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Ask Dr. Gott 7/5
Cancer survivor has digestive trouble
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   DEAR DR. GOTT: I’m a 53-year-old man, 6 feet 2 inches tall and 200 pounds. My waist is 33 inches, and I am built like an athlete. I have never smoked, bike 20 to 40 miles a day, usually doing the first 20 in an hour. I swim both in the ocean and the pool, lift light weights and surf occasionally. I also work in the construction field and do manual labor to keep in shape, even though I am the architect and builder of each project. Having said that, I have been to hell and back, surviving cancer.
    My problem and something that seems to affect my social behavior is that I cannot eat anything without almost immediately heading to the bathroom to make room for whatever I consume. Whatever I manage to store at dinner comes out in the morning immediately after waking. After breakfast I again return for a bathroom visit.
    I don’t have an eating disorder, I love food, and I enjoy eating at the best restaurants. I also enjoy cooking. The stomach cramps I have after eating force me to seek a bathroom to relieve myself. The cramps that accompany gas are usually within 30 minutes of eating even small portions. Everything returns to normal after a return to the rest room.
    I know I have a relatively small stomach for my size, but can this really send me to the bathroom after every meal, or do you think there is something else involved? I don’t remember this being a great concern of mine in the past, although it has been going on for years. I now find myself skipping lunch to avoid foreign bathrooms.
    DEAR READER: I don’t have an explanation for your bowel urgency and frequency. Because you may have low-grade colitis or some other treatable condition, I suggest that you check in with your doctor.
    Also, you don’t mention the location of your previous cancer. If it arose in the intestinal wall, your symptom could reflect a regrowth or a reaction to anticancer therapy. Your physician should be able to pin this down or refer you to a specialist if necessary.
    If a low-grade infection or abnormality exists, a visit to your primary-care physician would be appropriate. He or she can order a simple stool analysis to rule out giardia, salmonella or other disorders. If the testing is abnormal, it would explain your diarrhea and gas, and antibiotics will help. Should the test results be negative, your doctor might refer you to a gastroenterologist for a colonoscopy to rule out polyps.
    The answer is not a simple one, and it may have to be determined through exclusion. Start with your primary-care physician. Provide a history, and if he or she can’t find an answer, request a referral to the appropriate specialist.
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