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I Am A 49 Years Old Male. Physically Active, No

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Posted on Tue, 23 Jun 2020
Question: I am a 49 years old male. physically active, no family member with colon cancer. 9 years ago (40 years of age), I had pain in the lower left of the abdomen and frequent bowel movement but no loosing stools. My doctor did not have any concern but still referred me to a GI to have a colonoscopy because I insisted. The colonoscopy only found grade 1 internal hemorrhoid and the pain was gone right after that and I realized that I took too much of laxative herbal tea. I've been taking fiber powder & stool softener daily for a while since I've been having anal fissure due to hard stools sometimes and lately I had some good amount of fresh blueberry because they were so good and the exact same problem 9 years ago started. A friend of my who is a practitioner told me not to eat too much fiber and fresh veggies, the problem seemed to subside about couple days and it happens again when I ate a large avocado and some vegetables. I again had to reduce those to almost none and that seems help but I can feel the cartilage on the very low & far side of the left rib cage tenderness and pain when touch and so as the lower muscle below it near hip also tendered. My doctor plans to send me for another colonoscopy next year when I turn 50 and also 10 years interval. I've reduced consuming veggies & fruits and the mild pain in the lower left of abdomen seems better but not 100%, I guess. a couple muscle spots right beneath the skin on the left abdomen are tender to touch with stretching.

Do you think my symptoms cause for a concern?
What the odd of having colon cancer in my situation, a clean colonoscopy 9 years ago without family history?

Thank you for helping
doctor
Answered by Dr. Ramesh Kumar (7 hours later)
Brief Answer:
Chances of it being colorectal CA are extremely low.

Detailed Answer:
Hello and thanks for choosing "Ask a Doctor" service for your query,
Have gone through your details and I appreciate your concerns,
Very likely you are having diverticulitis.
Tenderness and pain in left iliac fossa in a patient with history of hemorrhoids could be diverticulitis.
I don't think that it could be colorectal cancer.
Why?
It is associated with sudden change in bowel habits.
Pain is severe and starts worsening with time very quickly and usually is associated with heavy bleeding and don't respond to medication or change in diet.
Stool is pencil like in shape.

Why diverticulitis?
1)Tenderness in left iliac fossa.
2)Having a low fiber diet from many years lacking in vegetables and fruits.

So for me chances of it being a colorectal carcinoma is less then 0.1% however a sure shot answer could be only after colonoscopy as you were on a low fiber diet from a very long time and those patients are good candidate for any G.I condition including colorectal ca.
Follow ups are welcome.
Thank you!

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (1 hour later)
Dear Dr.

Thank you for your answer, I%E2%80%99ve on high fiber for a long time and might be over dosed and laxative because I sometimes had anal fissure due to hard stool.

I did have similar symptoms several times
before but my family Dr said it was not IBS but shorter times.

i don%E2%80%99t think the mild pain in my stomach still there but I do feel some 2-3 very small tender spots when touch right below the surface of the skin of the stonach but they mimic some very short deep pain throughout the day
doctor
Answered by Dr. Ramesh Kumar (7 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Hi there,
Thanks for follow up.
See IBS is diagnosis of exclusion. There is no specific test for IBS.If patient has symptoms with all tests like colonoscopy fecal calprotectin etc are normal...Patient is labelled as having IBS.
Basically IBS is a functional disorder where anatomically every thing is normal but physiologically some problem is there. So no comments on IBS till colonoscopy is done.
Fiber intake should be around 35 grams a day.

Follow up with colonoscopy reports.
In case you have any question please revert back.
Thank you!
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2907 Questions

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I Am A 49 Years Old Male. Physically Active, No

Brief Answer: Chances of it being colorectal CA are extremely low. Detailed Answer: Hello and thanks for choosing "Ask a Doctor" service for your query, Have gone through your details and I appreciate your concerns, Very likely you are having diverticulitis. Tenderness and pain in left iliac fossa in a patient with history of hemorrhoids could be diverticulitis. I don't think that it could be colorectal cancer. Why? It is associated with sudden change in bowel habits. Pain is severe and starts worsening with time very quickly and usually is associated with heavy bleeding and don't respond to medication or change in diet. Stool is pencil like in shape. Why diverticulitis? 1)Tenderness in left iliac fossa. 2)Having a low fiber diet from many years lacking in vegetables and fruits. So for me chances of it being a colorectal carcinoma is less then 0.1% however a sure shot answer could be only after colonoscopy as you were on a low fiber diet from a very long time and those patients are good candidate for any G.I condition including colorectal ca. Follow ups are welcome. Thank you!