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What Could Cause Recurring Abdominal And Pelvic Pain With Recent Bloody And Mucus-filled Diarrhea Despite Controlled Celiac Disease?
Posted on
Sun, 17 May 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 17 May 2020
Answered on
6 days ago
Last reviewed on
Question : Can you help me what could be wrong with me? I am 30 years old, i have celiac disease but i am following strict diet and my antibodies are 0. I will write down symptoms:
1. In january 2018 i started feeling pain very close to my navel to the left. In January 2018 went to doctor, did lab test and ultrasound of abdomen- all clear. Pain continues even today but never escalated. Twice per day and last several minutes.
2. In january 2020 i started to feel pain near my left ovary. Was mild. My last vaginal ultrasound was in january 2019 was clear also pap test. My OBGYN said it cant be some gincological cancer as i am taking oral contraception.
3. 10 days ago i woke up in the middle of the night with worst imaginable pelvic pain. It was like pressure. When i went to the toilet pain clears. I had massive diarrhea but at the start there were solid parts. Went to toilet 3 times at night, there was visible blood in diarrhea. Not blood drops, only blood tingled diarrhea. Went to ER next day as i was still very weak. Did blood test, normal crp, no anemia, liver tests, kidney tests all clear. Only lymphocites midly low 13%25 (instead of 20%25) they did digital rectal exam was clear and no blood on finger.
4. Had bloody diarrhea another 8 days and then stopped. I now only have yellow mucus diarrhea
5. I think i had yellow mucus doarrhea for 2 months before BUT i had massive stress (really big stress time)
6. For 6 months since i had antibiotics i had anal yeast infections. It just dont clear up totally.
*****************************************************************
Is there any chance this is colon cancer?
*****************************************************************
1. In january 2018 i started feeling pain very close to my navel to the left. In January 2018 went to doctor, did lab test and ultrasound of abdomen- all clear. Pain continues even today but never escalated. Twice per day and last several minutes.
2. In january 2020 i started to feel pain near my left ovary. Was mild. My last vaginal ultrasound was in january 2019 was clear also pap test. My OBGYN said it cant be some gincological cancer as i am taking oral contraception.
3. 10 days ago i woke up in the middle of the night with worst imaginable pelvic pain. It was like pressure. When i went to the toilet pain clears. I had massive diarrhea but at the start there were solid parts. Went to toilet 3 times at night, there was visible blood in diarrhea. Not blood drops, only blood tingled diarrhea. Went to ER next day as i was still very weak. Did blood test, normal crp, no anemia, liver tests, kidney tests all clear. Only lymphocites midly low 13%25 (instead of 20%25) they did digital rectal exam was clear and no blood on finger.
4. Had bloody diarrhea another 8 days and then stopped. I now only have yellow mucus diarrhea
5. I think i had yellow mucus doarrhea for 2 months before BUT i had massive stress (really big stress time)
6. For 6 months since i had antibiotics i had anal yeast infections. It just dont clear up totally.
*****************************************************************
Is there any chance this is colon cancer?
*****************************************************************
Brief Answer:
Please go through detailed answer dear.
Detailed Answer:
Hello,
Thank you for your query. I have gone through your query in detail.
I would say that both the events (off and on pain since 2018) and this bloody diarrhea episode are not connected to each other. Both are separate issues.
For the first one as it now has a history of 2 years I would suggest you to go for a test called serum procalcitonin. This is one of the best test till date which would indicate even mild infection in any part of the body(But this test should be done once the episode of diarrhea completely settles down).
2)Bloody diarrhea is usually caused by infection of Bacterium called E.coli.
Was a stool test and culture done at the ER?
What treatment are you taking right now or was suggested by ER Dept?
Well, if you are not taking any meds right now I would suggest you to get a prescription for-
- Zithromax once daily and Metronidazole thrice daily for 3 days.
- Take a over the counter probiotic like VSL#3 Twice daily for 14 days.
- Along with it take Imodium thrice daily for 2 days if stools remain soft/mucoid.
- Eat BRAT diet. Banana, apple, toast, and all home cooked light food would be ideal for you.
