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Have acid reflux, pain and itching under rib cage. Feeling bloated. Hepatic ultrasound done. Cancer?

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General Surgeon
Practicing since : 2008
Answered : 5762 Questions
i recently had a hepatic ultrasound which has revealed some changes to my liver. i also have acid reflux and recently had a bout of gastritis. My urine looks like water-no color and I am bloated after I eat. Also I have some itching at times under my rib cage and occassionally dull pain. Do I have cancer?
Posted Wed, 10 Apr 2013 in Cancer
Answered by Dr. Grzegorz Stanko 19 minutes later

Thank you for the query.

Typical symptoms of almost every cancer is weight lost, weakness, night sweating. However such symptoms usually appear if the cancer is quite advanced. In early stages cancer usually gives no symptoms.

What exactly has been described in the liver ultrasound? You need to know that ultrasound is very sketchy test and can only reveal large changes.

Acid reflux symptoms should be always checked with stomach cancer. It is because this cancer does not give any typical symptoms and every stomach disease symptom can appear due to stomach cancer. Moreover, acid reflux is very often caused by Helicobacter Pylori infection. This bacteria can trigger cancerous changes if the infection is present long enough. That us why, upper GI endoscopy with Helicobacter Pylori test should be performed.

Water like urine can appear due to increased fluid intake or due to severe kidneys disease. It usually does not indicates cancer. To have it checked, urine analysis, creatinine and blood urea level should be checked.

Bloating after eating can be also related to the stomach disease and can be checked with endoscopy. Sometimes bloating after a meal can appear due to air swallowing caused by chewing gum, fast eating, loose dentures, drinking carbonated drinks.
If bloating appears with constipation or/and diarrhea, large intestine diseases should be ruled out.
Moreover, every person older than 50 should have colonoscopy performed every 10 years or FOBT (fecal occult blood test) every year to rule out colon cancer.

Pain under the rib cage and itching can appear also due to stomach disease or gallstones (should be visible in abdominal ultrasound).

So in conclusion, in cancer prevention you should:
1. Have upper GI endoscopy
2. Colonoscopy (if constipations, weight lost, low hemoglobin level are present) or FOBT (if no symptoms)
3. If there were any ovarian or breast cancers in your family (especially in the young age) BRCA1/BRCA2 mutation should be checked.
4. Mammography or breast ultrasound should be performed.
5. Ca-125 level and transvaginal ultrasound (or better abdominal and pelvis CT) to rule out ovarian cancer.
6. If you do smoke, chest CT should be done every 2 years.

Hope this will help. Feel free to ask further questions.
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