THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.
When in college she used to eat spicy street food very often, but each time used to have gastric problems (burping, abd. pain, bloating) because of it. Pain used to go away on taking Aciloc.
4 months ago, 2 days before a marriage occasion in her home she noticed blood coming out mixed with stool. The stool was of normal consistency, but light yellow with mucus and blood and excruciating pain while passing stool. Dr. prescribed medicine that did not work. The patient used to pass stool 7-10 times. Blood used to come out 2-3 times mixed with stool and stool sometimes very hard to pass, while sometimes of normal consistency and normal brown color. She tried homeopathy which also failed. Again visited Dr. who told her that maybe it's an infection, told her not to eat spicy food, and gave medicines accordingly. But after taking the medicine her stool became very hard and painful to pass and frequent blood used to come out. So, stopped medicine on her own after 2 days. A second Dr. recommended her USG (an incidental finding of stone measuring 3.5 mm in rt. kidney; patient in no pain/discomfort because of it), colonoscopy (ulcerated lesion detected 5cm from anal verge), biopsy (low grade dysplasia). Dr. prescribed Zanocin oz (taking for the past 1.5 months), Rifagut (taking for past 20 days; to reduce stool freq.).
CURRENT CHIEF PROBLEMS AND PATIENT'S REQ.: For the past 4 months although not eating any spicy food (except during the days of the marriage), she is having frequent gastric problems (burping, acidity). For the past 2 months, pt is passing stool 5-6 times daily, small amount each time, feels as if the bowel not emptying completely. No blood. Burning sensation only if she passes stool for more than 4-5 times. Feeling of incomplete bowel clearance. Sometimes pus is coming out with stool. She also experiences left side abd. pain with other gastric issues, and the pain goes away within a few hours if she takes Aciloc. She had to compress her and with a pillow to try to reduce pain.
DIET: For the past 2 yrs she is dieting to keep herself fit.
Diet plan:
After waking up - lemon water in empty stomach. Then tea before going for tuition
Goes to tuition where she drinks 2 cups of tea.
10:30 return home. Eats puffed rice/roti/bread/curd/milk
1:30 - lunch (rice, fish, sabji)
Evening - Tea (in tuition)
Dinner - prefers roti with sabji/daal/fish
Used to eat lot of chicken 4 months ago. Completely stopped on seeing colposcopy results on own accord. Consumes dried amla to increase appetite.
FAMILY HISTORY: Mother has had external hemorrhoids for more than 25 yrs. Underwent 2 Sx, but not cured. No HTN, DM.
Father - Used to consume alcohol 500 ml (2-3 times weekly with friends). Due to heavy losses in business (did different business-like poultry farm, car renting) heavy drinker in the last 2 yrs of life (more than 2-3 bottles/ day). Sometimes only alcohol without any food the whole day. Was a smoker (10 - 15 cigarettes/day). Often complained of pain in abd. for last 2 yrs. Admitted in hospital with severe abd. pain and ascites. Died 10 yrs ago at age 42.
Younger brother - no health issues.
REPORTS:
FINAL DIAGNOSIS: RECTAL CA
[29-06-2025 20:01] PPM 1: [29/06, 19:16] Pt advocate 25F Rectal Ca:
Good Evening Sir
[29/06, 19:22] Pt advocate 25F Rectal Ca: Stomach tightness with pain, Vomiting, No Gas release
Sokal 7 tai admin korano hoyeche.
Hospital e admit hoyar por sudhu salain, pain killer, ekbar Enema koriyeche tarpor 2 bar olpo poop hoyeche , erpor abar vomiting, pain ektu kom but stomach tightness ache, r gas release hochhe na.
Er 20 hour age poop hoyechilo kichuta loose type er.
[29/06, 19:22] Pt advocate 25F Rectal Ca: Sir eta ki normal gas problem na onno kichu
[29/06, 19:23] Pt advocate 25F Rectal Ca: Ekhane dr kichu bolche na, sudhu salain r pain killer
[29/06, 19:27]pm: Sune intestinal obstruction er moton mone hocche.
Last amader ekhane theke jawar por ektu ghotona krom ta sankhepe janaben?
[29/06, 19:35] Pt advocate 25F Rectal Ca:
Ei year ei gechilam check up April month e tokhon sob e thik chilo er por kono problem e hoi ni .
Last Friday theke erokom hochhe, Friday admit chilo, Saturday chuti dilo, tokhon pain ba tightness kichu chilo na.
Er por ses rate mane ajke Early morning theke abar pain suru hoi,
Abar admit kori morning e
Tarpor theke pain kakhono komche ektu abar bere jachhe , vomiting olpo olpo kore onek bar hochhe.
Saradin sudhu salain, pain killer esob e diyeche.
Biker dike 5:30 pm e enema koralo, er por 2 bar poop hoyeche olpo porimane.
Ekhono same obostha
[29/06, 19:41]pm: Amader team er aashole shudhu matro ekhane joto tuku ache July 2022 obdhi👇
Tar porer theke sompoorno ghotonaboli ta sequentially jante parle aro better suggest korte subidhe habe.
[29/06, 19:44] Pt advocate 25F Rectal Ca: Sir eta ki serious problem
[29/06, 19:45]pm: Patient ke clinically examine kore regularly follow up korte parle bola jeto
[29/06, 19:48] Pt advocate 25F Rectal Ca: Er por er theke sob image gulo apnake send kore debo
[29/06, 19:49]pm: Na image guno send korar theke better habe apni date wise ghotonaboli ta share korun
[29-06-2025 20:10] Rakesh Biswas Sir: Approximately @CR the sequence of events are as follows:
July 2022 evaluated in our hospital diagnosed signet cell rectal carcinoma
Since then
Operated in Yashoda Hyderabad with tumor removal and anastomosis sometime in 2023-24
She was asymptomatic since then till today when she developed features suggestive of intestinal obstruction as in today's post above by the patient advocate.
I guess you can create an updated case report using the previous data logged in July 2022
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