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Colitis or Diverticulitis

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I'm 24 years old and I'm 6'1 about 215 lbs. I run 5-6 times per week and in good health, or at least that is what I think. I had my gallbladder taken out in 2008 because of some stomach issues. It has helped out a lot. Well this past Tuesday I started noticing some cramping, bloating, and pain/soreness in my left abdomen. I let it go for a day and then went to work and my duty belt was really hurting my left side with all of the weight on my left abdomen, so I went home. Wednesday the 9th of 2013 I went to the University of Iowa Hospitals to see a doctor. I had blood work, urine, and even my stool examined for any type of issues. Everything came back okay and within range. I received all of my blood/urine paper work in person. The doctor had me do the old turn and cough to make sure it was not hernia and also had the doc stick his you know what up my behind to check for any bleeding etc. After the doctor had me complete those tests etc, we talked for a bit and he believed that I had colitis. He explained what it was and I sort of understand it but don't totally understand where it comes from or how I would get it. My biggest concern is cancer. This just all of a sudden started happening early last Tuesday morning. I asked doctor if he thought it was a tumor, colon/liver cancer etc or anything life threatening that it could be. He obviously said he could not say 100 percent for sure that it was not cancer but because of my age and health and the symptoms I was experiencing he was highly confident it was not cancer and that it was Colitis and or Diverticulitis. He prescribed me ciprofloxacin HCL 500 mg tab and metronidazole 500 mg to take. He said to come back in a week if things did not get better. He talked about doing a CT scan of my stomach the other day, but said he did not recommend it because of my age and the radiation exposure. Also, he said that if he thought it was life threatening etc that I would be experiencing other symptoms. Like fever, vomiting, increased stool etc. My question is, was this just a way to get away from actually doing the scan when there could actually be something seriously wrong with me or am I just overreacting? I have been on the medication since Wednesday afternoon and I do feel better. There is still some soreness in my lower left abdomen and cramping at times, but it has gotten better. When it first started I was SOOOOO bloated, had cramps and it was very sore to lay down and even walk at times, but it has gotten a lot better and I would say for the most part it is just sore and a little bit of cramps/bloating at times but not much. Can somebody help me out and give me some advice and let me know if this is something I should be worried about? How long should I expect it to take for the medicine to actually work and for the soreness etc to be gone. Any help would be great! I do have copies of all my blood work etc if u would like it scanned and sent to u


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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days ago

Hello,

Thank you for asking your query at DoctorSpring.

The symptom pattern you have mentioned is NOT suggestive of cancer at all. I assume you are concerned about the cancer of stomach/GB/liver/intestines etc. Each of these cancers have more or less a characteristic presentation. And none of them are acute. (sudden presentation over a few days).

Your symptoms are typical of a infective / inflammatory / acid-peptic etiology. Colitis is strong possibility as suggested by your Doctor. Anyhow the symptoms are NOT major and there are NO red flag warning signs. You need to take the antibiotics for minimum 3-5 days to see a difference. An anti-ulcer medication like Prilosec (OTC) can be taken once daily, just before sleep in consult with your Doctor.

I would like to get some additional information from you, so that we can be near 100% sure.

1. Is there a family history of cancer or polyps in the interstine ?
2. Do you have any weight loss in the recent past ?
3. Is there any passing blood via stools / constipation / jaundice ?
4. Is there any significant abdominal symptoms in the recent past , prior to this episode ?

You can reply as a followup.
Thank you


Patient replied :

Thanks for the reply!!! It really seems like it is getting better, just at times I feel the cramping/bloating be worse than other times. There is no history of cancer or polyps in the intestine. The only thing in my family was on my mothers side and her father had a heart attack, but did not have any known heart problems. He was a heavy drinker/smoker. No weight loss in the past. I have been out of high school since 2007 and I'm around 215-220. I was 215 when I graduated give or take a few pounds. I always say I'm going on a diet, meaning I'm going to eat better but does not last long (ha). My weight is always between 210-215...220 when I get too heavy. No blood in my stool. I have never seen any blood at anytime when going to the bathroom. They took a sample of my stool the other day to be analyzed and there were no problems with that. I would say constipation maybe just a bit...but when this whole thing started it was just difficult to push to go to the bathroom...meaning it was sore and some what painful to push when on the toilet. There was a bit of constipation the first day or two but over the past two days and on I have been able to go to the bathroom (number 2) on a regular basis and with no problems. And no abdominal issues in the past at all. That was my concern because this just all of a sudden came on. I felt the bloating/cramping and thought maybe I just ate something that was causing that. Like I said, it has just spooked me since I have never had to deal with this before. Anymore information etc that you need please let me know. I know/ or at least hope that I'm worrying about nothing, but just want to make sure that I'm covering my basis. Thanks!


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days ago

Hello,

Thank you for the additional information.

Again no features are suggestive of Cancer.
You do not require a CT scan as of now. Cancer or anything significant is unlikely. There is no reason to worry. Please continue the medications and your Doctor's recommendations. You will be all right in no time.

Wish you good health
Thank you
Please feel free to ask followups/ clarifications.


Patient replied :

I really do appreciate your help. Today would be the 5th day on the medicine. I do feel a lot better. My only additional concerns is the length of time to be back to normal and the reason for continuing to have cramping in the left lower abdomen. When this all first started I had bad bloating, cramping, and it was difficult to use the restroom- due to the fact it was hard using my abdomen to push out etc. Not that it hurt when actually going to the bathroom. A lot of that is gone now. The only thing I can really say is left is the cramping. It is just some what sore in my lower left abdomen. It kind of comes and goes. At times you can barely feel the cramping at all- if you push on the lower left abdomen you can feel the cramping/soreness. At other times, like this morning- it was sore/cramped up, but once I took the medicine it seems to calm it down quite a bit. Is this something that I'm going to have to continue to take medicine for a long period of time? I may sound like a worry wart, but in reality I'm not. I just have never had this happen to me and the cramping/soreness is what gets to me. I'm going to go and run today for the first time in 5 days and see how that goes. I'm supposed to go back this Wednesday to the doctor for a follow up if things are not better. The doctor said if things have gotten better then I could just cancel the appt. Do you think I should go just to be on the safe side? I know his follow up appointment is just going to be a verbal appointment. He said if things hadnt gotten better then he would go with the CT scan, but you are saying you don't feel that is necessary at this time, considering the fact that things have gotten better. I know I need to stop freaking out and just relax, but the whole thing about stomach cancer etc really freaks me out, or even a tumor.


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days ago



Hello,

It might take couple more days for the symptoms to completely resolve.
If your symptoms are all gone by your followup date you can skip it. Otherwise I recommend the followup. And in case if there are recurrent symptoms you should get a followup
Again cancer is highly unlikely. But other diagnosis need to be considered. If there is response to medication this is mostly likely to be colitis.

Hope this helps
Please feel free to ask followup questions.

Thank you


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
Dr. Deepu Sebin Sebastian and 4 other Medical Specialists are ready to help you

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