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Is Flatulence And Gas Caused Due To Rectal Cancer?

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Posted on Thu, 16 Jan 2014
Question: I had rectal surgery 10 weeks ago and 7 weeks ago i started having severe flatulence and would like to know the likely cause severe gas flatulence after eatting meals?? why after eatting mostly low b12 137 pmol/L hands and feet tingle cold and they did 8 months ago scans good 3 months ago what are the chances the gas is caused by rectal cancer
doctor
Answered by Dr. Grzegorz Stanko (31 minutes later)
Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. What kind of rectal surgery have you had? Do you have any stoma? When was your last colonoscopy done? When was the last CT done? Last blood work? I`m looking forward to hearing from you. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (13 minutes later)
open anterior resection blood work one week ago low b12 137 pmol ct scans done 3 months ago no stoma scoped 3 months ago does the fact severe gas happens right after eatting indicate and upper GI issue
doctor
Answered by Dr. Grzegorz Stanko (21 minutes later)
Brief Answer: Detailed below. Detailed Answer: Low B12 and symptoms right after eating sounds like a stomach problem indeed. The surgery you have had can give diarrhea for first few months as a normal reaction for shorter intestine. Bloating after such surgery can be caused by bacterial infection of intestines (due to antibiotics used during and after the surgery) or by intestine narrowing (in the intestinal junction which can get narrow). In case of narrowing, your abdomen should be bloated and larger than usually, gas and stool can be occasionally obstructed. Diarrhea and constipation can be present alternately. Cramping can be present as well. Symptoms can appear right after the meal as well. Bacterial infection rather gives bloating and loose stools. Possibility of cancer recurrence is low (depending of the cancer staging - you should have histopathologic report with TNM values). Here is what you should do: - consult your surgeon and have physical examination and rectal examination (if the junction were done very low, the surgeon should be able to palpate it and tell if there is any narrowing or not), consider colonoscopy - if no narrowing in the lower part of GI tract, gastroscopy should be next - in a meanwhile please start probiotic supplementation 3x1 Hope this will help. Feel free to ask further questions. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (1 hour later)
Have you done colon cancer surgery and have you have had patients with severe extreme flatulence still 10 weeks after surgery I have like 30 large flatulence right after and during dinner could the colic reflex cause severe flatulence in the colon right after eatting or does this sound more like gallbladder or pancreas issues they did a recent abdominal xray for obstructions it was good so does this eliminate narrowing of colon. is 137 pmol b12 low enough to cause foot tingling and numb cold feeling -and malabsorption - all other blood work good.
doctor
Answered by Dr. Grzegorz Stanko (18 minutes later)
Brief Answer: . Detailed Answer: Yes, I have done colon cancer surgeries. Some of my patients have had what you call flatulence. But there can be several reasons of that and its hard to diagnose it from the point of this service. Colic reflex is not a cause. It is rather a response for some factors (like infection for example). So it can not be a main cause of your symptoms. Its moe like a mechanism of action. Pancreas or gallbladder issues give acute pain in the upper middle or left abdomen. The pain usually radiates to the back. Nausea and vomiting is characteristic. Flatulence is not. Abdominal X-ray does not rule colon narrowing or duodenum narrowing. This test only helps in emergency cases diagnostics (complete bowels obstruction). As tingling and numbness appears prior to other B12 insufficiency symptoms, yes this can be the reason. In conclusion, mentioned before tests should be done. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (3 hours later)
if you think the severe flatulence after eatting is caused by an upper GI issue and it sounds like a stomach problem then doesn t that mean its likely rectal cancer related since i had no issues in the stomach until after i got rectal cancer. The only way i can see this not being rectal cancer related is if the cause of the severe flatulence is in the colon itself since thats the only area the surgery effected. How can you say the chance of cancer as a cause is low if you think the cause of the severe flatulence is in the stomach or anywhere in the upper GI. Thank you.
