Fit Test

[Hammerboy]

Hi , not sure if this too off topic but looking for some reassurance after a worrying test result.

I've never been diagnosed with IBS but gave suffered most if not all the symptoms for many years .I've always had what I call a nervous stomach since childhood and am used to the discomfort, the effects of stress and food on my digestive system .

Over the years I've had 3 endoscopys showing nothing overly serious other than irritation and following the last one the evidence of some bile reflux. The advice given was double the dose of Lanzoprazol .I'd had my gall bladder removed the previous year and I was told this may have contributed to this.

I'm the last few months I have tended to wake up with stomach discomfort, not particularly painful and my bowel habits have changed a bit with looser stools generally and sometimes an urgent need to go with more than one movement in the day. I generally go every day first thing after breakfast but sometimes lately I feel mildly nausea afterwards for about half an hour.

I called my GP to ask his advice and he said it would be appropriate to refer me to the hospital for a consultation. I had a Sigmoidoscopy performed late last summer after developing an anal fissure which has healed well and the camera examination revealed nothing sinister so was discharged by the hospital.

I was advised late last week I needed a blood test and a Fit test before I could attend the consultation so on Monday I had the tests.

Yesterday I was called by the hospital to arrange an urgent colonoscopy as I'd had a positive Fit test. Apparently the result prompted my GP to refer me quickly but I had no call from him to explain the results or what was coming next .

I managed to get a nurse to call me back from the surgery who apologised for the lack of contact and said my blood test was normal but there were traces of blood in the stool sample which were not visible but required investigation.

My notes say I'm being referred for suspected bowel cancer which has scared the life out of me as I'm fit and well, no weight loss , good appetite etc .

As I said I've never been actually diagnosed with IBS but could any of my issues such as reflux, gastric pain , extra bowel movements and a small haemorrhoid cause the blood in my stool and would IBS cause the same discomfort rather than it being the dreaded C word

Thanks for your patience if you read this

[Maureen1958]

Hi, I would assume they are airing on the side of caution. All what you describe sounds like IBS to me. I think every one with IBS has had blood at some point. I used to get it often towards the end of several hours on the toilet. My husband doesn't have IBS but still gets blood from piles. Going back towards the beginning of your post, you mention having your gallbladder removed, this can cause problems itself. Look up Bile Acid Malabsorption (BAM). Sorry, I'm on my kindle and not sure how to post a link from here. I hope this may go some way to reassuring you!

[Hammerboy in reply to Maureen1958]

Yes that's very kind of you

[32malewithcolitis]

Has IBD been considered? They also use the urgent referral for blood in stool as it’s a red flag symptom, but it’s usually caused by crohns or ulcerative colitis. I have ulcerative colitis and everything you’ve said are key symptoms, especially blood in stool. I go 2-3 times a day, loose stools and occasionally have blood and mucus. I wouldn’t worry too much personally, even if it’s ulcerative colitis, medication will help you straight away, but they can’t diagnose it without doing the full colonoscopy and taking biopsies

[Hammerboy in reply to 32malewithcolitis]

Thanks for replying, I'm probably being over anxious as my notes say suspected bowel cancer which is alarming in itself. The surgery nurse said that's the standard wording for this kind of referral I'm not sure that's helpful though .I'm assuming if they find no cancer in the colon they will look for other possibilities ?

[32malewithcolitis in reply to Hammerboy]

I think the urgent two week referral is always classed as suspected cancer if any of the symptoms match, I had a suspect mole checked out and they put it under a 2 week referral for cancer and it was nothing. They’ll do the colonoscopy and have a good look at the colon walls. Cancer usually is very obvious and will stand out so they’ll see that, but what they’ll also see is ulcers and inflammation caused by a bowel disease, if they see scarring it’ll be from ulcers that have healed, they’ll likely take biopsies to confirm it is IBD. Hemmeroids can cause specks of blood in stool too. How dark is the blood? Light blood suggests fresh bleeding towards end of colon. I know it’s worrying how they refer you but it’s just to cover bases but it’s much more likely to be IBD. It’s unlikely to be cancer if you are well and have no weight loss: I also have gastric issues such as heartburn and reflux, which is a hiatus hernia:

[Hammerboy in reply to 32malewithcolitis]

Hi thanks for replying. I do have a small internal pile which occasionally bleeds .I've wondered if that happened at the time I took the sample but there was no evidence of blood I could see at the time I understand a FIT test can detect tiny amount of blood in a stool sample thats not visible to the naked eye and the concentration level has figure that beyond which further investigation is recommended

Apparently the level in the test result is not shared with your GP strangely.

I have asked my surgery if blood from a pile can affect the test result and they couldn't answer .

I've suffered reflux from a teenager and have been on Lanzoprazol for 40 years but since my gallbladder was removed 4 years ago my sensitivity to food and general digestion has been worse.

[Maureen1958 in reply to Hammerboy]

Did you look up BAM?

gutscharity.org.uk/advice-a...

