IBS/Colon Cancer - not sure of the next step, looking for advice

[invisible.monster]

Hi All

I'm new here so please forgive me if I'm not posting in the right subforum

First of all I would like to say that reading the threads in this forum has been incredibly helpful in dialling down my health anxiety, and thanks to the help of my GP and psychologist, I have been able to try to think of my symptoms in a more rational fashion.

However, I do have some remaining doubts which I was hoping I could get some advice for from you guys.

It first started in July this year after about 6 months of sedentary lifestyle in lockdown and unhealthy diet full of refined carbs and no fruits/veggies for the most part. The main symptom I experienced was constipation (I went regularly/semi-regularly but had pebble-like stools), and following my GP's advice, I changed my diet and lifestyle to a healthier one that incorporates fruits, veggies, and complex carbs. After about 2 months of trial and error full of weird-looking/textured/coloured stools as well as numerous emotional breakdowns in relation to bowel cancer fears, I managed to start pooping smooth, formed stools, which made me happy.

However, twice this week I've had two strange episodes - the first one was on Monday in which I went to the bathroom twice following the urge to defecate, however very little actually came out (only a couple of 1cm pellets each time, with some whitish/yellowish mucus when I wiped my anus afterwards). Then on Thursday, something similar happened but I went to the bathroom 4 times in 2 hours, pooping more stools this time but still small in size apart from the fourth one which produced formed, smooth, slightly larger stools albeit a bit flat. Friday and Saturday, I had hard stools that were a bit bigger than pellet-sized, so I thought, oh no, my constipation is back - but this time I don't have any diet/lifestyle factors to explain it. I've been taking Metamucil (psyllium husk supplement) since Saturday and my stools have been smoother and well-formed since then.

Now, I'm aware that this forum is not a place to confirm/rule out any diagnoses but I *think* the following seem re-assuring:
- I'm 27 years old so despite the increasing prevalence of bowel cancer in this age group, the odds are still pretty small for us to have bowel cancer
- I've had two blood tests done in the last 3 months and all the numbers look fine, in fact my iron level improved between the first and second test - the only thing was that I was mildly deficient in Vitamin D
- My faecal occult blood stool tests have all come back negative, meaning no hidden blood was found in my stool (I've done 3 in the last 3 months due to my health anxiety)
- I've been ruled out of any inflammatory bowel conditions by way of a negative faecal calprotectin test result
- I don't appear to have any infections in the bowel present by way of a negative OCP/PCR stool test result
- I haven't had any unexplained weight loss - the only weight loss I've had is due to the fact that I've been on a diet and also because I've started exercising regularly
- I haven't had any changes in my appetite

My only persisting fear (which I have managed to control a bit better these days, as mentioned before) is that, if it's IBS instead of bowel cancer, then how come I haven't had any abdominal pains/cramps? This leads me to the question of whether or not I should still ask for a colonoscopy to be entirely sure that it's not bowel cancer.

My GP and gastroenterologist both believe that a colonoscopy is not warranted given my age and the fact that I don't have many of the "red flag" symptoms like blood in stool, anaemia, weight loss etc. I do tend to agree with their observation, but the tiny anxious voice inside my head says "what if it turns out to be cancer - you'd want to be detected as early as possible".

For those of you who have had a colonoscopy done and found no bowel cancer, were you glad that you did it? Or, do you think that in hindsight, it was probably not necessary for you to have done it?

Thank you and I hope that at least some of you wouldn't mind sharing some insights - thanking you in advance!

[Aussie11]