Get a stool culture test done to find out if E.coli is involved. Once the episode is over go for serum procalcitonin test to rule out any infection/inflammation in body.
For weakness drink plenty of Electral/oral rehydration solution/water with sugar and salt.
What antibiotics were given for yeast infection. Yeast is a fungus and antibiotics wont effect it. I think you would be on antifungals. Can you please mention the detail?
What medicines are you taking for celiac disease?
Stress stimulates autonomous nervous system specially vagus nerve and increase the rate of peristalsis of intestine hence, water is not absorbed properly and mucous can be there in stools. I would suggest you to take initially natural Anti anxiety pill Lactium for one month. If nothing happens then prescription meds like Xanax could be taken for few month to curb anxiety.
Hope I was helpful. Please feel free to follow up. Thanks.
Regards
*****************************************************************
Brief Answer:
Very low but sure shot answer can be given only after colonoscopy.
Detailed Answer:
Hello,
Frankly speaking as COVID 19 crisis is going on at present I would suggest you to take a 3 day course of treatment and if things keep on worsening colonoscopy is the only answer.
But as history of pain and massive bleed is of just 10 days and the things have improved chances of it being colon cancer is quiet low (1-5%)as cancer and it's symptoms usually don't respond well to medications and keeps on worsening and rate of worsening is very high.
Therefore, for me chances of it being cancer (considering you have celiac is 5% at the max) but real and sure shot answer could be given only after colonoscopy.
Stay safe. Follow ups are welcome.
Regards
*****************************************************************
Please go through detailed answer dear.
Detailed Answer:
Hello,
Thank you for your query. I have gone through your query in detail.
I would say that both the events (off and on pain since 2018) and this bloody diarrhea episode are not connected to each other. Both are separate issues.
For the first one as it now has a history of 2 years I would suggest you to go for a test called serum procalcitonin. This is one of the best test till date which would indicate even mild infection in any part of the body(But this test should be done once the episode of diarrhea completely settles down).
2)Bloody diarrhea is usually caused by infection of Bacterium called E.coli.
Was a stool test and culture done at the ER?
What treatment are you taking right now or was suggested by ER Dept?
Well, if you are not taking any meds right now I would suggest you to get a prescription for-
- Zithromax once daily and Metronidazole thrice daily for 3 days.
- Take a over the counter probiotic like VSL#3 Twice daily for 14 days.
- Along with it take Imodium thrice daily for 2 days if stools remain soft/mucoid.
- Eat BRAT diet. Banana, apple, toast, and all home cooked light food would be ideal for you.
Get a stool culture test done to find out if E.coli is involved. Once the episode is over go for serum procalcitonin test to rule out any infection/inflammation in body.
For weakness drink plenty of Electral/oral rehydration solution/water with sugar and salt.
What antibiotics were given for yeast infection. Yeast is a fungus and antibiotics wont effect it. I think you would be on antifungals. Can you please mention the detail?
What medicines are you taking for celiac disease?
Stress stimulates autonomous nervous system specially vagus nerve and increase the rate of peristalsis of intestine hence, water is not absorbed properly and mucous can be there in stools. I would suggest you to take initially natural Anti anxiety pill Lactium for one month. If nothing happens then prescription meds like Xanax could be taken for few month to curb anxiety.
Hope I was helpful. Please feel free to follow up. Thanks.
Regards
*****************************************************************
Brief Answer:
Very low but sure shot answer can be given only after colonoscopy.
Detailed Answer:
Hello,
Frankly speaking as COVID 19 crisis is going on at present I would suggest you to take a 3 day course of treatment and if things keep on worsening colonoscopy is the only answer.
But as history of pain and massive bleed is of just 10 days and the things have improved chances of it being colon cancer is quiet low (1-5%)as cancer and it's symptoms usually don't respond well to medications and keeps on worsening and rate of worsening is very high.
Therefore, for me chances of it being cancer (considering you have celiac is 5% at the max) but real and sure shot answer could be given only after colonoscopy.
Stay safe. Follow ups are welcome.
