Hereditary bowel polyps and malignancy

Patient

Q: I had 5 bowel motions yesterday, from 0730 (when i woke up) till 1030. first motion was maroon, was formed with frank PR bleedin and observed one small clot. third motion was red loose fluffy pieces with no brown colouration 1cms in length and jelly looking. last bowel motion was formed with PR bleeding maroon in colour. I had no diificulty passing the stool, no abdominal pain had small discofort all around the lower part of my abdomen, prior to the start of the first bowel motion. My local GP, could not see a fissure or haemarrhoids. I have not had further episodes since. IM 25year old female, my father had a polyp removed when he was 30 and he was diagnosed at 49 with bowel cancer which he later died of. I have regular bowel motions, my local Gp was concerned and referred me to have a colonscopy i have a consultation in a week. Just wondering if it could be something else, is he acting too over the top

Doctor

A:   The presence of unaltered blood in the stools suggests bleeding from the lower end of the gastrointestinal tract. This bleeding is most commonly due to the presence of haemorrhoids. Other causes of bleeding from the back passage include: diverticular disease (inflammation of an outpouching of the colon or large intestine); colitis (inflammation of the colon); polyps (slow-growing overgrowth on the surface of the colon); inflammatory bowel disease; malignant growth or angiodysplasia (vascular abnormality that causes bleeding from the large bowel). There are several hereditary conditions which may form polyps and can predispose to colon cancer. Therefore with your family history of polyps and bowel cancer, I would advise further investigation with a colonoscopy, as suggested by your family physician and follow-up with a gastroenterologist as appropriate.

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