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Answered by Dr. Grzegorz Stanko (12 hours later)
Brief Answer: . Detailed Answer: It is hardly possible for colon cancer to give any stomach changes (especially rectal cancer). This type of cancer can give metastases to liver and regrow in the large intestine, but it does not give any stomach lesions. You can not say anything about your stomach condition before the surgery if there was no gastroscopy done. Many stomach issues do not give any symptoms for a long time. Moreover, surgery is a huge stress for whole body. Due to such stress, peptic ulcer can appear in a day or few days (it is called stress ulcer). I`m pretty sure you have not been eating few days after surgery (and few days before). This also does not help with stomach condition. All this facts make stomach issue possible (I do not insist that this must be a stomach, but it can be). Cancer is a type of tumor which grows really slowly. It is known that it takes approximately 10 years (!) for colon cancer to appear and give symptoms. That is why any cancer related issue is in such early time after surgery rather impossible. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (1 hour later)
could a a CRC mass on the liver or gallbladder or pancreas be causing the severe flatulence after I eat my severe flatulence has a very bad fowl different smell to it. Does that indicate anything note- taking probiotics makes my gas worse what are the chance this is liver related- should i get another abdominal MRI at 3 months Thank you
doctor
Answered by Dr. Grzegorz Stanko (17 minutes later)
Brief Answer: . Detailed Answer: You have been well diagnosed 3 months ago with CT. This is enough to see any (small) lesions in the liver or pancreas. So possibility that there is a mass (which needs to be really large to compress the stomach) is also very low. CT should be done after chemo (if you have any) treatment to control and find any new lesions (if any). But for now, I think mentioned before tests (colonoscopy and gastroscopy) should be done. For sure also ultrasound will be done (which is good enough to find large lesions). Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (2 hours later)
could small CRC lesions in the liver effect the bile thats going into the stomach enough to effect stomach and cause severe flatulence my liver mri showed a 6mm hemingioma and a 2mm indeterminate mass is this a concern- also showed 2mm indeterminate mass on kidney thanks
doctor
Answered by Dr. Grzegorz Stanko (2 hours later)
Brief Answer: . Detailed Answer: Liver has a huge reserves. It can be 2/3 of the liver removed and still its function will be enough. So small lesion in the liver will be unnoticeable and it needs long time for it to give any symptoms. Hemangioma is a benign lesion which needs only observation. If you have indeterminate masses in the liver (it can be kind of metastatic lesion but does not have to), the best choice for you is to have PET of whole body. This test is able to detect very small metastatic lesions. Kidney mass is nothing to be concerned. CRC does not give kidney metastases. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (2 hours later)
if you scope the stomach what would they be looking for to cause flatulence and it safe to scope the rectum and colon just 10 weeks after surgery my severe flatulence after eatting also smells very foul , could you tell me what the bad smell indicates please thank you
doctor
Answered by Dr. Grzegorz Stanko (18 hours later)
Brief Answer: . Detailed Answer: Gastroscopy should check if there is no narrowing of the stomach and dueodenum which obstructs and impedes food passage. In such situation, if the food stays for a long time in the stomach, starts smelling really bad. Even if the obstruction is somewhere lower, the smell can be bad as all what is inside the intestines gets infected by bacteria and this can cause bad smell as well. But it is really hard to tell exactly why you have such symptoms from the point of this service. You may find this theory wrong after the tests. 10 weeks after the surgery is quite safe time to have colonoscopy. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (18 minutes later)
would you recommend I request an abdominal MRI too and additional blood tests- stool test etc thank you are foul smelling stools more likely to be caused by rectal cancer
doctor
Answered by Dr. Grzegorz Stanko (4 hours later)
Brief Answer: . Detailed Answer: No, this is not a rectal cancer symptom. Foul smelling stools usually appear due to bacterial infectionof GI tract. Sometimes pancreas inflamation can also give such symptoms, however fatty stool are characteristic for this cindition.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Grzegorz Stanko (26 hours later)
i was in the hospital for 8 days after surgery on IV 10 days with food they performed an NG on me too, stomach was distended for first 6 weeks at home had severe rectal pain which prevented sleep, small frequent stools and low energy on this week 10 i started chemo pills adjuvante xyloda which makes my flatulence worse how long do you think the gas will last , i want to start preventive radiation treatment next month does this info tell you anything thank you i was in the hospital 8 days after surgery on a IV and 10 days WITHOUT food-correction What are the % chances you think the cause of symptoms are related to Rectal Cancer and regarding % chances what is your reasoning
