Question: Hi, I am a 33 y.o. female with a 3 years history of digestive issues. I have been previously diagnosed with IBS and gastritis. At that time I had frequent diarrhea and lower left quadrant pain.
About two years ago, I started having upper left quadrant pain and pale stools, and I did a lot of analysis including an MRI, which revealed nothing. I went gluten and lactose free and was pain-free until 2 months ago.
In july, I started having occasional dull pain on my mid right side (gallbladder location) and was feeling tiredish. The pain was worse when bending, or in positions in which my rib was hitting the spot. I went to my GP who did a serie of blood analysis and a ln abdominal ultrasound. All the findings were normal except somewhat lower ferritin (11ng/L). The US was clear. However, since the pain continued and moved also to my mid-left side under ribs, I went to hospital for further analysis, suspecting that there might be somthing wrong with my pancreas. However, all my findings are normal: pancreatic enzymes normal, CA 19.9 negative, blood sugar normal, ferritin back to normal, CT and MRI of the abdomen clear, gastroscopy showed an "atrophy of the duodenum", colonoscopy normal except for internal hemmorroids. The doctors didn't see the need to perform MRCP or EUS. It would all be very good if I didn't have this pain, that seems to be worse after I eat (especially if that something is fried). I also feel that the food I eat stays undigested for a very long time. Above all, I lost 4kg in 3 months and I am extremely worried that I might have pancreatic cancer. I read that this cancer is somtimes quite difficult to diagnose. Please help with suggestions. Would a serious issue show up on some results? What could be causing all of my symptoms? Is there a need for asking for additional analyis like MRCP or EUS?Thank you in advance!

Hi, thank you for your answer. The doctors here do not want to do further analysis, since all my other results are normal and nothing is indicative of a pancreatic lesion. They have taken a biopsy of the atrophic tissue, but the upper END was done a few days ago and the result hasn't arrived yet. What can be the cause of this atrophy and is this linked to my other symptoms? Is it possible that I have some form of chronic pancreatitis, causing some kind of pancreatic insuficency? When I measured my amylase and lipase levels a couple of years ago, my lipase was lower than ref. range. Is it possible that a pancreatic insuficiency is causing my progressive food intolerancies over the last years? In the last two years, I have pale stools from time to time. My cancerophobia aside, I guess that if it was cancer causing it, I would already be dead by now and it would show up somewhere. I just want to get an explanantion, because it is so frustrating not knowing the cause. "You are just stressed is my diagnosis for now". BR, XXXX

Hi, thanks again for answering! I have indeed adjusted my diet about 1M ago, since I noticed that the pain is stronger after I eat. However, I started losing a little bit of weight prior to that. Two things worth mentioning however:
- I had a lot of stress un the period before the pain begun. I lost my job and discovered I had infertility issues. I guess the change of daily routine (less sitting and less snacking) + stress could also have impacted the weight loss.
-1M before the onset of pain, I also started taking a lot of supplements in order to boost my fertility: DHEA, royal gelly, vitamin B, Q10 + aspirin for the circulation. Could these supplements have triggered anything?
Since you think I should try to persuade my doctors to get an EUS (who do not think at all that it is something serious), can you please tell me if you think that there are chances that I have Pan Can, even though all my other results are normal and show no indication of a lesion? Would an MRCP be any useful in my case? BR, XXXX