[Hammerboy in reply to Maureen1958]

Yes I did thank you , interesting reading and food for thought 🙂

[Hidden]

You have a two week wait referral. The FIT is very sensitive and picks up signs of human blood. Probably likely it’s piles .Even if it’s blood from a early polp it cdm be removed.

[Bmco]

I think I’m the UK if you have certain symptoms and a positive fit test guidelines state you need to be referred urgently to the colorectal cancer team for investigation, usually the urgent colonoscopy and perhaps CT.

I had this in may - slight change to bowel habits, nausea, weight loss and then a positive fit test. I convinced myself it was cancer and I was dying, given all the symptoms. But it turns out it was all fine and just small interns piles found. All the other things were explainable individually.

I think having it all tested is the best plan as gives you piece of mind even if scary while waiting. Plus you’ll hopefully get some answers to help with treatment! Also, I read while waiting for mine that less than 10% of positive results from a FIT are ever cancer.

Based on my experience I wouldn’t worry too much - the fact you have no weight loss and your bloods came back normal (so no low ferritin or anaemia) is a great sign. I’m no doctor of course.

Take care

[Hammerboy in reply to Bmco]

Thanks for that, yes I do feel anxious but I'm a very level headed and logical person. I think it's mainly the lack of contact and reassurance from my GP that got me worried especially after reading my notes on the Patient Access app.All it said was ' refer for colonoscopy , suspected Lower GI cancer '

Interestingly I've read that if a Sigmoidoscopy shows a polyp which mine did and was benign and removed , the usual next step would be a colonoscopy as a precaution .

[Bmco in reply to Hammerboy]

Yes, the fact they didn’t personally talk to you and then you read that is poor. A slip I imagine but worrying none the less I know.

When I spoke to the nurse who triaged me I said “this is cancer screening, do you think I have cancer?”. She responded that this is more about eliminating it to find the root issue, rather than identifying it as cancer and how awful it is. She also said that the vast majority of people they see do not have cancer. I guess maybe writing that is just a standard way of getting people initially triaged?

I appreciate that this may not help but hopefully a little bit of it eases some of the anxiety!

I don’t know anything about the sigmoidoscopy / colonoscopy relationship. Although a good sign about the polyp being benign! Most important thing is getting it done now and hopefully it’s really soon so you can continue on as normal without the worries.

[Hammerboy in reply to Bmco]

Thank you for that, I've tried to reassure myself on all the positive points .My blood tests were normal, I'm not losing weight, there is no history of cancer in my family, all my older relatives either died at a great age or are still alive in their 90's and I've never seen blood in my stools other than a spot of bright red from hemorrhoids I've had since my teens .I'm slightly concerned that my bowel habits have changed over the last few months, looser in general and occasionally urgent and my tummy is generally tender.

As you say its this new FIT test and the way you are then urgently processed (I'm happy with the speed by the way)but the wording on your notes is alarming to say the least especially without any reassuring contact and explanation from the GP

[Bmco in reply to Hammerboy]

Sorry I didn’t see this reply. But yes, totally agree - both wording and communication (lack of) poor! Hope you are doing ok.

[Hammerboy in reply to Bmco]

Thank you , yes all is well .The procedure went smoothly and everything is fine No sign of cancer but no explanation for the blood in my bowel leading to the positive test. I'll get on with my life now 🙂

[soregut]

The vast majority of positive fit tests are from benign causes, especially piles, a fissure can cause a positive test.Colonoscopy is to exclude early colon cancer and it’s very unlikely your positive test is due to the big C.Hopefully you will be reassured knowing a clinician has had a good look at the colon.

[Hammerboy in reply to soregut]

Many thanks, yes I hope you're right. I had my Sigmoidoscopy after suffering an anal fissure which showed it had healed well , there were 2 small hemorrhoids in the rectum and a small polyp of no significance that was removed .

[Evonne02]

Hi Hamnerboy,I have Ibs for around 30 years now and it seems as though you have some of the IBS issues that I have. I have also had the same issue with the blood in my stool at the age of 54. I had an emergency referral and was told to expect a cancer diagnosis by my GP. Scared wasn't the word.

When I had the camera put up it showed I had what was called a 'Self healing Heamorroid' I'd never heard of it before so was very surprised. The consultant stated that these bleed then heal until they completely disappear which it did.

I hope it all goes ok and you get to push for a definitive diagnosis as I think it's cruel to leave you in limbo just wondering what the issue with your body is.

[Hammerboy in reply to Evonne02]

Many thanks , yes it seems the NHS still have the attitude that we don't need to know details and just endure the worry of not knowing .I've lived with a tender and irritated stomach for years but after being diagnosed with Atrial Fibrillation 3 years ago I'm now on anticoagulants daily and BP tablets.

I'm curious as to whether these medications can lead to blood in the stool and wether a small hemorrhoid that occasionally bleeds very lightly during a bowel movement can show up in that kind of test.

