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Abdominal discomfort, broken stool, anxiety, lack of appetite, stone in gall bladder, medicine for IBS, blood test normal. CT scan or MRI needed?

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Practicing since : 2000
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Worried about Pancreatic Cancer
I am male, 35 years old, 1.90cm and 135kgs. My firsts symptoms were late jan/12: vague lower abdominal discomfort (on/off) and soft/broken stools. At that moment I was working away from home for one month in another country. Almost every day the food was spicy (indian food). It is different from my normal eating habits. Then 3 weeks ago I returned home and thought everything would back to normal. But the stools remained soft/broken. Then last week, searching on google, I was terrified with the symptoms of Pancreatic Cancer. Since then, after searching on google, I have a lot of anxiety and think about it all the time! It is driving me crazy! Coincidence or not, I began to feel vague pain in the upper back (on/off), very small itches (sometimes) and lack of appetite (anxiety?). And the stools remain soft/broken, sometimes yellowish. Last week I did two ultrasounds and went to two doctors. All fine with ultrasounds, with the exception of stones in gallbladder (I know I have them for 3 years but never had symptoms) and soft hepatic steatosis. The doctors told me to stay quiet, that I had no problems, all is fine! But I am still stressed and think about it all the time! What bothers me is that the stools do not return to normal and about the vague back pains (on/off). Since then I am taking medicine for IBS. I did some blood tests. Everything normal, except for glucose (105), colestorol (250) and Trigliceridies (230). Questions: 1) If the symptoms are from Pancreatic Cancer, would have been detected on ultrasounds? Even if the Cancer is in the initial phase? 2) It is necessary to do a CT Scan or MRI? 3) The high glucose (105) can be a sign of diabetes which is one of the symptoms of Pancreatic Cancer? 4) My bilirubin test gave a total bilirubin of 1.34, with 0.19 (direct) and 1.15 (indirect). It is a problem? 5) My doctor said that my concern should be to lose weight (diet and exercise) to control glucose levels, cholesterol and triglycerides. 6) Should I be worried?
Posted Tue, 22 May 2012 in Chron's Disease
Answered by Dr. Poorna Chandra K.S 8 hours later
Thanks for the query
I believe that you do not belong to India and have visited the country for a short work assignment. Your symptoms are suggestive of a condition called tropical sprue which is commonly seen in people from other countries who visit India and other tropical countries. This is seen especially when these people get back home. This commonly causes an alteration in stool consistency, bloating, discomfort and flatulence. It responds to topical antibiotics like rifaximin and multivitamins including folic acid. Avoiding milk also helps.
1)     Given your history, the likelihood of you having pancreatic cancer is low. Early cancers are not effectively picked up on ultrasonography.
2)      However early pancreatic cancers are better picked up on a contrast magnetic resonance imaging (MR) scan.
3)     Pain with diabetes is more often associated with pancreatic cancer. However, diabetes is a common disease and can be seen as a chance finding with any other disease. This must be kept in mind when evaluating a disease
4)     Even though your bilirubin levels are high, they would need attention if your liver enzymes are also affected. Meanwhile, take lots of fluids, have light and frequent meals and avoid alcohol.
5)     You should definitely be losing weight to take care of the high sugar levels and cholesterol levels. Even though you do not have diabetes, losing weight can help you cut your risk of developing diabetes by half . It will reduce your cholesterol levels.
6)     You need not be worried. Speak to your physician about this and I’m sure you’ll respond.
I hope I have addressed your concerns.
Above answer was peer-reviewed by
Follow-up: Abdominal discomfort, broken stool, anxiety, lack of appetite, stone in gall bladder, medicine for IBS, blood test normal. CT scan or MRI needed? 8 days later

Thank you for your attention. Just to clarify, Tropical Sprue has anemia and diahreia as symptoms, right? I don´t have anemia! And about diahreia it does not occur so often with me, just sometimes.

I stayed one month in Oman (Middle East)!

Best regards,
Answered by Dr. Poorna Chandra K.S 20 hours later
hi and thanks for the follow up. if diarrhoea is not a predominant symptom it could be a condition called tropical enteropathy where there is some absorptive defects. anemia may take some time to develop and diarrhoea could be intermittent. get your stool checked for three days and take multivitamins including folic acid 5mg and follow the other instructions listed earlier. you should start feeling better within a month.
regards, dr XXXXXXX
Above answer was peer-reviewed by
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