Blood in stool requires investigation, pronto
DEAR DR. ROACH: For longer than a month now, I have had blood in my stool. Not just a little, and not just with stool. I am losing blood constantly. My doctor said he's sure it's a hemorrhoid, which he checked me for and then told me it wasn't that. I can't afford to see another doctor. My wife found something on the Internet about an internal bowel infection that can be treated only with antibiotics. I cannot get antibiotics without a doctor's prescription. We both are scared to death and have nowhere to turn. I am only 27 years old! -- S.M.
ANSWER: Bleeding from the GI tract is always a frightening thing. Blood can come from every part of the GI tract, but when it looks like blood in the stool, that almost always means the blood is coming from the colon.
At age 27, colon cancer and polyps are unlikely but not impossible. It's possible that you have an infection, since many intestinal infections can cause bleeding, but a month is a long time to have bleeding from an infection. One big concern I have upon hearing your story is inflammatory bowel disease. There are two kinds -- Crohn's disease and ulcerative colitis. Both of these can cause abdominal discomfort and bleeding. The right diagnostic test is an endoscopy. I understand when you say you can't afford to see another doctor, but actually, you can't afford not to. Don't delay.
The booklet on colon cancer provides useful information on the causes and cures of this common malady. Readers can obtain a copy by writing: Dr. Roach -- No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: Will you please discuss a polyp in the stomach? I have been told that I have one. I know polyps in the colon can lead to cancer, but what about in the stomach? Should it be checked on, or just left alone? The doctor's answer was that it is nothing to be concerned about. What do you think? -- D.B.
ANSWER: A polyp is a growth in the cells that line an organ. They usually are benign. Colon polyps come in different types, and each has greater or lesser risk of becoming colon cancer. Just like in the colon, there are many different kinds of stomach polyps, and what to do about them depends on what kind of polyp it is. Polyps almost always are found now during an endoscopy of the stomach
The most common type of stomach polyp is called a fundic polyp, and they're often associated with taking medications like omeprazole (Prilosec and others). Most of these are small and very unlikely to become cancer. I suspect this is the kind you have. The appearance is characteristic on endoscopy. Most physicians would not recommend any kind of surgery or removal, but only to keep an eye on it with a repeat endoscopy.
There are other, rarer kinds of stomach polyps that have higher risk. It's OK to go back and talk to your doctor if you are concerned about these, but most of them are quite low-risk.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters or mail questions to P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.
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