Brief Answer:
Information

Detailed Answer:
Hello,

My husband is extremely resistant to going to the doctor or getting any labs done, so I understand how this is. Personally, I am not fond of going to doctors as a patient either, but sometimes it's the best thing to do.

I'll go thru the symptoms you mentioned:

Pain in the upper abdomen, if near the middle or to the left can be from GERD or gastritis/duodenitis. Depending on whether his symptoms are consistent with this, treatment, if mild-moderate can be ranitidine 150 mg twice a day, and avoidance of tobacco products, alcohol, and NSAIDs (such as ibuprofen, aspirin, naproxen). Pain in the right upper abdomen can be from the liver or gall bladder and would need to be examined with a physical examination and then liver enzyme blood tests and an ultrasound (which is non-invasive).

Dark urine can be from the urine just being concentrated (not enough water) but it can also be from a liver-gall bladder problem, especially if it is brownish. Evaluation is as described above.

Bleeding with a bowel movement can be from a number of things including a small tear (which usually heals quickly) from passing a hard BM. Hemorrhoids. But of course it can also be from something going wrong in the colon. He is not too young to need a colonoscopy given he has a primary relative who had colon cancer. My sister was diagnosed with colon cancer at 43 yrs old.

Now about chewing tobacco: while he is not inhaling the amount of carcinogens one does from smoking, there is the particular risk of head and neck cancers (which are pretty horrible), and an increased risk of cancers all the way down. Quitting tobacco in any form is very difficult. That said, it can be done, and many people get benefit from a combination of bupropion (a prescription antidepressant that also helps a great deal with cravings and desire for tobacco), and nicotine patches used in decreasing dosages.

I hope this information helps. Please let me know if I can provide further information.

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