Im Currently Struggling For The Past Two Years With Upper

Posted on Tue, 10 Mar 2020

Question: Im currently struggling for the past two years with upper stomach problems. I am a 27 year old who%25E2%2580%2599re female with no real history of issues besides headaches. I do take excedrin for migraines. My stomach hurts constantly throughout the day. The pain is right between my lower ribs and sometimes goes over to the left side right near the bottom of my ribs. It does get better at times when I eat. However, if I eat something spicy or drink alcohol it is worse and it%25E2%2580%2599s difficult to sleep. However there is always this constant burning pain that feels like heart burn. I can feel it when I breathe right in the center and it does feel slightly painful going down towards my belly button. I have tried multiple antacids. I have also had an ultrasound that came back negative and a CT scan with contrast of my upper and lower abdomen that was negative. It showed that my pancreas, spleen, and liver were all clear. There was also nothing noted on my lymph nodes. There was also a negative colonoscopy. My current doctor wants to me to get an endoscopy with an eus. I have high anxiety and this test is not for another two weeks. I am very concerned that I have cancer due to that fact that when looking up what an eus is, it is used often for cancer of the pancreas. I was wondering what are the thoughts on this and if I should be concerned that this can be something like pancreatic cancer.

Answered by Dr. Ramesh Kumar (42 minutes later)

Brief Answer:
Doctor is using gold standard test to diagnose pancreatic cancer however very very rarely a CT with contrast misses it.Go for it but i need few more details before making any comment dear.
Frankly pancreatic cancer presents with completely different set of symptoms that you are having.You have none of the signs or symptoms of pancreatic cancer.
Detailed Answer:
Hello and thank you for choosing "Ask a Doctor" service for your query my dear patient,
Have seen your details and i appreciate your concerns,
You have not mentioned about Endoscopy? Was an Endoscopy performed earlier on you by your doctor?
If endoscopy done earlier was normal and you have tried many antacids(If possible kindly mention the names and doses and duration for which you tried them in follow up) plus your CT with contrast is completely normal then your doctor is doing the right thing by performing ultrasound guided endoscopy;This would definitely help to rule out minor possibility of any non specific lesion which even contrast CT had missed. As far as pancreatic cancer is concerned patient in early stages have severe back pain ,severe jaundice nausea vomiting etc...I mean your symptoms have nothing to do with pancreas rather are suggestive of gastritis.
However first thing i want to know is the name potency and duration of antacids used by you.
Please write in detail.
Waiting

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ramesh Kumar (1 hour later)

i had an endoscopy that came back normal as well as an ultrasound and CT scan. They were all normal along with bloodwork. i am just worried that because of the constant pain that does not go away os something like cancer if they are using a eus test. Im worried that this is what they think it is and they are not telling me. however, i do not have vomiting, nausea, or jaundice. i have taken omprezole in the oast

Answered by Dr. Ramesh Kumar (2 hours later)

Brief Answer:
It's not cancer.

Detailed Answer:
Hi there ,
Omeprazole is not even the drug of choice to treat gastritis.

Secondly pain felt by you is mostly limited to right side upper abdomen while pain of pancreas is usually not felt on right upper side and radiation is almost always there on back.

Secondly it's not always necessary that gastritis related changes are seen on endoscopy. Basically its done to rule out ulcers.
I assure you your pain is related to acid peptic disorder and is there because of improper and incomplete treatment.

99.99% its not cancer.
But you can go through endoscopy guided by ultrasound.
Ask your doctor to treat you with high doses of Esomeprazole 80 mg twice daily.
Along with it take antacids containing aluminium and magnesium hydroxide.
A prokinetic drug like domperidom could also be added to help prevent reflux.
This protocol would help.

Along with it stop any fast food or food high in spices.
Take food cooked in house.
Avoid citric fruits.
Rest assured it's not cancer.
Thank you.

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Above answer was peer-reviewed by : Dr. Prasad