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History of duodenal ulcer. CT scan shows lymph nodes in chest. Pain in side, diarrhea. Taken Imodium. Digestive problem?

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Practicing since : 1985
Answered : 140 Questions
Dear Doctor
Many years ago I was diagnosed with a Duodenal ulcer, at the time I was prescribed Tagamet which I took for years, I cant ever remember being given an actual physical test for this I think I may have had a blood test but as it was over 20 years ago, a lot has happened since. I was diagnosed with Diabetes in XXXXXXX 2012. I had Hodgkins Lymphoma in 2005 and in remission since 2006, my oncologist put me on Nexium back in 2006. A recent CT Thorax showed small lymph nodes in the chest area my oncologist doesn't seem concerned as he got written report from other hospital but was more or less positive that I wouldn't have any problems, he also did a physical exam on me including my right side and centre of tummy, in the last 2 - 3 weeks I been having a dull "ache" in my right upper side just at the side of my waist line, I have noticed that when I eat dinner or am out having a meal about 10 minutes after eating I get diarrhoea , nothing sinister in the stools, just diarrhoea, I was beginning to think I was Gluten intolerant, I have a terrible fear of any cancer returning, and am afraid to tell my local Doctor about the ache, I had roast veg and chicken today and I had had no pain all day, I had cereal this morning but just a little bowl movement, but after dinner this evening I had diarrhoea and the dull ache seemed to come back. I took Nexium and some milk, which "seemed" to ease it, sometimes I take Imodium plus for any irregular bowel movements. Is it possible the side pain is digestive problem, or something more sinister, could it be my liver, pancreas causing pain and could I get bowel upset if it was these organs, I am having panic attacks over this, why I wont go to the doctor is because I am so scared , I am normally a rational person who takes things in my stride, I know I should not think bad, but it cannot be helped, I seem to think that I might have something worse than maybe a food allergy or even IBS, these things I could cope with no problem , I am just asking your professional opinion on what you think, when I go to bed pain eases and I get a lot of rumbling in my tummy but not hardly any tummy upset in the night. Its only with a few weeks I have had the gnawing ache in my side its way over to the right of my waist line nearly to my back. In the last month or so the doctor at hospital because of my Diabetes prescribed 75mg Nuseal Aspirin, could this be affecting my ulcer and causing the side pain. I told the doctor I had Duodenal ulcer and he said "who told you" I explained I had it diagnosed years ago he said it was probably not there anymore, and if there were problems then they would order a colonoscopy that is another test that frightens me in what they might find. Am I being overreacting Doctor?? I am not usually as stressed out as this, I am physically and mentally drained from lots of things regarding my health with years. Thank you for your time Doctor, I appreciate any feedback you can give
Posted Mon, 8 Apr 2013 in Digestion and Bowels
Answered by Dr. Dinesh Kumar Singal 6 hours later

Thanks for contacting Healthcare Magic for your problems.

I can understand your fears since you have gone through a lot during last years.

What I understand is that you have right flank pain and diarrhoeal episodes after meals for last 2-3 weeks. The cause of these symptoms can range form mild infection to something sinister. But most likely cause should turn out to be a innocuous one. The most common cause for similar symptoms will be some gut infection. For this you should consult your physician who can prescribe a course of antibiotics.

If you do not respond in 10 - 14 days then certainly further investigations will be required and these may include blood tests, stool examination, CT scan and also a colonoscopy. Live is unlikely to cause diarrhea as well as right flank pain. Liver pain is usually just below the right rib cage. Pancreatic problems are likely since you also had recent onset diabetes. Pancreatic problems can cause diarrhoea. But the site of pain does not point to pancreas. pancreatic pain is more in upper abdomen in center or to the left. Gluten intolerance can be there. The duration of symptoms is too less to label it as IBS. Pain in right flank and diarrhoea suggests problem in ileo-caecal region of the gut.

