I have mild duodenitis, rectal bleeding, and my CRP is elevated. Is this due to cancer?

Question

Hi doctor,

I am a 45-year-old female. I have recently been experiencing some GI issues. I had an endoscopy, which showed mild duodenitis that has resolved. However, I have had some minor rectal bleeding lately after running or exercising hard, so a colonoscopy has been scheduled, and I did have a CBC and metabolic panel run today, as well as a C-reactive protein test.

All are normal except the C-reactive protein, which was 5.0 mg/L with a standard range of 0 to 3.0 mg/L. I am terrified that this is due to some cancer.

I am overweight with a BMI of 32, and I have a thyroid disorder (Graves'), but I had my thyroid removed years ago.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Thank you for the query. I can understand your concern.

According to your statement, you have been suffering from GI (gastrointestinal) issues. In addition, you have obesity and thyroid problems, as well as a history of thyroidectomy.

For rectal bleeding, you have recently done some investigations and found that the C-reactive protein, or CRP level, is 5 mg/L, which is above normal (normal range is 0 to 3.0 mg/L). An elevated level of CRP (C-reactive protein) in the blood is a marker of inflammation.

Various underlying health conditions, like the presence of any bacterial, viral, or fungal infections; inflammatory bowel diseases like Crohn's disease or ulcerative colitis, heart diseases, inflammatory bowel syndrome or IBS, stress, obesity, medications, any carcinoma etc.

As your recent colonoscopy, CBC (complete blood count), and metabolic panel reports are normal (attachments removed to protect the patient's identity), your raised CRP level may result from obesity.

According to the studies, obese females are more likely to have clinically elevated CRP levels than normal females. However, only an elevated CRP level in the blood does not confirm any cancer, as your colonoscopy has shown no abnormalities in your GI tract. So do not worry.

Let me know if I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for joining again.

Yes, autoimmune conditions can raise CRP levels. But, again, autoimmune diseases like Graves' disease are closely related to inflammatory bowel diseases or IBD, especially ulcerative colitis.

In general, the pathophysiology of ulcerative colitis is associated with the Th2 cytokine phenotype, and there is increased Th2 activity in Graves' disease. So, a patient with a history of Graves' disease is more prone to develop ulcerative colitis than a person without a history of Graves' disease. Inflammatory bowel diseases like ulcerative colitis may cause rectal bleeding. As your colonoscopy has not been done yet, IBD, such as ulcerative colitis, may be the exact cause of bleeding.

Ulcerative colitis or Crohn's disease is not cancerous. Again, according to the studies, obese females are 4.76% more likely to have clinically elevated CRP levels than normal-weight females. So, a colonoscopy will confirm everything. You have no recent history of unexplained weight loss, fever, loss of appetite, alteration of bowel habits, night sweats, etc.

Again, you have a normal CBC report and metabolic panel, so how can you have cancer due to elevated CRP levels?

Hopefully, your sons will grow up with your affection in the future, too.

So, do not worry. In case of any other query, ask me

Thank you.