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Abdominal Pain. Had IBS. Urinary Tract Ultrasound Came Normal. Worried About Testicular Cancer

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Posted on Fri, 5 Apr 2013
Question: Over the past two months I have not been feeling 100% myself. It's a long story, I'll try to keep it short whilst including all the details.

I visited a GP (not my own) with abdominal pain and a change in bowel movements (I have been previously diagnosed with appendix but apparently wasn't in enough pain so told to come back in two weeks if pain continues. I went away for 6 nights, but cut it short (to 3 nights) as generally wasn't feeling well. Went back to doctors and saw my own GP this time. I had a urinary tract ultrasound as I felt bloated in my groin and lower abdomen a lot. This came back clear (no kidney stones etc). At this point in time I also got results from a urine test and blood (full blood count) test: both normal, apart from high bilirubin (was diagnosed with gilbert's syndrome a few years ago).

I was doing a monthly check and found a small lump on the top of my right testicle, when I pushed on the lump firmly it was making the pain I was experiencing in my groin worse. Went back to my GP, referred for a testicular ultrasound scan. Had to wait 3 weeks, during this time I got quite anxious and started to suffer from a lot of anxiety symptoms such as tight chest, shallow breathing, body aches and pains, back ache etc - having being worried I linked this all to symptoms of testicular cancer. After a long 3 weeks, it turns out the lump was a small (5mm) and harmless cyst and everything else was fine. Was told that growing cysts can sometimes cause a little discomfort in the area but are nothing to worry about. I got home, had one more feel... and felt a bean-shaped lump on the right side of my groin, a lymph gland/node I assume. I knew nothing about these, so just assumed it was normal.

Back to the GP I went as I was still experiencing abdominal pain and what I thought were anxiety symptoms are still present, even though anxiety levels had dropped dramatically after learning that the lump was a harmless fluid-filled cyst. My GP looked at previous records and discovered I had an inhaler when I was younger (I used it for sports). I haven't used one for years though. She listened to my chest and said everything sounds fine and it was left at that. This was 2 weeks ago. Since then I still have shortness of breath from time to time (sometimes brought on by walking - I find it hard to talk and walk especially uphill). On a couple of occasions I have had severe stabbing pain in the sides of my chest and back when taking a XXXXXXX breath. These usually come and go in spells of 2-3 minutes, and seem to happen randomly (tried to look for things that set it off but it has happened whilst walking and sitting still!). I have been feeling more tired than usual, a lack of concentration (anxiety maybe?), body aches and pains and muscle weakness. I'm still experiencing abdominal pain, and have noticed an increase in mucus. On three occasions in the past two weeks I have been to the toilet with the feeling of needing to pass stool, and just passed mucus mixed with bright red blood instead. I have also woken up once very cold and soaking wet. At first it felt like I had wet myself but quickly realised I was dripping in sweat, my back, chest, neck and head were wet, as was my pillow and the top of my bedding. This has happened a few times in the past year or so, so maybe I was just hot? I have also lost some weight, although I am not sure how much. I know this time last year I weight around 11st5 (almost 6ft) and now I weight about 10st5 - I'm not sure how quickly this weight was lost. I haven't really changed my diet - although I am probably walking more since moving back to my hometown.

Cut to the present day - I went back to my GP today. Told her about the blood, swollen node and my other symptoms - I forgot to mention back pain and the night sweat though. She has referred me for a colonoscopy to check for any underlying causes of the mucus and blood and I have to send in a stool sample (she is testing for anything I may have picked up whilst in Australia for 11 months, Thailand for 1 week, or Paris/Amsterdam for 3 days - although Australia and Bangkok were 6 months ago, Paris & Amsterdam in the past 3 months). She felt the swollen lump in groin and said it was a lymph node/gland. Said it could by due to the cyst or maybe just easier to find as I have lost weight.

A list of my symptoms at the moment:

- Occasional mucus (over the past 6 months has happened a few times, put it down to IBS)
- Occasional blood and mucus (3 times in past 2 weeks, never happened before then - all happened in the evening, not consistent with my normal bowel movement pattern
- Generally feel weak, more tired than usual, bones and muscles aching
- Back ache (upper and lower, tends to move around)
- Inconsistent aches in upper-sides below armpit
- Unexpected lost weight - 32" jeans I bought 1 month ago seem to have got bigger
- Abdominal aches and cramps, especially in morning - sometimes relieved by bowel movement
- 2-3 bowel movements per day, usually 2 within first hour of waking up, sometimes a third in evening
- Body temperature (always cold during day with heating on and windows shut, always hot at night with heating off and windows open - it's still chilly here in the UK)
- Occasional shortness of breath, usually worse when walking uphill especially when talking
- Occasional pain when inhaling, sometimes mild and other times quite painful, lasts 2-3 minutes
- Occasional dull ache in groin (doc has put it down to testicular cyst)
- Random numb and tingling sensations in arms and legs
- Increase in mild headaches (normally don't get any)
- Painless lymph gland/node in right side of groin, close to testicular cyst - not sure if swollen, about the size of a kidney bean, found it 3 weeks ago, hasn't grown in size