It's the lack of information from the GP that frustrates me

[Evonne02 in reply to Hammerboy]

Yes, that Heamorroid' bleed can show up. They let me see it on the screen and gave me pictures and sent copies to my GP too. I must say though that I cannot take your tablet as it's too strong and causes more pain, inflammation etc of my stomach even at a low dose. I take Omerprazole at 20mg just once a day, laxatives X2 per day and peppermint oil capsules X3 each day. I'm at the stage now with my IBS that my new Gp thinks I have Diverticulitis which can lead to the need of a Colostomy bag. Like you I have had stomach issues since I was a child.

[Hammerboy in reply to Evonne02]

It's something I'm used to but frustrates my wife as she's always worried about what to cook and the excessive wind is a pain lol.I've taken Lanzoprazol 15mg most of my adult life but after my last endoscopy 3 years ago I was advised to increase the dose to 30mg daily.

I've often wondered if that can mask other more sinister symptoms but my GP doesn't seem concerned .

[Scout]

Hi, I’m in the same situation as you at the moment. I have been diagnosed with IBS but my symptoms changed end of March. Very loose stools, emptying bowels a lot, passing mucus & blood. I’ve been nagging my GP since April but they have been very dismissive, told me to practise mindfulness for anxiety and other self help. I had a colonoscopy in September 2019 which was clear and they kept referring back to this. I’ve lost a stone since Christmas but I’ve picked up my running again plus been careful with my diet, so that’s no surprise.

Eventually saw a GP in person on Monday, FIT test ordered, urgent referral Friday with a bumbled call from my GP who was very evasive. Like you I’m just waiting now for a colonoscopy with no support or further info from the GP.

I know how you feel, frankly it’s terrifying. But google is our worst enemy. Yes, my symptoms point towards cancer but also IBD, piles and general stress. And it’s worth remembering that very few people who have a positive FIT test are actually diagnosed with cancer! Worrying just makes me feel worse (albeit it’s impossible not to worry).

I would think, as you recently had a scope, they would have picked up anything nasty then, but again, I know it’s still a worry.

I hope you don’t have to wait long and you get positive news. I’m sure they are just ruling everything out and being safe. Good luck!! Keep us posted

[Hammerboy in reply to Scout]

Many thanks for your reply, its sad in this day and age that we are still treated like cattle at times by the NHS .My procedure is scheduled for the 30th and an I formation pack was delivered yesterday. I'm sure all the information will be there to read about the procedure itself but that doesn't excuse the lack of support and reassurance from my GP at such a worrying time .

The best of luck to you on your journey and keep me posted on how it all goes

[Scout in reply to Hammerboy]

The information and pack should explain everything you need to know but you can always ring the clinic where you are having the scope done too, they are usually happy to help. Have they asked you to isolate or have a Covid test before? I’m just trying to work out the logistics here if so. My daughter is finishing primary school and I’m supposed to be a chaperone on a bus!!! That will be on a wing and a prayer with my tummy!!!! Trying to keep my sense of humour amongst all this.

Good luck, try and stay positive.

[Hammerboy in reply to Scout]

Yes ,I have to have a covid test 3 days before which has to be negative .It was arranged by the hospital at the same time my colonoscopy was booked I have to say the speed and admin side of this has been very good as was the first Sigmoidoscopy. I was in and out in2 hours and was very well treated throughout .I hope to expect the same this time as I'm going back the Quantum institute in Norwich .

Have to say I'm not looking forward to the laxatives and actual examination although the Sigmoidoscopy

was a doddle . I didn't feel much and there was no sedation or gas and air even though it was offered .I was pleased too that the consultant performing it told me straight away there was nothing there to worry about.

[xjrs]

There is a set protocol for diagnosing IBS in the UK. This is via blood and stool sample tests including an inflammation marker called Calprotectin:nhs.uk/conditions/irritable...

Did they test your Calprotectin levels and not just FIT? Normally referral to colonoscopy is from high Calprotectin. They may be being cautious about your FIT test. If you have piles this could be the reason.

Statistically far more people come back with an IBS diagnosis than anything else - even after high Calprotectin and a colonoscopy.

Maureen1958 is right to point you towards BAM due to your gallbladder removal.

There is no harm in going ahead with what they recommend since at least this will put your mind at rest and they are being thorough. In the mean time the best thing to do is to try to distract yourself and not think too far ahead. Nothing is fact until it happens (and it is more likely to be something like IBS or BAM), so speculating can be a pointless activity.

[Hammerboy in reply to xjrs]

Yes you're right and thanks for the info.I'll do my best not to worry about something I can't change 🙂

[BabblingBrooks]

Hi, just wondering if this issue got resolved, sometimes posts appear from a while back and I presume everything was ok ?

[Hammerboy in reply to BabblingBrooks]

Hi yes , my colonoscopy was clear and I’ve now changed from Lanzoprazole to Nizitadine which I feel better about taking and has certainly settled my reflux so far

[BabblingBrooks in reply to Hammerboy]

Good news!