Finally you should not panic and see your doctor. he can advise you what to do next. Most likely it will be something innocuous.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: History of duodenal ulcer. CT scan shows lymph nodes in chest. Pain in side, diarrhea. Taken Imodium. Digestive problem? 7 hours later
Hello Doctor
Thank you for your fast and informative reply, the pain isn't constant but I thought it was muscular and applied bio freeze muscular gel to it, any of these gels will take it away almost immediately , when I was 27 I was told that I had "the spine of a 50yr old" due to degeneration of the spine, sometimes the ache seems better when I stretch, the reason I am saying this is that I forgot to tell you that in the first email, I can't walk far due to the Lymphodema but I never have the pain when walking. My oncologist did a tummy exam but didnt seem to find anything swollen or otherwise, I guess I am so panicked now I don't know what to think, the region you speak of is the colon is it? When I apply heat it eased the pain too. Thank you again doctor I will follow up with any other info
Answered by Dr. Dinesh Kumar Singal 19 hours later

Thanks for getting in touch again.

I agree that this can be a muscular pain as well. Points in favour of muscular pain are relief on applying local analgesic gels and a lateral position of pain in the flank. So you should worry now. Contact your local physician, who can prescribe you something for diarrhoea and that should also settle.

Best Wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: History of duodenal ulcer. CT scan shows lymph nodes in chest. Pain in side, diarrhea. Taken Imodium. Digestive problem? 11 hours later
Thanks Doctor Singal
Today the pain eased and was more or less toward my back, I am also thinking it may be menestural I applied bio freeze again today seemed to help although the ache still at the back but eased by heat also again, I know having the back spinal problem is no help either I hope it goes soon, I didn't have tummy upset with 2 days so perhaps this is a good thing I live in hope that it will go soon thanks again for your help
Answered by Dr. Dinesh Kumar Singal 20 hours later

Nice to know that you are better. My best wishes are with you. let me know if I can help you in future.

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: History of duodenal ulcer. CT scan shows lymph nodes in chest. Pain in side, diarrhea. Taken Imodium. Digestive problem? 2 hours later
Today my friend checked my back under back rib cage she said she felt what seemed like a swelling under the back of my rib tender slightly to touch ,last night when in bed I felt something "give" with pain but then today no pain i will go to doctor next week if it returns the place at the back is where I have had back trouble for years I pray it will be muscular thanks again for your help doctor
Answered by Dr. Dinesh Kumar Singal 16 hours later

Looks like muscular pain only. But I guess we can be certain only if a doctor examines you and comes to that conclusion.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
Follow-up: History of duodenal ulcer. CT scan shows lymph nodes in chest. Pain in side, diarrhea. Taken Imodium. Digestive problem? 2 days later
Dear Dr Singal
I just wanted to let you know regarding my side Flank pain, I attended my own GP today I told him that I had lots of anxiety concern with this pain, I hadnt slept at all with a few nights before my visit. I gave a urine sample which he said was fine, then he did a physical examination, he examined the areas where the pain is and surrounding tummy. He asked me to take deep breaths as he pressed in this area? Why is this? He said he didnt think there was anything sinister and that he would be more than certain it was muscular radiating pain, my question is can he definately be sure there is no "mass" or otherwise by doing the physical exam? He has been my Doctor since 1988, I am curious what would he look for with the physical exam, I am still so anxious even after being told this, am I going crazy? I told him of my anxiety attacks, he prescribed 14 Calmex to "take the edge off", also is telling me to double my Prozac per day and to take Panadol for the pain. Dont get me wrong I am not doubting his word, but my mind is still racing I cannot understand why this anxiety is continuing. My friend called to see me tonight I found myself get very anxious when they were here, not wanting to talk much also I had been sitting upright for about an hour and could still feel the ache. I am all questions , I just would like your opinion again now on all this. I appreciate your help once more, thank you
Answered by Dr. Dinesh Kumar Singal 7 hours later

Thanks for getting back again.

I think you should trust your physician. Mass lesion can not be ruled out by certainty on just physical examination. To rule it out with absolute certainty you need to undergo some kind of an imaging like CT scan.

My suggestion is you should leave your anxiety behind and follow your physician's advice.

Best wishes,

Dr Dinesh Singal
Above answer was peer-reviewed by
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