Regards
*****************************************************************
Above answer was peer-reviewed by :
Dr. Prasad
i uploaded photo of my stool. it has brown streaks like veins in it. If o press on them they do not dissapear like bloood would, they stays veins shape. Is this blood or what could it be?
Today it was my third day of probiotics and i have to say my stool is not diarrhea but much harder. But it has this veins on it. i am afraid it is blood again?
about antibiotics you asked me.... i had antibiotics in september because i had nose infection. after 6 days of antibiotics i got fungal yeast infection and it lasted 5 months. i still get some itching sometimes.
*****************************************************************
i had plain CT of abdomen and pelvis (not ct colonography!) in august 2017. Would it show polyps there? because my CT was clear. Would they se something already there?
*****************************************************************
Today it was my third day of probiotics and i have to say my stool is not diarrhea but much harder. But it has this veins on it. i am afraid it is blood again?
about antibiotics you asked me.... i had antibiotics in september because i had nose infection. after 6 days of antibiotics i got fungal yeast infection and it lasted 5 months. i still get some itching sometimes.
*****************************************************************
i had plain CT of abdomen and pelvis (not ct colonography!) in august 2017. Would it show polyps there? because my CT was clear. Would they se something already there?
*****************************************************************
Brief Answer:
Follow up.
Detailed Answer:
Hello,
A simple test called stool for occult blood would be required to make a comment on blood. A small amount of stool sample would be tested in a laboratory for blood. It can be done at the nearest lab.
No. CT scan can't find a polyp. An MRI is required for that or a colonoscopy has to be done.
Thanks and take care!
Regards
*****************************************************************
Brief Answer:
Follow up.
Detailed Answer:
Hello,
C-Reactive protein is a marker of inflammation and it could be raised in any inflammatory condition. What has it do do with cancer?
Yes. Patients with colon cancer could be anemic but even problems like fissure or hemorrhoids could cause gross anemia. Hence, they are not markers of colon cancer. Colon cancer needs colonoscopy followed by biopsy of sample.
Take care. Let me know if I can assist you further.
Regards
****************************************************************
Follow up.
Detailed Answer:
Hello,
A simple test called stool for occult blood would be required to make a comment on blood. A small amount of stool sample would be tested in a laboratory for blood. It can be done at the nearest lab.
No. CT scan can't find a polyp. An MRI is required for that or a colonoscopy has to be done.
Thanks and take care!
Regards
*****************************************************************
Brief Answer:
Follow up.
Detailed Answer:
Hello,
C-Reactive protein is a marker of inflammation and it could be raised in any inflammatory condition. What has it do do with cancer?
Yes. Patients with colon cancer could be anemic but even problems like fissure or hemorrhoids could cause gross anemia. Hence, they are not markers of colon cancer. Colon cancer needs colonoscopy followed by biopsy of sample.
Take care. Let me know if I can assist you further.
Regards
****************************************************************
Above answer was peer-reviewed by :
Dr. Raju A.T
If there would be colon cancer cause, wouldnt i have a high crp or anemia? How many patients have abemia or crp high?
Brief Answer:
Very low.
Detailed Answer:
Hi,
Guaiac based fecal occult blood test should be done at the minimum to say any thing about cancer. Very likely it's not cancer but no doctor can give you 100% sure shot answer just on basis of anemia or CRP.
Hence, it is very likely it's not, but minimum basic screening test should be done for a professional answer.
Take care and thanks!
Regards
Very low.
Detailed Answer:
Hi,
Guaiac based fecal occult blood test should be done at the minimum to say any thing about cancer. Very likely it's not cancer but no doctor can give you 100% sure shot answer just on basis of anemia or CRP.
Hence, it is very likely it's not, but minimum basic screening test should be done for a professional answer.
Take care and thanks!
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
I have normal CRP and no anemia. So my chances of colon cancer are lower right?
Brief Answer:
Follow up.
Detailed Answer:
Hi there,
It may or may not show a polyp. It depends really on what radiologist is looking for. I mean, a polyp is just a small growth in intestines (So chances of it being detected in a abdominal ultrasound which scans complete abdomen are very low) unless the doctor has asked radiologist to look for it/try to look for it.
