Oncology (General Cancer)/Colon Cancer?

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Question
Hi,
   I am an active, healthy 24 year old female. However, I have been having persistent abdominal pain in both the lower and now, upper right quadrants. In November last year, I had to have an emergency appendectomy while living abroad in a third-world country. To be honest, problems with my stomach have been going on for over a year and now progressing to what I think fairly alarming state. I also just learned an aunt actually died of colon cancer, which got me reassessing why I made light of my symptoms during my last check-up.
   These are my symptoms. I am consistently thirsty despite drinking tons of water. I have never ending pain in my abdomen, which seems to worsen at certain times. If anyone even presses my stomach, it is extremely painful. I also went off all gluten and dairy several months ago to see whether that might be the cause, but it did not do much other than I have lost weight. About three weeks ago, i thought I might have gotten food poisoning. I had absolutely horrible diarrhea with some traces of blood, joint pain, and fever for two weeks. Then, last week I had constipation.
Today, I defecated what felt like all of last week's food, mixed with suspicious red coloring.The changes in bowel movements are concerning. However, most worrisome ailment I have is a sore and red rectum.
        I would like to know what you advise me to do? What are the steps I should take? Thanks so much; I really appreciate it!

Answer
First of all, at 24 with your history, even though you had an aunt with colon cancer, you probably don't have that.  However, you do have something and it's definitely important to figure out what.  Being thirsty despite drinking tons of water, and having abdominal pain could be a sign that you have diabetes.  Having the bowel symptoms you describe could be related to some kind of colitis.  The red and sore rectum could be due to all the diarrhea, or could be an extension of the colitis.  The abdominal pain could be from colitis as well.  
If you were my patient, I'd certainly screen you for diabetes, and I'd do some electrolyte studies as well, given that some people who drink water in excess can lower their serum sodium and get into a "vicious circle".  I'd also refer you to a gastroenterologist to consider a colonoscopy to determine whether you have some sort of colitis.  You are certainly at the age where ulcerative colitis and/or Crohn's disease may occur.  It's unlikely that you have gluten enteropathy, since you went on a gluten and dairy free diet but did not notice a change in symptoms.  Please look into these things and let me know how it turns out.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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