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Forum Name: Gastroenterology Topics

Question: Blood in stools.


 darr902 - Fri Jan 24, 2003 7:59 pm

My 65 year old Brother-in-Law was diagnosed with colon cancer in April 2002.
May 2002 he had surgery to remove it.
He chose not to receive chemo.
In November 2002 he was getting extremely tired and his color was white.
He had a blood test.
Hemoglobin was 7.3.
He was given 3 units of blood.
Hemoglobin went to 11.6.
The doc found blood in stools.
Had a colonoscopy and found nothing.
Had a cat scan of stomach and found nothind.
2 weeks after getting the transfusion that upped his hemoglobin to 11.6 it dropped to 10.
Docs are baffled and can't tell us where the blood in the stools are coming from.
( years ago the patient had stomach ulcers but no problem with that in last 20 years )
Please let me know what you think his problem is and what kind of tests or doc should he see next.
 Dr. Tamer Fouad - Sat Jan 25, 2003 4:04 am

User avatar Dear Darr902,
You can find a detailed review of the causes and methods of assessment of chronic gastro-intestinal bleeding leading to anemia here:

Click here!

Assessment includes:
history and exam to suggest the most likely site of bleeding. In brother in law's case a stomach ulcer is still a viable possibility and should be excluded. So he would need an upper gastro-intestinal endoscopy.
Ofcourse your main concern now is that the cancer returned. What are the results of his tumor markers (CEA)? Were they ever elevated before? If they are rising it would suggest that the cause is infact cancer. A thorough work up and follow up would then be in order. CEA may precede the clinical appearance of colon cancer by 3 months in some patients.

My best regards to your relative, keep me posted.

Tamer Fouad, MD.
 Anonymous - Sat Jan 25, 2003 1:27 pm

dear dr fouad i just spoke to my brother-in-law and the dr did do a stomach scope a couple weeks ago and found nothing.
we looked at his copies of the blood test they have taken since prior to surgery and there was not anything on a cea
we will suggest he do this at his appointment this wednesday
last night he complained that his stomach fely hard and was painful
he felt like he could vomit but did not
 twillia3 - Thu Sep 08, 2005 10:17 am

The original email regarding this subject has hit very near and dear to my family. My father was diagnosed with colon cancer in August 2004. He took chemo for 6 months that ended in March 2005. He started having blood in his stools about 2 months ago with severe to moderate left side/back pain. Two weeks ago he had another colonoscopy and a CT scan. Both came back clean. His doctor told him nothing is wrong with him but my dad insists he is in much pain and he keeps having blood in his stools. The doctor says no further testing is needed. Please tell me if you ever figured out anything with the brother-in-law as we are at a loss with my father. I have suggested an upper GI but the doctor says he didn't see any ulcers in the CT scan so doesn't plan to do this. Any help would be much appreciated.

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