Hemorrhoids are of two types -
External and internal.
Internal hemorrhoids rarely bleed.
So try to understand digital rectal examination and abdominal ultrasound are just basic things and are not even a part of colon cancer screening.
My question-
Write down your three current symptoms with decreasing intensity like
For e.g. bleeding pain changed bowel habits which means main symptom is bleeding followed by pain followed by changed bowel habits.
I shall await your reply.
Regards
Follow up.
Detailed Answer:
Hi there,
It may or may not show a polyp. It depends really on what radiologist is looking for. I mean, a polyp is just a small growth in intestines (So chances of it being detected in a abdominal ultrasound which scans complete abdomen are very low) unless the doctor has asked radiologist to look for it/try to look for it.
Hemorrhoids are of two types -
External and internal.
Internal hemorrhoids rarely bleed.
So try to understand digital rectal examination and abdominal ultrasound are just basic things and are not even a part of colon cancer screening.
My question-
Write down your three current symptoms with decreasing intensity like
For e.g. bleeding pain changed bowel habits which means main symptom is bleeding followed by pain followed by changed bowel habits.
I shall await your reply.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
I had abdominal ultrasound 20 months ago. It showed nothing. Would it show polyp or something?
And one more question my digital rectal exam was clear and no blood. Does that mean i dont have hemmoroids and cancer in rectum or is rectum bigger than they can palpate with finger?
And one more question my digital rectal exam was clear and no blood. Does that mean i dont have hemmoroids and cancer in rectum or is rectum bigger than they can palpate with finger?
Brief Answer:
Follow up.
Detailed Answer:
Hello there,
These are just suggestive of dyspepsia or mild gastroenteritis.
You don't have colon cancer. No tests are required, not even screening.
The initial presentation of colon cancer is severe bleeding and pain. Therefore, just eat light food. Take probiotics for few days and you will be fine. For nauseam Prizolec can be taken as and when required.
Thanks! Let me know if I can assist you further.
Regards
Follow up.
Detailed Answer:
Hello there,
These are just suggestive of dyspepsia or mild gastroenteritis.
You don't have colon cancer. No tests are required, not even screening.
The initial presentation of colon cancer is severe bleeding and pain. Therefore, just eat light food. Take probiotics for few days and you will be fine. For nauseam Prizolec can be taken as and when required.
Thanks! Let me know if I can assist you further.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
I dont have blood in stool anymore (i had it only 2 days) i also dont have pain anymore (maybe just a little) but my Nausea is there. I did not have nausea yesterday but today i have full blown nausea. Diarrhea is still here but first stool in the morning is solid. I dont have appetite. This are all my symptoms.
Could this be ecoli or samonella? But for 12 days? This is insane
Could this be ecoli or samonella? But for 12 days? This is insane
Brief Answer:
Very likely E.coli.
Detailed Answer:
Hi there,
Exact answer needs a stool analysis lab test however, in most of the cases, E.coli is involved.
Thanks and take care.
Regards
Very likely E.coli.
Detailed Answer:
Hi there,
Exact answer needs a stool analysis lab test however, in most of the cases, E.coli is involved.
Thanks and take care.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Is it possible that i had obstruction when i had worst pain in my life and when i had bowel movement it webt away? And thats why i have nausea and loss of apetite now?
Brief Answer:
Follow up.
Detailed Answer:
Hello there,
I think you are overthinking about things it's not a good sign to think of any random possibility. There is not even a single thing which suggests obstruction.
Obstruction is to be corrected by surgery and is an emergency condition. No obstruction.
Please share with me about the symptom you are most worried about right now and how do you keep guessing problems from cancer to obstruction?
Thanks.
Regards
Follow up.
Detailed Answer:
Hello there,
I think you are overthinking about things it's not a good sign to think of any random possibility. There is not even a single thing which suggests obstruction.
Obstruction is to be corrected by surgery and is an emergency condition. No obstruction.
Please share with me about the symptom you are most worried about right now and how do you keep guessing problems from cancer to obstruction?
Thanks.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
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