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

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 01, 2021

Hi doctor,

I am a 45-year-old female. I recently have 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 if this is due to some cancer. I am overweight with a BMI of 32, and I have thyroid disorder (Grave's) but had my thyroid removed years ago. Please help.

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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 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 in the blood is a marker of inflammation. Various underlying health conditions like 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), so 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. Take care. Let me know if I can assist you further.

Hi doctor,

Thanks for the reply.

I have not yet had the colonoscopy. But I did have a recent endoscopy which revealed duodenitis that has resolved. My thyroidectomy was due to Grave’s disease and was removed more than ten years ago. Could my history of autoimmune disorder raise the c-reactive protein level? I will certainly be relieved when I do a colonoscopy. The bleeding has only occurred after exercise and is slight. But I have two young boys, and I am terrified of being taken from them by cancer. Is it a good sign that nothing else is out of range in my CBC or metabolic panel?

#

Hi,

Welcome back to icliniq.com.

Thank you for joining again. Yes, autoimmune conditions can raise CRP levels. But, again, autoimmune diseases like Grave's 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 Grave's disease. So, a patient with a history of Grave's disease is more prone to develop ulcerative colitis than a person without a history of Grave's disease. Inflammatory bowel diseases like ulcerative colitis may cause rectal bleeding. As your colonoscopy has not been done yet, so IBD like ulcerative colitis may be your 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


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