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Dr. Singh
Dr. Singh, Doctor
Category: Health
Satisfied Customers: 6496
Experience:  MBBS. General Practitioner, experienced in hospital care and primary care.
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Our 17 yr old son informed us that he has experienced blood

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Our 17 yr old son informed us that he has experienced blood in the toilet when he has a bm for the past two weeks. After having him leave one for us to examine, we found the bm itself covered in blood, blood in the water, and the toilet paper looked like someone had a nose bleed. We had him seen by his doctor who did an digital rectal exam. She said no fissures or hemorrhoids were apparent. We did three days of fecal tests to see about parasites, amount of blood, etc.

During those two weeks he said he had no pain, itching or other symptoms. He wasn't constipated, but only went every other day (which is his normal), but without difficulty. No fevers, diarrhea, abdominal pain or nausea. No weight loss (in fact he is about ten to fifteen pounds overweight for his age). His is a very sedentary life (not a sports fanatic), and he loves carbs (breads, pastas, etc.) He is on multiple meds for aspergers and a major depressive disorder, but his meds have not been changed in about a year.

His first day sample looked like the one he showed us prior - formed, not hard, brown in color with blood on it and in bowl. His second bowel movement came just a day later and was greenish, slimy, loose and had blood in it but not on it or in the bowl. I also noticed small white "spots" throughout the bm. Didn't look like anything specific like corn would, just tiny pin head sized spots. The third one came less than a day later, loose, greenish, slimy with tarry chunks in middle and still white spots. He says his abdomen has been a bit unsettled.

Our son also has a bone condition called hereditary multiple osteochondromas. His father, aunt and older brother also have it. While I'm waiting on test results, I searched on possible connectivity between this condition and what is going on (because there is a low incidence of the osteos becoming cancerous), and there are some published studies on this connection. Given all that I've detailed, I'm so worried and wonder if I am doing so needlessly. What are the most likely scenarios for my son?

Your insight is appreciated.
I can understand your concerns. You have done the right thing by taking him to the doctor to have the studies performed. The likely causes of a rectal bleed are hemorrhoids and fissures (which his doctor has ruled out by exam), infection which will be able to ruled in or out with stool samples and seems as if you have already done that, inflammatory disorder such as Crohn's or Ulcerative Colitis. I think the next step for you is to see a gastroenterologist for a possible colonoscopy to see if anything can be found in his colon to suggest the source of his bleeding.

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Customer: replied 4 years ago.

My concerns relate to possible connectivity between current symptoms (which may or may not be polyposis of the colon) and his bone condition (which does have incidence of cancer development). The New England Journal of Medicine has an article dated Nov. 10, 1955 titled "Multiple Polyposis of the Colon, Osteomatosis and Soft Tissue Tumors: Report of a Familial Syndrome". Should I bring this up to my son's doctor or am I just panicking?



Yes that is certainly a concern. In patients with osteochondromas risk of colon cancer is definitely present and should definitely be mentioned when you visit with a gastroenterologist. One such syndrome is Gardner syndrome in which patients have osteomoas and soft tissue tumors as well as colon polyposis. This definitely needs to be brought up with your son's doctors and further tested, which would be in the form of a colonoscopy.

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