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Family history of bowel cancer. Having abdominal pain, back pain and IBS. Am I at any risk?

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Practicing since : 1962
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Good Afternoon Doctor,
I’m a reasonably healthy 23 year old who is currently studying at University. Recently however, I have come under some very distinguished problems within my bowels.

It started towards the back end of February (27th). I have not suffered with any previous bowel problems before until now. Family history has come under threat of bowel cancer, with my mother’s sisters, 3 out of the 12 having been treated for bowel cancer but a genealogist has notified that it is not hereditary.

Throughout most of March I have been suffering from a variety of bowel movements and small sharp stabbing pains in my abdomen. Quite specifically, sharp stabbing pains (every now and then) directly in the centre, about 5cms from the belly button. My stools have been very soft, yellow in colour and very sticky and food parts have been undigested more than what is regarded as normal. (I.E. Carrots, herbs, nuts are totally undigested). Further to this they have been very smelly to what is regarded as my ordinary stool.

Sometimes my stools have been hard, similar to normal stools, but have been lined with a good proportion of mucus if this is the case.

About two weeks ago I saw a small, what looked to be a ‘blood clot’ buried within a part of the stool. It was very small and a deep red.

I have been passing stools more frequently to that of my usual times. Usually I would pass stools twice a day. Now I am passing stools 3-4 times a day.

I feel constipated and feel like I haven’t fully ‘emptied’ my bowels when going to the toilet.
The main consideration however is that passing gas either through burping or flatulence has been a significant symptom. Sometimes trapped gas is very painful and creates a bloating feeling, almost making myself not want to eat. Further to this, when I do burp, I feel a slight rumble on my lower left rib cage (underneath the last left rib cage). Burping also relieves chest pain and lower abdomen pain.

I have also been suffering from significant lower back pain, predominantly around the areas of the lIiac crest, the ball like feeling on the lower back, both left and right hand sides. This back pain is sometimes relieved by visiting the toilet.
Lying down on my front predominantly makes my back pain a lot worse, so lying on my back can sometimes relieve this pain.

To Finalise;

My stools have been yellow, very soft and contain a variety of undigested food parts within them. They are sticky and hard to pass with a distinct smell. I feel constipated, I’m starting to lose my appetite with foods and have a feeling of being sick, especially within the stomach. I also have, every now and then, sharp stabbing pains within my abdomen, about 5cms above the belly button. I have been suffering with lower back pain since this has occurred.

If I was to predict what the cause of this might be I would point towards food that was eaten on the 26th, or what I can remember of it. I do remember eating an Egg, around 1 month out of its best before date. I did not recognise this until looking at the packet. I personally believe it may be some sort of parasite infection because there has been a significant increase in the amount of gas recently + all other symptoms mentioned above. I have not noticed any relaxation within my bowel movements without yeast, diary or wheat as I rarely eat them anyway.

Can you help?
Posted Sun, 28 Apr 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 1 hour later

Thank you for your query.

I can tell that as a young man, you got too much on your mind because of your Aunts having bowel cancer and this is constantly on your mind. You do have bowel issues, alternating constipation and soft stools sometimes.

You also have a lot of gas bloat and abdominal pains. You have a lot of other aches probably related to trapped gas pressing on surrounding organs. All these symptoms point to Anxiety adds to the symptoms.

Most people will have either constipation or diarrhea predominant symptoms. You seem to have the mixed variety.

You stated sometimes you see undigested food particles in the stool. This indicates that your intestinal contractions are faster and stronger and pushes the food through . If you are constipated, then it is a slow transit through the intestine.

If you have not had any systemic symptoms such as fever,chills, weight loss, loss of appetite etc, you can rule out any serious disease. You mentioned that you noticed fresh blood one time with stool.

More than likely, you were straining and you were constipated. It is possible that you may have small hemorrhoids or piles or even a fissure or a tear in the lining at the end of rectum.

It is O.K. to have your stool tested for ova and parasites still.

I would even recommend a sigmoidoscopic examination by a specialist to rule out any rectal problems including hemorrhoids.

You need to be on a high fiber diet which should include whole grain cereals, fresh fruits, vegetables, nuts and legumes.
You should drink enough fluids.
If needed, you can take an over the counter stool softener daily. If that does not get you regulated, you can take a PEG solution (Polyethylene glycol) according to instructions. You can adjust the dose up or down to keep the stool normal.
Make sure you stay active physically.

You have a long fruitful life ahead of you and I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Family history of bowel cancer. Having abdominal pain, back pain and IBS. Am I at any risk? 1 hour later
Good Afternoon Dr. XXXXXXX

Thanks for replying to my concern. It was extremely detailed and very easy to read.

I'm a little unsure of your last point, whether or not I should take a stool softener. Currently, my stools have been very yellow, very soft already and very sticky. It is only when, on the very odd occasion, is my stool hard and when I have a lining of mucus surrounding the stool.

My considerable concern is the gas that is produced. Is it possible you could let me know what/why and which food groups are causing this gas?

In relation to Hemmorhoids, I can feel a large, spot like lump on the edge of my sphincter whilst wiping. This was in-fact discovered today.

Do/Would a combination of Hemmorhoids and IBS be a probable conclusion to my symptoms? Taking into account my age etc.

I did forget to point out that my activity (physical exercise) has been down over the last 4 months due to University pressure and exams.

Could this also influence and exaggerate my symptoms?

All the best Dr. XXXXXXX
Answered by Dr. Charles S Narasi 1 hour later

Good to hear from you again. You do not need to take the stool softener if you have soft stools. Take it only during the times you are having hard stools.

As for gas producing foods and drinks, if you have lactose intolerance, all milk products give you lots of gas because of lack of lactase enzyme. You can experiment eliminating dairy products for a week and see if the gas problem gets better. Cabbage family of vegetables give you gas. If you chew gum
a lot, those that contain sorbitol, you swallow more air and sorbitol also gives more gas. Beans and legumes in some give more gas. There is a product called "Beano" which you take once a day if that is the case. Peppermint capsules help reduce gas also.

As for your hemorrhoids, I suggest that you see a proctologist or maybe your doctor can advise you what to do.

Get back to active life.

I again wish you the very best.
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