I have suffered for IBS for about 10 years. At first I really panicked about it, was all very similar to what you described. I didn’t get the cranky stuff that just read about in relation to IBS. I had a colonoscopy as although I was only 31 at the time, there’s bowel cancer in my family and most relatives get polyps. So GP was happy to send me off to specialist and he did colonoscopy to reassure me more than him I think. If you’ve had negative fecal occult test that’s reassuring, as well as blood work all ok. Most of us health worriers would probably say yes we felt much better after having the colonoscopy as it reassured us and it’s what we need to be able to switch off from it and/or accept it’s nothing sinister. But you’re still young and with no other symptoms or tests pointing to red flags, then doctors will be pretty confident there’s nothing else going on. It does sound like IBS, the mucus thing is very common in IBS. Metamucil can actually make IBS worse in some people (give cramps) but if you tolerate it well that’s good to hear. Of course we aren’t doctors on here so can only really talk about our own experience. Your dr has your test results, has seen you and examined you, so it’s reassuring if they aren’t wanting to take it further. If it continues and gets worse perhaps just ask to be referred to gastroenterologist. Then you’ll be seeing an expert and if they say no colonoscopy needed you will probably feel more reassured by them than you would be from your GP. Sorry just saw you already have seen gastroenterologist so that’s great.

[invisible.monster]

Hi Aussie11, thank you so much for taking the time to reply. I really appreciate it. Yes I understand that this forum doesn’t replace professional medical advice but it was still reassuring nonetheless to read your response. Again thanks so much for your input, I hope you’re managing your IBS symptoms well x

[NoraB]

For those of you who have had a colonoscopy done and found no bowel cancer, were you glad that you did it? Or, do you think that in hindsight, it was probably not necessary for you to have done it?

I'm glad I had it done because it was the kick up the arse I needed in order to stop fannying about imagining I was dying of bowel cancer and to start putting some serious effort into getting myself better.

Plus, the sedation was ver ver good.

Difference is, I was 47 with a colon that was seriously playing up and some major weight loss...

[invisible.monster]

Hi NoraB, thank you for your response, that’s a fair point as I think I’d feel the same way if I had the colonoscopy done, maybe it’s the kick I need up the arse too lol. But I suppose your reasoning is more justifiable than mine considering the age factor and it seems you had more symptoms as well based on your comment.

If you don’t mind me asking, what were your symptoms besides weight loss that indicated your colon was majorly playing up? And did you ever get a diagnosis afterwards?

I think for now I will focus on symptom management more than anything. Depending on how this continues for another couple of months then I will ask to get another referral to a GI...

[NoraB]

Hi NoraB, thank you for your response, that’s a fair point as I think I’d feel the same way if I had the colonoscopy done, maybe it’s the kick I need up the arse too lol. But I suppose your reasoning is more justifiable than mine considering the age factor and it seems you had more symptoms as well based on your comment.

I need to correct that to 'a kick up the arse' as the main kick up the arse was the psychological damage I was doing to my son and the potential for him developing HA in the future..

If you don’t mind me asking, what were your symptoms besides weight loss that indicated your colon was majorly playing up? And did you ever get a diagnosis afterwards?

Chronic constipation with intermittent shits kicking in at 4am. Nausea. Loss of appetite. Turns out that aside some Farmer Giles, I have the best looking colon in Manchester!

Point is, that I was 100% convinced I had bowel cancer!

I think for now I will focus on symptom management more than anything. Depending on how this continues for another couple of months then I will ask to get another referral to a GI...

Sensible, but you really need to be looking at this in a logical way - which is that you've suddenly become sedentary (as have most other people) due to Covid and that in itself will cause digestive problems, and also you have been eating unhealthy food. That's the problem as I see it, so get moving and get some fibre in you - and your body will do the rest.

[invisible.monster]

Hi NoraB, thanks again for clarifying. Glad to hear it was nothing sinister for you!

Yes, I have changed my diet to a healthier one incorporating more fibre, drink water, and I’ve been exercising daily for the past 3-4 months, and I still get the symptoms on and off. I think bowel cancer would NOT cause on and off symptoms and would get progressively worse despite changing the lifestyle factors (I hope I’m right in thinking this!). That, and all the stool tests and blood tests I have done make me reluctant to ask for a colonoscopy. But I also think that it will give me some peace of mind if I have it done so that I can conclusively see that it’s just IBS, so that’s why I’m thinking of seeing how it goes in the next few months

[NoraB]

I think bowel cancer would NOT cause on and off symptoms and would get progressively worse despite changing the lifestyle factors (I hope I’m right in thinking this!).

Absolutely. Cancer grows and keeps on growing. It doesn't take holidays - not without medical intervention, anyway.