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Abdominal pain and shaky hands after eating or BM. CT showed adrenal gland nodule. Any cure?

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Practicing since : 1962
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Hi. I'm an XXXXXX . I'm taking my 83 y/o mom to UFlorida GI specialist Tues. She's been sick for a year. Unexplained shaking in the am when she eats breakfast or has a BM. Pain in the left side abdomen w/ radiation to back. Feels better if she lies down. Usually golfs 2-3 times/wk - has been homebound for a year. Negative EGD/Colonoscopy, neg enteroclysis, neg SBFT, mesenteric arteries clear. weight loss of 30 lbs. Are exploratory laps ever tried for this, would a capsule EGD/colon help? Lab work is normal. CT showed left adrenal gland nodule - 24 hr urine and labwork neg for pheochromocytoma. She also had new onset Afib and hypertensive episodes this past year. Can I pick your brain - I'm one frustrated and worried daughter. Thanks.
Posted Sat, 23 Feb 2013 in General Health
Answered by Dr. Charles S Narasi 11 hours later
God bless your 83 years young mother. Looks like she has had
extensive work up from your reports. I can see that they have
ruled out inflammatory bowel disease, mesenteric ischemia as
a cause . You only mention left adrenal gland nodule. Hope
they have taken a very good look at the pancreas.
With history of left sided abdominal pain with radiation to
the back and 30 lbs. weight loss concerns me about possible
pancreatic origin. Whether she has pancreatic insufficiency
or pancreatic cancer (Tail of the pancreas) has to be looked
into. 72-hour stool fat (Quantitative ) along with enzyme
studies would be helpful. Hope she has been checked for
Celiac disease through specific blood tests. That can be missed
by a lot of doctors if they don't look for it.
You mention hypertension and atrial fibrillation.
I am sure she is on medications for that. Look into all the
side effects of the drugs.
You also ask about capsule endoscopy. It is very helpful to
diagnose subtle Crohn's and Celiac changes. Occasional
cases of endocrine tumors of the intestinal tract can produce
various symptoms.
The only other thing I can think of is a condition called
"Microscopic Colitis " which can only be diagnosed by doing
a biopsy during colonoscopy. I don't know if this was done.
Hope this gives you some idea what to discuss with the
GI-specialist you are taking your mother to.
I wish her the very best.
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