialist? I have some similar things happening (w/o blood), but mine have been going on for almost four years (and there are so many other symptoms). It could be simply a bout with IBS, but maybe to be on the safe side you might want to do some scoping.

I'm being looked at for autoimmune, due to blood testing that came back positive (so different there and not usually associated with bowel upset), but to ease your mind, it makes sense to get to a specialist and get some tests. The worry alone could cause your GI to go a bit wonky (but maybe it's not stress and should be looked it, it could be food sensitivities, celiac or something else, too).

Hope you're able to see someone! When I get back to see the GI, I am going to ask about scoping (he's already told me that I don't need it because I'm so young w/ no family history: 29 years-old)

Best of luck!