Question

William’s medical record reads:

49 year old male presented to the office today to establish care. Patient revealed that his mother died of colon cancer at the age of 53. His maternal grandfather also died at a young age due to ‘stomach problems’. He has an older brother who recently underwent extensive surgery after he had several polypectomies. William denies abdominal pain or tenderness, acid reflux or indigestion. He has noted he occasionally has some bright red coloring in the water of the toilet after bowel movements.

What are the implications of William’s family history? What tests would the doctor order for William and why? What is the likely reason William’s brother required extensive surgery after the polypectomies? (Consider also the family history)

Answer 1

Williams family hstory shows the probability of colorectal cancer.Williams mother died of colon cancer and his brother was operated .

As william presented to office with a history of occasional bright red stools(Hematoschezia).Bright red blood on the toilet paper after a bowel movement or red or pink water in the toilet bowl can be signs of rectalbleeding.The problem is severe and it should be ruled out to prevent potential risk to life.

It is believed to take about 10 years for a small precancerous polyp to grow into cancer. Therefore, if appropriate colorectal cancer screening is performed, most of these polyps can be removed before they turn into cancer, effectively preventing the development of colon cancer.

The tests that can help william to find the issue may be

Upper endoscopy and colonoscopy are the mainstay of initial investigations.Angiography and radionuclide imaging are best suited for acute overt gastrointestinal (GI) bleeding. Capsule endoscopy and deep enteroscopy play significant roles in the diagnosis of obscure GI bleeding, usually from the small bowel.

Extensive ploypectomies surgeries in williams brother shows as a risk of inherited colon cancer,that was diagnosed in stage of polyps and operated.