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Having difficulty in swallowing, suffer very loose stools and daily nausea. With strong gerd. Barretts syndrome or esophageal cancer?

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General Surgeon
Practicing since : 2008
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48-yr old caucasian male; 14 cm spleen (was 12 cm 9 months ago); difficulty swallowing; scheduled for endoscopy and colonoscopy next Friday; 71" tall with average weight of 197, but now fluctuating +- 9 lbs over last several weeks; very loose stools and daily nausea persisting for 1 month; strong gerd with prescribed ppi regimen for over decade, ppi's (ranitidine and omeoprazole) now not controlling the gerd and chronic esophageal spasms; persistent and very strong fatigue with sob on light exertion. bottomline: likelihood of barretts syndrome or esophageal cancer or other? Two specialists have verbalized the possibility of MS as an "umbrella condition for all the various symptoms.
Posted Mon, 26 Aug 2013 in Digestion and Bowels
Answered by Dr. Grzegorz Stanko 36 minutes later

Thank you for the query.

GERD symptoms and diarrhea can be caused by gastrine secreting tumor called gastrinoma. Symptoms caused by this tumor are called Zollinger-Ellison syndrome. MS is kind of strange idea. Gastrinoma should be ruled out at first. In case of gastrinoma, endoscopy should reveal peptic ulcers.

Nausea, acid reflux, difficulty swallowing can be caused by stomach or esophageal cancer. However neither of this diseases gives diarrhea. Is kind of hardly possible for the stomach cancer to give diarrhea. It may happen if fistula between stomach and large intestine will appear (but this is extremely rare).

Barretts esophagus is possible as this condition appears due to long time stomach acid irritation. This can be present apart from other conditions.

Gastroscopy is a very good idea and should be done as soon as possible. In case of peptic ulcers, also gastrine level should be checked.

Hope this will help. Feel free to ask further questions.
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