Test Results:
- Urine Sample (Jan 31st 2013): Normal
- Urinary Tract Ultrasound (Feb 5th 2013): Normal, no signs of infection, swelling or stones
- Complete Blood Count (Feb 12th 2013): Normal with exception of high bilirubin (Gilbert's Syndrome)
- Testicular Ultrasound (Feb 25th 2013): Normal with exception of 5mm fluid-filled epididymal cyst
- Stool Sample (Feb 14th 2013): Awaiting results
- Colonoscopy: Awaiting appointment date

Any help would be appreciated. Are we heading in the right direction? Would you recommended any other tests? One thing that concerns and affects me most is the chest, side and back pain.
doctor
Answered by Dr. Samik Basu (12 minutes later)
Hi ,
Thank you for your query.
I can understand your problem.
I can understand your concern and anxiety.
Your doctor is going in the right direction.
Colonoscopy will give diagnosis of any sinister lesion in the intestine which is causing bloody stools,weight loss and abdominal discomfort.
If it comes normal a CT scan of the whole abdomen is warranted and a repeat blood test is warranted.
If you continue to have chest discomfort and breathlessness you need to have an ECG and ECHO done.
Don't worry too much.The doctors will take good care of you.
Take rest and plenty of fluids.
Consult your doctor if the problem persists.
If you have any further queries you are free to consult me.
Hope this answers your query.
Wishing a speedy recovery.
Have a nice day.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Samik Basu (29 minutes later)
Thank you. It's good to know that I am at least heading in the right direction, and I now know if the colonoscopy doesn't reveal anything, I'll ask for a CT scan. My abdominal pain isn't actually that severe - it is often relieved after going to the toilet.

A couple of questions relating to the lymph gland/node:

- Is it common to have one lymph node/gland in the groin larger than others? The one I feel is kidney-bean size (probably about 1-1.5cm long)?
- Is it common for these glands/nodes to swell from a harmless cyst?

I have researched my symptoms and a couple of things I have found sound similar to what I am experiencing:

- Overactive Thyroid / Hyperthyroidism: especially fatigue, frequent bowel movements, increased sweating, nervousness, weight loss, weakness, occasional itching. How would this be diagnosed? Would this have been found already?

- Malnutrition or Vitamin B12 Deficiency: especially fatigue, lethargy, weight loss, breathlessness, headache, tinnitus (had this for years, very mild), reduced sense of touch, irritability, weakened muscles, pain in bones and joints. How would this be diagnosed? Would this have been found already?
doctor
Answered by Dr. Samik Basu (10 minutes later)
Hi,
Lymph node swelling in the groin area is common due to some skin problems near the genital area.Get the area checked.
Hyperthyroidism will be diagnosed by a thyroid profile.
Vitamin deficiency will be diagnosed by taking blood samples to detect their levels.
I think these symptoms are related to generalised anxiety disorder due to the stress you are undertaking in diagnosing your medical problem.
Don't panic.Everything will be fine.
have a nice day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Samik Basu (9 minutes later)
Yeah, I have a feeling a lot of it is anxiety, producing symptoms I don't really have. Sometimes they disappear if I am very busy or out having fun (all but the stomach problem - which is the reason all of this started). I'll go ahead with tests, and I'll return if any other questions. Thanks.
doctor
Answered by Dr. Samik Basu (2 hours later)
Hi,
Please go ahead with the tests....best of luck
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Samik Basu

Pediatrician

Practicing since :1999

Answered : 711 Questions

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Abdominal Pain. Had IBS. Urinary Tract Ultrasound Came Normal. Worried About Testicular Cancer

Hi ,
Thank you for your query.
I can understand your problem.
I can understand your concern and anxiety.
Your doctor is going in the right direction.
Colonoscopy will give diagnosis of any sinister lesion in the intestine which is causing bloody stools,weight loss and abdominal discomfort.
If it comes normal a CT scan of the whole abdomen is warranted and a repeat blood test is warranted.
If you continue to have chest discomfort and breathlessness you need to have an ECG and ECHO done.
Don't worry too much.The doctors will take good care of you.
Take rest and plenty of fluids.
Consult your doctor if the problem persists.
If you have any further queries you are free to consult me.
Hope this answers your query.
Wishing a speedy recovery.
Have a nice day.