Polyps and Rectal Ulcers: A Guide for Patients - Gastroenterology and Hepatology

Polyp, rectal ulcer

Hello, doctor! A few days ago, my father underwent a self-paid comprehensive physical examination, which included a colonoscopy.
During the procedure, he was given sedation, so he didn't feel anything.
The doctor informed us that there were no significant issues, but a polyp was found 40 centimeters into the colon and was removed.
He returned home that day feeling fine, but by the evening, he began to experience abdominal bloating, pain, diarrhea, and red mucus.
The pain persisted until the next day when he started having bloody stools and a mild fever.
He visited a small hospital where he received IV fluids and medication, but the pain and bloody stools continued the next day.
When we consulted the doctor who performed the colonoscopy, he recommended another colonoscopy.
The results showed that there was an ulceration at 20 centimeters, and the doctor could not provide a clear reason for it.
He prescribed medication to manage the ulcer and sent some tissue for biopsy, scheduling a follow-up in about a week.
However, my father has continued to experience abdominal pain over the past few days, and I am very concerned that he may have had cancerous cells removed.

1.
What should my father do for early intervention?
2.
Should he remain at the original hospital?

Rong Er, 30~39 year old female. Ask Date: 2017/05/20

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Based on the description, it seems unrelated to the presence or absence of pathological cells.
Further inquiry into the pathology report of the excised polyp is warranted.

Reply Date: 2017/05/20

More Info

When it comes to understanding polyps and rectal ulcers, it's essential to recognize the significance of timely diagnosis and appropriate management. Your father's recent experience with a colonoscopy, where a polyp was removed, followed by the development of symptoms such as abdominal pain, bloating, and bloody diarrhea, raises several important considerations.

Understanding Polyps and Rectal Ulcers
Polyps are abnormal growths that can form on the lining of the colon or rectum. While many polyps are benign, some can develop into cancer over time, particularly if they are adenomatous polyps. The removal of polyps during a colonoscopy is a common preventive measure to reduce the risk of colorectal cancer. However, complications can arise post-procedure, including bleeding, infection, or the development of ulcers, especially if the polyp was large or if there was any underlying disease.

Rectal ulcers, on the other hand, can occur due to various reasons, including inflammatory bowel disease (IBD), infections, or as a complication of procedures like colonoscopy. The presence of ulcers can lead to symptoms such as pain, bleeding, and changes in bowel habits, which can be distressing for patients and their families.

Immediate Actions and Recommendations
1. Seek Immediate Medical Attention: Given that your father is experiencing persistent abdominal pain, bloody diarrhea, and fever, it is crucial to seek immediate medical attention. These symptoms could indicate a serious complication, such as an infection or significant inflammation, which may require urgent intervention.

2. Consider a Second Opinion: If the current medical team is unable to provide clear answers or if your father’s condition does not improve, it may be beneficial to seek a second opinion from a gastroenterologist or a colorectal specialist. They can provide a more comprehensive evaluation and may suggest additional diagnostic tests, such as imaging studies or repeat endoscopy, to assess the extent of the ulcers and rule out any malignancy.

3. Stay in the Current Hospital or Transfer: Whether to remain in the current hospital or transfer to another facility depends on the quality of care being provided and the availability of specialists. If the current hospital has the necessary resources and specialists to manage your father's condition effectively, it may be best to stay. However, if you feel that his needs are not being met, transferring to a facility with a strong gastroenterology department may be warranted.

Follow-Up and Monitoring
After the initial management of your father's symptoms, it is essential to have a follow-up plan in place. This may include:
- Regular Monitoring: Continuous monitoring of symptoms and regular follow-up appointments to assess healing and response to treatment.

- Biopsy Results: Awaiting the results of the tissue samples taken during the colonoscopy is critical. These results will help determine the nature of the ulcer and whether there are any cancerous cells present.

- Medication Management: Depending on the diagnosis, your father may require medications to manage inflammation, control symptoms, or treat any underlying conditions.

Conclusion
In summary, your father's situation requires careful attention and prompt action. The symptoms he is experiencing post-colonoscopy are concerning and warrant immediate medical evaluation. It is crucial to ensure that he receives appropriate care, whether that is through his current medical team or by seeking a second opinion. Understanding the nature of polyps and rectal ulcers can empower you and your family to advocate for the best possible care for your father during this challenging time.

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