doctor
Answered by Dr. Grzegorz Stanko (11 hours later)
Brief Answer: . Detailed Answer: Ok, this makes things little bit different. Chemo pills destroys cancer cells but also destroys quickly proliferating cells. Intestinal cells are very quickly proliferating cells. So chemo will harm healthy intestines. This can be the reason of all your symptoms and for sure can make flatulence worse. It is well know side effect of chemo. It will be present as long as you take chemo. And it can take few days to week for intestines to regenerate when chemo will be stopped. So we can have a conclusion that your symptoms (flatulence) were due to bacterial infection (mentioned before) and has gotten worse due to chemo intake. However junction narrowing should be ruled out (with rectal examination and colonoscopy). Stomach condition should be also checked because of low B12 level. Like I have mentioned before, this symptoms are not cancer related for 99%. It is really to early for cancer to regrow (narrowing which I am thinking of is most likely caused by healing process). The cancer grows slowly and 10 weeks is not enough for it to give symptoms. So please visit surgeon and have simple rectal examination and abdominal examination. Without this, nothing is certain. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (7 hours later)
what is the % chance its not upper GI- stomach etc- related to rectal cancer My flatulence was severe before which was for 7 wks and chemo which i started 5 days ago and has made it worse I am on chemo 2wks on 1 wk off for 6 months now so my flatulence won t go away till i stop even if i take probiotics ec? my stools are very small 4inch and and not many now to me it feels like all my food is being excreted via flatulence. is this common
doctor
Answered by Dr. Grzegorz Stanko (2 hours later)
Brief Answer: . Detailed Answer: There is less than 1% chances that your upper GI problems are related to the colon cancer. Unfortunately, as long as you take chemo, your symptoms can not be stopped with probiotic. Yes, its common with chemo that food comes out via vomiting. Its because whole digestive tract is affected by chemo. You should be prescribed with Ondansetrone which should help with your symptoms. Small stool can be caused by flatulence or by narrowing in the rectum. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (40 minutes later)
Are you basing the 1% chance on the fact my imaging was good 3 months ago?
doctor
Answered by Dr. Grzegorz Stanko (13 minutes later)
Brief Answer: . Detailed Answer: I am basing it on your good imaging, on the fact that colon cancer very rarely give any upper GI problems and on the fact that the cancer grows slowly and needs really long period (like a year or even longer) to regrow on the size which would give symptoms. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (17 minutes later)
well rectal cancer does go to the liver but your XXXXXXX t think the liver would cause these kind of symptoms . Only the gallbladder would and the cancer usually doesnt go there?
doctor
Answered by Dr. Grzegorz Stanko (51 minutes later)
Brief Answer: . Detailed Answer: Like I have mentioned before, liver metastases must be really large to cause any symptoms. Even if the gallbladder is affected, the tumor grows slowly so the liver and bile ducts can adapt to it. Only large tumor around or i the liver can cause such symptoms. But generally jaundice would appear much earlier than any other symptoms. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (15 minutes later)
the fact my feet have a numb tingly cold feeling is that b12 cause for sure or can the surgery or other things effect that thank you
doctor
Answered by Dr. Grzegorz Stanko (5 minutes later)
Brief Answer: . Detailed Answer: If your numbness is on both feet same, B12 deficiency is most possible. If one side is more affected than the other one, nerve problem caused by surgery (rectum removal can cause such nerves problem as there are nerves in the close neighborhood to the rectum) is possible. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Grzegorz Stanko (13 minutes later)
I was in the hospital for 8 days on an iv with no food for 10 days they also performed an NG on me could this have caused any of my symptoms thank you and can u try probiotic tablets or is it no use till i am off the chemo which is 6 months from now would taking metamucil help with stools and flatulence Isn t my b12 quite low at 137 the aver person is at 350 pmol/L so it there a chance i have some serious malabsorption going on
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Dr. Grzegorz Stanko

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Practicing since :2008

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Is Flatulence And Gas Caused Due To Rectal Cancer?

Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. What kind of rectal surgery have you had? Do you have any stoma? When was your last colonoscopy done? When was the last CT done? Last blood work? I`m looking forward to hearing from you. Regards.