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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is localized pain in the abdomen relieved upon physical pressure indicative of colon cancer?

Answered by
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Dr. Salah Saad Shoman

Internal Medicine Specialist

Practicing since :2004

Answered : 1668 Questions

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Posted on Thu, 24 May 2018 in Cancer
Question: Hello doctor,

I attached a picture; would it be a sign of cancer or something else malignant if applying pressure (such as pressing my thumb into it) to that area relieves the pain, despite having a normal MRI (in February), a normal Endoscopy, and a normal abdominal CT with contrast (this month)?

I saw a surgeon today but i identified the improper location to him as it was not acting up when i saw him. Im just worried that its colon cancer as i have not had a colonoscopy and have heard that CTs cannot see inside of intestines.
doctor
Answered by Dr. Salah Saad Shoman 2 hours later
Brief Answer:
Various causes

Detailed Answer:
Dear sir, I have gone through your question and I understand your concerns but this pain could be due to a number of causes including liver, pancreatic , gall bladder , stomach and colon pathology.. However , a ct scan basically detects masses and is very sensitive to even small ones but it cannot detect inflammatory conditions of tissues such as hepatitis, pancreatitis and inflammatory bowel diseases.. Also since you have had an endoscopy then this shall exclude stomach related causes..
I would recommend that you get a blood test for hepatic function tests including AST and ALT to exclude fatty liver and non-viral hepatitis.. Also I would recommend that you get a blood test for bilirubin levels to exclude cholecystitis and bile ducts blockage.. Also blood tests for the levels of pancreatic enzymes should either confirm or exclude pancreatitis..
If All these cause were excluded then I would recommend that you get a colonoscopy to exclude inflammatory bowel disease or diverticulosis .. I hope you find this helpful..
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Salah Saad Shoman 20 hours later
Thank yoh for the response doctor. Ive had my amylase, lipase, trypsin, and CBC counts checked, all of which were normal. Its so bizarre that it occurs in such a specific and localized spot .
doctor
Answered by Dr. Salah Saad Shoman 19 hours later
Brief Answer:
Muscular or skin causes

Detailed Answer:
Dear sir, hello again..

If the pain is very localized then it might be muscular tear or myositis that can be treated with an anti-inflammatory medication as diclofenac once daily and application of Voltaren gel three times daily...

Also if the skin is firm at that localized spot then it might be due to a skin condition as lipoma...

I hope you find this helpful...

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Salah Saad Shoman 6 hours later
Could a muscle tear last for years and cause pain after eating or drinking? And I imagine that an MRI or CT would have seen a lipoma, yes?

I find myself nauseous quite often (but have never vomitted due to this) and when i press my thumb into that spot, it relieves it (when its hurting), particularly when sitting upright (see new picture). My GI doctor does not know what it is and when i saw the surgeon that removed my gallbladder, be believes it to be a "trigger spot" on my abdominal wall. But its so bizarre that it hurts when i eat or drink certain things. Again, he doesnt think its cancer but i dont have any kind of answer, which is why my mind goes there .
doctor
Answered by Dr. Salah Saad Shoman 16 hours later
Brief Answer:
Dysfunction of sphincter of Oddi to consider

Detailed Answer:
Dear sir,

Since all possibilities have been ruled out then you should also consider the rare possibility of the sphincter of Oddi dysfunction. Please discuss this with your doctor as ERCP sphincterotomy may be considered in that scenario...

I hope you find this helpful..

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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