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Hi Doc, First Of All Apologies For The Lengthy Query,
Question: Hi doc,
First of all apologies for the lengthy query, but desperately a detailed reassurance and diagnosis.
I am 42/M with no diabetes/hypertension etc & a teetotaller. Had generalized anxiety disorder/mild depression/panic attacks in the past few years and was treated with low dose Sertaline 25 mg, every alternate day (have slowly tapered it and stopped)
I used to get gastritis like symptoms on and off for the past many years. Done Endoscopy in 2014 which was normal. Abdomen CT in 2018 which was normal & master health checkup which have been normal till now (last done 8 months back).
Current Issue:
I have a bit of loose /not properly formed stools (just in the morning and rarely couple of time a day) for the past 4 weeks & was given rifaximin 400 mg , pancreatin enzyme supplement (enzar forte) and rabeprazole 20 mg for 7 days.
Still there is no improvement in symptoms & in fact after the medicine duration of 1 week, i am experiencing gastritis/stomach ulcer kind of symptoms in upper abdomen like pain, bloating after eating etc & in the last 1 month, have lost around 1 -1.2 kg weight due to these abdomen issues.
Stool test is normal, whole abdomen USG was normal (just an incidental finding of grade 1 fatty liver & 1-2 tiny gall bladder polyps).
Blood work : LFT, RFT, Thyroid, Lipid profiles normal. In CBC - Haemoglobin was 13.7 (normal range was 13-17), But they have mentioned Alert!!! Predominantly normocytic normochromic with ovalocytes. Hs CRP - 2.65 (Average risk - 1 to 3), Electrolytes are normal. Lipase is 60 (5 - 51.6 is normal range) and Amylase is 80 (28-100 is nromal range).
Query:
1. Is the elevated Lipase levels a cause of concern & is something serious like pancreatic cancer being missed to be picked up from the blood work/USG etc ?
2. What is the alert message in the CBC signify? Is it something to worry ?
3. What further tests i need to do to rule out any serious gastrointestinal issues for my current symptoms ?
4. Can i just ignore my stools and live life as usual, since in 2018 too my depressive/anxiety symptoms started with digestive issues first and it settled down after the SSRI therapy for few months ?
5. By nature , i have a lot of health anxiety and if any pain /discomfort appears, the first thought comes of worst diseases.
First of all apologies for the lengthy query, but desperately a detailed reassurance and diagnosis.
I am 42/M with no diabetes/hypertension etc & a teetotaller. Had generalized anxiety disorder/mild depression/panic attacks in the past few years and was treated with low dose Sertaline 25 mg, every alternate day (have slowly tapered it and stopped)
I used to get gastritis like symptoms on and off for the past many years. Done Endoscopy in 2014 which was normal. Abdomen CT in 2018 which was normal & master health checkup which have been normal till now (last done 8 months back).
Current Issue:
I have a bit of loose /not properly formed stools (just in the morning and rarely couple of time a day) for the past 4 weeks & was given rifaximin 400 mg , pancreatin enzyme supplement (enzar forte) and rabeprazole 20 mg for 7 days.
Still there is no improvement in symptoms & in fact after the medicine duration of 1 week, i am experiencing gastritis/stomach ulcer kind of symptoms in upper abdomen like pain, bloating after eating etc & in the last 1 month, have lost around 1 -1.2 kg weight due to these abdomen issues.
Stool test is normal, whole abdomen USG was normal (just an incidental finding of grade 1 fatty liver & 1-2 tiny gall bladder polyps).
Blood work : LFT, RFT, Thyroid, Lipid profiles normal. In CBC - Haemoglobin was 13.7 (normal range was 13-17), But they have mentioned Alert!!! Predominantly normocytic normochromic with ovalocytes. Hs CRP - 2.65 (Average risk - 1 to 3), Electrolytes are normal. Lipase is 60 (5 - 51.6 is normal range) and Amylase is 80 (28-100 is nromal range).
Query:
1. Is the elevated Lipase levels a cause of concern & is something serious like pancreatic cancer being missed to be picked up from the blood work/USG etc ?
2. What is the alert message in the CBC signify? Is it something to worry ?
3. What further tests i need to do to rule out any serious gastrointestinal issues for my current symptoms ?
4. Can i just ignore my stools and live life as usual, since in 2018 too my depressive/anxiety symptoms started with digestive issues first and it settled down after the SSRI therapy for few months ?
5. By nature , i have a lot of health anxiety and if any pain /discomfort appears, the first thought comes of worst diseases.
Brief Answer:
Please see detailed answer
Detailed Answer:
Hi
I Am Dr Diwashish
Welcome To Ask A Doctor Service
1. Your lipase level would be called normal, healthy weight because only 3 times increase is significant, nothing less than that.
2.your cbc is normal, healthy diet nothing to worry.
3. You have already got all tests done
4. You must follow healthy diet, exercise and can take probiotic capsules for proper stools.
5. You can take anxiolytic tablet to improve anxiety.
I Hope Your Query is clear now.
Thank You
Please see detailed answer
Detailed Answer:
Hi
I Am Dr Diwashish
Welcome To Ask A Doctor Service
1. Your lipase level would be called normal, healthy weight because only 3 times increase is significant, nothing less than that.
2.your cbc is normal, healthy diet nothing to worry.
3. You have already got all tests done
4. You must follow healthy diet, exercise and can take probiotic capsules for proper stools.
5. You can take anxiolytic tablet to improve anxiety.
I Hope Your Query is clear now.
Thank You
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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