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Abdominal pain, fatigue. Taking Nexium for acid reflux. Colonoscopy normal. Worried about pancreatic or liver cancer

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Endocrinologist
Practicing since : 2004
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Hi I am having upper right abdominal pain plus pain in the back in same general location I also have been extremely fatigued. I have been taking amitriptyline for 15 yrs and nexium/omerprazole for acid reflex for about 5 yrs. have had these type of pain for a few years but over the last two weeks it has gotten worse and doesn't go away. I had an abdominal ultra sound 6 months ago which showed nothing according to doctor, also a colonoscopy six months ago and everything was ok. Stools float and have chemical type odor. Liver function test shows elevated ggt of 150. Please help me I am worried about panacretic cancer or liver cancer
Posted Mon, 24 Sep 2012 in Digestion and Bowels
 
 
Answered by Dr. Om Lakhani 12 hours later
Hi XXXXXXX

The symptoms you have mentioned can happen with anomalies of pancreas. You need to get done a repeat ultrasound of abdomen and ask the sonologist to mention how the pancreas looks like.

Floating of stools can suggest excess fat in the stool. Also this can occur with excess gas production. You can get fecal fat estimation and fecal elastase to check if you are loosing fat in the stool. They are tests of pancreatic function. You can discuss these options with you treating physician. If there is weight loss and these symptoms continue to occur especially after meals then suspicion of chronic pancreatitis is high.

Having said that the symptoms you have mentioned also occur with irritable bowel syndrome (IBS). However IBS is a diagnosis of exclusion. We can get the above investigations done, if they are normal then we can have a trial of IBS treatment for sometime to see the response.

Hope I have answered your query. If you have any further questions I will be happy to help

Regards
Dr. Om Lakhani
Above answer was peer-reviewed by
 
Follow-up: Abdominal pain, fatigue. Taking Nexium for acid reflux. Colonoscopy normal. Worried about pancreatic or liver cancer 4 hours later
Because my other levels of my liver function test were not high my GP says it is a pancreas problem is he correct
 
 
Answered by Dr. Om Lakhani 10 hours later
Hi XXXXXXX,

It is difficult to diagnose chronic pancreatitis just based on liver function tests . Infact the only reason the LFT would be abnormal in chronic pancreatitis is when you have pancreatic inflammation causing block to you biliary system.

Like I said, if you have history of weight loss along with your other complaints then diagnosis of chronic pancreatitis is a possibility. Fecal elastase would be more helpful.

Hope I have answered your query. If you have any further questions I will be happy to help

Regards
Dr. Om Lakhani
Above answer was peer-reviewed by
 
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