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Have abdominal discomfort, bloating, nausea and fatigue. Scan showed mild gastritis and diverticulosis. Pancreatic cancer?

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Practicing since : 2002
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For the last 3 months I've had left upper abdominal pain, mid epigastric pressure/bloating, nausea, occasional diarrhea, fatigue, loss of appetite and some weight loss (8 lbs). The abdominal discomfort comes and goes throughout the day, but it is there every day for 3 months. If I eat anything fatty, the pain and diarrhea are worse.Over the last couple of days I've been having pain also in my upper back, between my shoulder blades.

I've had extensive bloodwork, 2 endoscopies, colonoscopy, abd ultrasound and helical ct with contrast. I have no jaundice and liver enzymes are normal. Only things that showed up on scans were some mild gastritis and mild diverticulosis, fatty liver and small hiatal hernia. Been on PPI, Bentyl, Xanax - nothing works. I am beside myself with worry that I have pancreatic cancer, but doctor says that it would have shown up on the ct scan. After all these tests he's calling it "nerves". I don't buy that diagnosis. What else can this be? Should I insist on another ct scan - could the first one have missed pancreatic cancer? I just don't know what to do next as I am still having pain and symptoms seem to be getting worse.
Posted Thu, 4 Jul 2013 in Cancer
Answered by Dr. Robert Galamaga 1 hour later
Hello and thank you for sending your question.

This is a very good question and I will work on providing you with some information and considerations.

I am sorry that you're dealing with such persistent and disabling symptoms. It looks like you have had a very thorough evaluation with endoscopy and imaging studies.

Pancreatic cancer does not appear to be a consideration in your case. Typically pancreatic cancer does present with pain but there are also findingson imaging studies which would be suspicious. Also there are blood tests which can be done to check for tumor markers.

One additional consideration in your case would be some type of food intolerance. It would be possible that your body has developed some intolerance to certain types of foods.

I think it would be beneficial for you to discuss your current situation with a nutritionist or dietitian to the highway for possible food sensitivity. Also there are certain blood tests which can be done to test for some of these food allergies.

I don't think additional imaging studies are needed at this time as I am sure they will be normal. I really don't see any evidence of cancer in your case. While it may be possible that some of what you are dealing with is related to nerves I completely understand your desire to have this worked up completely.

Thank you again for sending your question. Please let me know if you have any additional specific concerns.

Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Have abdominal discomfort, bloating, nausea and fatigue. Scan showed mild gastritis and diverticulosis. Pancreatic cancer? 5 hours later
Thank you for your time and input Doctor XXXXXXX I guess I should stay off the internet, but every pancreatic cancer website lists the following symptoms: upper left abdominal pain, back pain, nausea, loss of appetite, weight loss, diarrhea and digestive problems. I have all of these. All the tests I've had ruled out benign things with these symptoms, so I just keep thinking it's pancreatic cancer.
I have tried eliminating dairy, etc from my diet, to no avail. Also, the abdominal pain is not associated with eating. I sometimes wake up with pain, sometimes have pain even if I don't eat anything all day. It also doesn't seem like it's coming from inside my stomach - i.e. it's not like indigestion. If I bend over for too long I get the pain. It's almost like a constant dull cramp on the left and from time to time it is sharp and colicky pain in the middle and nausea on and off all day long which makes me not want to eat. Pressing anywhere on my upper abdomen is painful too.
I guess I'm scared that maybe the scan missed something. Of course, the logical part of my brain tells me that with these symptoms, the cancer would have to be big enough to show up on a CT scan. But I have heard of people having pancreatic cancer that didn't show up on CT. Have you heard of this and do you know why it wouldn't show up on a scan? Sorry for sounding so paranoid but I've been dealing with this since March and I'm pretty stressed now.
Thanks again.
Answered by Dr. Robert Galamaga 22 hours later
Hello and thanks for the query,

I understand your worry and concern. While it is theoretically possible to have a cancer without imaging findings, I don't think this is the reality in your case.

For some reassurance you could have your doctors request a CA19-9 level which is often elevated in the setting of pancreatic cancer. If this level
Is normal this is even more evidence that you are not dealing with a cancer.


Dr Galamaga
Above answer was peer-reviewed by
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