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What does my MRI scan report indicate?

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Posted on Sat, 25 Mar 2017
Question: Dr. Chandrakant,

My GI doctor called me and reassured that this isn’t cancerous given that the MRI didn’t show anything of concern. He said for me to take Creon (due to having a trypsin deficiency), along with Immodium (to see if slowing down the digestion might aid in the pain). I just started taking the two meds together today, to which I haven’t noticed any improvement yet; I still have to add pressure to my RUQ specific area for relief.

I don’t believe he wants to do an endoscopy at this time to see if these meds will work first.

My question is, even with this persistent pain, would the MRI rule out something serious like cancer? I’ve read that they’re used to see stages of cancer, so I imagine it would’ve picked it up.

The odd thing about this is that it will hurt even when I haven’t eaten food, but rather just sit down.
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
As explained below.

Detailed Answer:
Thanks for your review query.
Read and understood.
MRI of the abdomen is good for solid organs, or anything that is fixed hence not much good for moving organs like for lungs and small intestine.
It does help to rule out cancer in such organs as discussed.
Well, cancer of small intestine is very very rare.
And cancers are very rare at your age of 30 too.
Pain on its own, without any instigating factors like food can be due to Neurological reasons as explained in previous sessions and MRI of the spine and spinal cord should be done to rule out any cause at the spinal level causing pain in right upper quadrant.
Costochondritis has also to be considered.
Creon should be taken with food.
It is okay if he is not willing to do endoscopy now as his clinical acumen may be against this possibility.

Please tell me again what type of pain do you get?
Explain in good details so that I may get a clue.

Take care, continue medicines as advised.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. T Chandrakant (19 hours later)
Its an ache right where my fingers are in the photo, although it does go through to my back sometimes as well (on the same side). I'll sometimes have nausea but it has neeeeever prompted me to vomit or anything .
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
I still feel this to be costochondritis.

Detailed Answer:
As we discussed on XXXXXXX 12, this may be due to costochondritis as per the fingers and the history you have provided.
This may be the reason for your GI Doctor's not interested in endoscopy.
Please discuss possibility of costochondritis with the Doctors you meet. Possibly someone would give a though and check and treat you accordingly.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 days later)
Will do doctor. Im sorry to keep mentioning it, as you did address it in your previous response, but i was reading that fatal illnesses, such as colon and lung cancers are on a dramatic rise in people younger than thirty. And since the mri cant see inside the intestines, it fueled the worry about this being a reality. Because the pain is always there .
doctor
Answered by Dr. T Chandrakant (56 minutes later)
Brief Answer:
As detailed below.

Detailed Answer:
I can understand your worry.
But both the cancers as you have mentioned would not cause such a pain in such a location as you have indicated in the picture you have provided.
And there will be additional symptoms relate to the these organs as well as there will be other general symptoms such as weight loss, loss of appetite and so on, which I think you do not have.
In fact your anxiety and/or stress can add on the costochondritis.

Has this been examined by some Doctor?
Any progress on this front?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (44 hours later)
The pain/area gave been examined by my GI doctor (mri, blood work) and he seens to think thats its a fluid build up of sorts that's effecting my pancreatic function (drawing this from having a low trypsin count). He gave me pancreatic enzymes and some immodium to see if slowing the digestion to allow the pancreas to work better. I just started it today.

As stated, i started getting back on a gym regiment and eating cleaner to lose weight; i was wondering if it's normal for some core/back muscles to be sore due to my first time back at running (after quite some time atleast)? Because they are sore today haha. The upper right pain seems to be a little more accented after working out i noticed as well .
doctor
Answered by Dr. T Chandrakant (5 hours later)
Brief Answer:
Go slow on exercises, gym activities - take care.

Detailed Answer:
Can you please post the scanned copy of MRI report?
Noted about the thought your GI Doctor has.
With the pain you have, going back to Gym and having such activities that cause strain and sprain of the muscles, ribs and so, should not be done till full diagnosis.
Take care about this.
Has the physical activities increased the pain at the previously affected area. Have warm up exercises only.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (15 minutes later)
The specific ruq pain has not increased at all with going back to the gym. He said that losing weight could definitely help as this was not occuring when i was thinner. I would assume that being around 250lbs at 5'8" is not helping and that by dropping it, the pain might subside. He didnt note his thoughts on paper, he verbally explained why having a possible low trypsin count could be causing this; an underperforming pancreas.

However, i did notice that the mri said that there's a 4mm cyst on my liver. But there were no lesions that it was normal size .
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Let us see if the present therapy helps you or not .

Detailed Answer:
MRI says small cyst in the left lobe hence can not be related to any pain.
Well, let us try the medications and see the results.
BMI is 33+ and hence reducing weigh can help for many things.
Nice to know that gym work has not increased the pain.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (20 hours later)
Sounds good. Thank you so much doctor .
doctor
Answered by Dr. T Chandrakant (32 minutes later)
Brief Answer:
Thanks for your appreciation.

Detailed Answer:
You are most welcome.
Will be happy to assist you anytime in future too.
Dr T Chandrakant.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

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What does my MRI scan report indicate?

Brief Answer: As explained below. Detailed Answer: Thanks for your review query. Read and understood. MRI of the abdomen is good for solid organs, or anything that is fixed hence not much good for moving organs like for lungs and small intestine. It does help to rule out cancer in such organs as discussed. Well, cancer of small intestine is very very rare. And cancers are very rare at your age of 30 too. Pain on its own, without any instigating factors like food can be due to Neurological reasons as explained in previous sessions and MRI of the spine and spinal cord should be done to rule out any cause at the spinal level causing pain in right upper quadrant. Costochondritis has also to be considered. Creon should be taken with food. It is okay if he is not willing to do endoscopy now as his clinical acumen may be against this possibility. Please tell me again what type of pain do you get? Explain in good details so that I may get a clue. Take care, continue medicines as advised.