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Dr. Andrew Rynne

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Having irregular bowel movement with mild cramps. Worried for colon cancer

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Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5770 Questions

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Posted on Fri, 18 Jan 2013 in Digestion and Bowels
Question: I have consistent bowel movements at least once a day. Oddly on the weekends, I will have a bowel movement that is solid and immediately after passing the solid stool, I will pass soft sort of mushy stool in small pieces. It is kind of hard to explain. I will have minor cramping before the bowel movement then of course that goes away after passing the stools. I am 42 and get regular colonoscopies, due to father having colon cancer, every three years since I was 37. I constantly worry about colon cancer.
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Answered by Dr. Grzegorz Stanko 1 hour later
Hello!

Thank you for the query.

Your symptoms can be caused by stress, IBS, bad diet, irregular meals, severe intestines infection, inflammatory bowel diseases, thyroid problems, pancreas problems. As you do have had colonoscopy performed, colon cancer, rectal polyps and ulcerative colitis (one of the inflammatory bowel disease) has been ruled out. According to your constant colon cancer doubts, this can be the main reason of your symptoms. Brain has great domination in human body and your concerns can result with such strange bowel movements and abdominal pains. It can be the only manifestation of anxiety, however you may also suffer from shortness of breath, sweating, sleeplessness etc.
But before such diagnosis, I suggest you to try Rifaximine 400mg 2x1 for 7 days treatment and Mebeverine 200mg once a day and see if this gives any relief. If so, bacterial infection was the reason. If no, you should have stool tests, thyroid tests, pancreas tests. If no findings, you may ask your doctor about abdominal CT with oral contrast (called enteroclysis) for Crohn`s disease rule out.
If all this medicines and test wont bring anything, you may find SSRI therapy helpful.
Some words about colon cancer. If your father has this cancer diagnosed before 50, you may be suffering from HNPCC (Hereditary non-polyposis colorectal cancer). This is the most common reason of hereditary colon cancer and we do have genetics tests for it.
If you father has this cancer diagnosed when older than 50, this was most probably sporadic case and it does not runs in a family. You need to know that cancer is generally rare disease and the risk of colon cancer in regular population is only about 3-5%. Moreover, it takes about 10 years for cancer to develop in large intestine so colonoscopy (if HNPCC is ruled out and no polyps in previous tests) every 3 years sounds little bit too often.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko 4 minutes later
Thank you for your quick response. I failed to mention that I had an abdominal ultrasound performed April 2012 due to upper right quadrant pain. They did check liver, pancreas, and the gall bladder. It was negative with a slight thickening of my gall bladder wall. I also get a physical every year. Bloodwork has always been excellent.
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Answered by Dr. Grzegorz Stanko 12 minutes later
Hello!

Abdominal ultrasound is very sketchy test and good for gallstones and liver tumors diagnosis. Pancreas or intestines are generally invisible for ultrasound. So it does not change anything. Bloodwork can be excellent with inflammatory bowels diseases, anxiety, IBS and bacterial severe infection so it does not rule anything out.
I suggest you to try mentioned treatment and tests.

Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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