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Had Hodgkins Lymphoma. Getting Flank Pain, Diarrhea. Ultrasound Done. Took Prozac, Xanax. Cancer?

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Posted on Fri, 10 May 2013
Question: Hello Doctor
I am 51yr old female I had Hodgkins Lymphoma in 2005 in remission since, recently I have been having right side flank pain and a lot of loose bowel movement, I cant hardly eat anything as I have to go to bathroom directly after. I had upper abdomen ultrasound which they said was ok except for fatty liver and advised diet and excercise for that. I have left limb lymphodema and it is difficult to excercise. After the ultrasound that evening I got my period and the flank pain disappeared, still sore in the area though. Bowel movements still loose no blood in it though. I await to get appointment for colonoscopy but I am so worried it might be cancer, I have myself driven crazy over this, my doctor has me on 40mg Prozac and Xanax only 14 of them as required. I have copies of my scan results if you wish to view them I can upload them. The pain when its there is more achy and to the side. The ultrasound doctor said she thought it might be multiskeletal but surely it wouldnt be that when I have bowel movement problems. I was thinking of IBS that I could handle no problem, I am not Coeliac as i had blood test for that done. I would like your opinion Doctor please I can only download 3 of my 28 scan photos to you I dont know why I guess it exceeds the size limit, is there some way I can send you the entire folder to view
Thank you
XXXXXX
doctor
Answered by Dr. Abhijit Deshmukh (5 hours later)
Hi,

Thank you for the query,

The possibilities of your pain with diarrhea include,

Inflammatory bowel disease (Usually with mucus, blood in stool)
Irritable bowel syndrome
Radiation enteritis if you have received abdominal radiation
Lymphoid obstruction related diarrhea due to lymphoma or radiation (if any)
Lymphoma itself
Chronic infectious diarrhea
Diabetic diarrhea

First thing is do not panic it will just worsen your symptoms.

Get a stool examination, Complete blood count, ESR, C reactive protein and TSH (thyroid) done after advice of your doctor.

Second step is to do a colonoscopy and see the bowel.

Can take a mild anti-diarrheal after consulting your physician to limit your pain and diarrhea.
Remember anxiety could really worsen your symptoms. So try to handle it.
No need to upload your Ultra sound scan images only the report mentioned by you should suffice.

Hope this answer your queries.
Happy to help.
Wish you a speedy recovery.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Abhijit Deshmukh (13 hours later)
Hello Dr
Thank you for your reply and information, today was not such a good day, I got referral to the doc at the hospital but for May 1st it seems quite a while away, i know they will only assess me that day,I haven't eaten much today but had a bowl of gluten free soup, thinking I was being careful eating gluten free, I didn't have it swallowed five mins when I got tummy cramp and diarrhoea ,it seemed a bit yellow in colour, would the soup go down in that much time and trigger diarrhoea that fast ? I don't normally drink soup because it normally does cause tummy upset, but today I was weak because I hadn't eaten anything for fear of triggering the tummy, the right side flank pain is intermittent , I get the feeling of "something"being there,its at where my elbow would reach my waist on right hand side,I wonder what causing this ? I would like to ask you, if my upper abd ultrasound didn't show anything sinister, would it mean my bowel isn't holding something like a tumour ? I know bowels can't be seen by ultrasound, would I have right flank pain all this time if it was bowel related ? I am terribly tired today but when I get in bed it eases somewhat , I have eaten nothing since the soup, I do find if I eat a mint sweet it eases the full bloated feeling. I was going to take Colpermal (not sure if I have right spelling ) but don't know if I should or not
Thanks, I will await your reply Dr
XXXXXX
doctor
Answered by Dr. Abhijit Deshmukh (9 hours later)
Hi Mrs. XXXXXXX
Thank you for the query.

Unlikely something taken 5 min back can trigger diarrhea, likely an sensitive stomach causing reflex action to make you feel go to the toilet.

Do not worry thinking that it is a tumor, recurrence presenting this way is very unlikely. In addition, bowels are usually not seen clearly in ultrasound but a lymphoma recurrence in stomach is likely to have lymph nodes in stomach, which is unlikely in your case. If you do not eat you will feel drained out, so continue to eat even if you have diarrhea otherwise you will get dehydrated.

I think colpermal is peppermint oil, I would not suggest you to take it.

You should relax and continue with your routine diet.

Hope this answers your query.
Wish you a speedy recovery.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Abhijit Deshmukh (14 hours later)
Hello Dr thank you again for your reply my fear is not of lymphoma reoccurrence but something like colon or bowel cancer but I don't have blood in my stools just very loose movements. I had taken one calpormin before I read ur reply it did seem to ease the movements but then today I felt nauseated because I could get the taste of peppermint, at this moment I feel that I should ask to be admitted to hospital because all I am eating is plain crackers whatever else I eat goes through me almost immediately , in a ct thorax in feb they noticed small lymph nodes in chest area but my onc said they were there 3 yrs ago when I had last full body scan , the ultrasound I had was only upper abdomen , can ultrasound see any new nodes if they were there ? It is secondary cancer I fear not so much lymphoma as my onc did say that the lymphoma would unlikely reoccur after 8 years but I didn't have the side pain when I visited him in feb it only started in march I just wish they would hurry up and find out what's going on ? As not eating isn't good for me but I do drink lots of water
Thanks again Dr I await your reply
XXXXXX
doctor
Answered by Dr. Abhijit Deshmukh (10 hours later)
Hi,
Thank you for the query,

Ultrasound can see lymph nodes reasonably well. It is rare for primary bowel tumors to present only with diarrhea and not much other symptoms. I still strongly suggest that you should continue with your diet intake irrespective of diarrhea and it should help in prevention of weight loss, dehydration and excess fatigue.

Take ample of salt in your diet if your blood pressure is normal.

Hope this answers your query.
Wish you a speedy recovery.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Abhijit Deshmukh

Gastroenterologist

Practicing since :2001

Answered : 597 Questions

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Had Hodgkins Lymphoma. Getting Flank Pain, Diarrhea. Ultrasound Done. Took Prozac, Xanax. Cancer?

Hi,

Thank you for the query,

The possibilities of your pain with diarrhea include,

Inflammatory bowel disease (Usually with mucus, blood in stool)
Irritable bowel syndrome
Radiation enteritis if you have received abdominal radiation
Lymphoid obstruction related diarrhea due to lymphoma or radiation (if any)
Lymphoma itself
Chronic infectious diarrhea
Diabetic diarrhea

First thing is do not panic it will just worsen your symptoms.

Get a stool examination, Complete blood count, ESR, C reactive protein and TSH (thyroid) done after advice of your doctor.

Second step is to do a colonoscopy and see the bowel.

Can take a mild anti-diarrheal after consulting your physician to limit your pain and diarrhea.
Remember anxiety could really worsen your symptoms. So try to handle it.
No need to upload your Ultra sound scan images only the report mentioned by you should suffice.

Hope this answer your queries.
Happy to help.
Wish you a speedy recovery.