Advice on occult bleeding

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Advice on occult bleeding

Postby shadrack175 » Fri May 11, 2018 6:09 pm


I hope it is appropriate to seek advice here about my current situation. A little background. I am a 34 year old male that is otherwise healthy, and currently halfway through completing my bachelors of science in nursing. About mid February 2018 I started to experience unusual GI symptoms for me. I began having frequent loose and broken up stools that did not seem to have any trigger I could pinpoint. These come and go and have not improved with diet, probiotics or exercise. I consulted with my PCP at the VA and he attributed my symptoms to stress induced IBS and I was inclined to agree. However my symptoms have persisted and I became spooked a more nefarious cause may be driving my symptoms. I paid out out of pocket to have a fecal immunochemical test performed that came back positive for occult bleeding at 146 ng/ml, normal being less than 100 ng/ml. I have reported this to my pcp and he still does not seemed concerned, and does not believe I need a colonoscopy. How aggressive should I be in seeking a colonoscopy in this communities opinion, I am considering paying for this out of pocket as well.

My recent lab work showed no signs of anemia, but a mild elevated bilirubin, my PCP was also not concerned with.

Otherwise no significant abdominal pain, frank blood, dark stools, cramping, or other symptoms. I understand that I am a low risk patient given my age and lack of other comorbidities.

Thank you all so much for any advice.

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Re: Advice on occult bleeding

Postby CRguy » Fri May 11, 2018 11:03 pm

If your FIT is + for occult blood you need further follow up and maybe a new PCP.
I have reported this to my pcp and he still does not seemed concerned, and does not believe I need a colonoscopy.

...BUTT ... be pro-active and be your own best advocate
...and if you'd like .... tell your PCP that YOU would not be concerned if HE had a + FIT result either.

also : " You will miss MORE for not looking... than not knowing ! "
If he doesn't even LOOK for a cause how the hell would he expect to find it ?????
JMO, which you did ask for :shock:

Best wishes moving forward
my vote is : get the scope and / or a new doctor who will listen to your concerns and do what is needed

Caregiver x 4
Stage IV A rectal cancer/lung met
12 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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O Stoma Mia
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Re: Advice on occult bleeding

Postby O Stoma Mia » Sat May 12, 2018 11:25 pm

I think you should probably go for a colonoscopy. A good, thorough colomoscopy will give you information on the general state of your colon and will help put your mind at ease. It would help eliminate some of the possible causes of your distress. If you do decide to schedule a colonoscopy, be sure you follow the prep instructions closely because your colon needs to be totally clean in order for the doctor to see what is going on.

If the colonoscopy doesn't find anything nefarious then it might he necessary to look elsewhere -- perhaps in the upper GI tract, like an ulcer in the stomach or duodenum. Has your PCP mentioned anything like that? There are breath tests for ulcers as well as endoscopies for localizing the source of the problem if the breath test is positive.

Here is a description of the breath test for Helicobacter Pylori. You might try asking your PCP if this test might provide some insight into your ssues. If the test is postive for H. Pylori, then the treatment is a simple two-week regimen including several antibiotics.

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