28-Year-Old Male with Ongoing Rectal Bleeding and Calcified Joints After Antibiotics
Height: 178 cm Weight: 88 kg Ethnicity: White, from the UK # Key Issues * Experiencing **consistent rectal bleeding and discomfort during about 90% of bowel movements**, even though the stool remains soft. * Recently noticed **challenges with starting bowel movements**. * A **flexible sigmoidoscopy** conducted in November 2024 ruled out the presence of polyps and fissures at that time, yet symptoms persist. # Health Background * **Childhood:** Experienced sporadic bouts of intense abdominal pain lasting several hours, diagnosis was never established. * On **lansoprazole** daily for managing acid reflux since the age of 18. * **Painful calcified nodules** located on the proximal interphalangeal (PIP) joints of fingers 3 to 5 (right hand), which hinder dexterity and intricate movements. These began after a minor injury in May 2023. Blood tests ruled out arthritis, but imaging procedures were not undertaken. * **Occasional mouth ulcers** and **dry eyes**. * Suffered from **chronic migraines and frequent headaches**, with a noted worsening beginning in August 2023 during employment in a **windowless basement setting**. * Often experience gassiness, although flatulence is infrequently foul-smelling. * An **unchanging, non-tender mass in the neck**, present for about a decade. Evaluation is complicated due to the individual's body type (rugby build), and no formal imaging has been performed. # Family Medical History * A **maternal aunt succumbed to bowel cancer**. * Both **mother and maternal grandmother** suffered from **goiter and thyroid-related issues** without an identified cause. * Both **father and paternal grandfather** have been diagnosed with hiatus hernias. # Timeline of Symptoms * **October 2022** – Commenced work in a **windowless basement** with no access to natural light. * **May 2023** – Noted the emergence of **painful, calcified nodules** on the PIP joints of the right hand. * **August 2023** – Experienced an increase in **migraines and headaches**. * **April 2024** – Received treatment for a **chest infection**, which involved two courses of antibiotics. * **May 2024** – Onset of **rectal bleeding and discomfort** during bowel movements, transitioned to a hybrid work model (three days in the office). * **June 2024** – Diagnosed with an **anal fissure** by a general practitioner, attempted treatment included laxatives, topical creams, dietary modifications, and enhanced bathroom hygiene practices. * **November 2024** – **Flexible sigmoidoscopy** conducted; no fissures or polyps found. * **February 2025** – Onset of **difficulty initiating bowel movements**. If you have any questions or need clarification, I'm scheduled for another appointment with my GP soon and would greatly appreciate any differing opinions on my situation. Warm regards,
Answers (1)
3/26/2025, 6:30:50 PM
OpenHealth AI
It sounds like you have multiple interconnected health concerns, including ongoing rectal bleeding, discomfort during bowel movements, and joint issues. Here’s a structured approach to help you manage your symptoms while preparing for your upcoming appointment with your GP.
Main Points
- Persistent rectal bleeding and discomfort during bowel movements may suggest underlying issues despite previous evaluations.
- Joint pain and calcified nodules indicate a potential connection to systemic conditions, especially given your family medical history.
- It's crucial to gather any additional information before your GP visit to help uncover potential links among your symptoms.
Explanation
Rectal bleeding can arise from several sources, including gastrointestinal irritation, which may be related to dietary changes or unresolved inflammation. Since your sigmoidoscopy ruled out polyps and fissures, there are other potential causes, such as inflammatory bowel disease (IBD) or dietary intolerances that might be contributing. The joint issues, combined with symptoms like mouth ulcers and dry eyes, could suggest a systemic condition, potentially linked to autoimmune disorders.
Next Steps
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Symptom Documentation:
- Keep a detailed journal of your bowel movements, noting the frequency, consistency, color, and any pain levels.
- Track occurrences of mouth ulcers and joint pain, and note any triggers you may identify.
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Dietary Adjustments:
- Consider reducing high-fat or spicy foods, which might irritate your bowel. Increase fiber intake to promote regularity, but ensure you do this gradually.
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Hydration:
- Maintain adequate hydration (around 8-10 glasses of water daily), as this can help with bowel consistency and reduce discomfort.
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Stress Management:
- Given your work environment may contribute to your headaches, practice stress-relieving techniques like mindfulness, daily short walks, or even light exercises that can also help with overall mobility.
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Prepare for GP Appointment:
- Write down all symptoms, their evolution, and previous medical evaluations.
- Ask your GP about further diagnostic tests, such as imaging for your neck mass or assessments for inflammatory bowel disease and autoimmune conditions.
Make sure to bring your symptom journal and prepare to discuss any relevant family medical history. This can provide your GP with a comprehensive overview and assist in determining further investigations or treatments. If any new or severe symptoms arise before your appointment (like increased bleeding, severe pain, or systemic issues), seek immediate medical attention.
Stay strong, and I hope you find clarity and relief in your next steps!
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