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Gastroenterology (Expert Forum)
Severe stomach pain/No diagnosis/Leukemia
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Severe stomach pain/No diagnosis/Leukemia
by Clo121, Jun 15, 2007 12:00AM
3.5 years ago my father was sent to the ER due to severe stomach pain.Exploratory surgery was performed and he was diagnosed with a perforated colon.At this time he was also diagnosed with Chronic Mylogenic Leukemia (CML).He was put on Gleevec for the CML and after the surgery his abdominal pain disappeared.For three years he has lived mainly symptom free and his leukemia was under control.6 months ago he began experiencing severe headaches and he was eventually diagnosed with occipital neuralgia.Nerve blocks given made the neuralgia subside.His medication for CML was switched to Dasatinib(Sprycel) at this time.Shortly after his headaches subsided he was brought to the ER again for severe stomach pain and a fever of 100-104.The intitial diagnosis was pnemonia and divaticulitis.Along with pain,mostly shortly after eating or drinking,he had vomiting,inability to pass gas and an impacted colon.He has been taking morphine for the pain.Numerous CAT cans,colonoscopy,upper scope,bloodwork and barium enema in three different hospitals revealed nothing.Exploratory surgery was performed.Nothing was seen except some old scar tissue and a few adhesions that the surgeon said where insignificant.No inflammation was seen.His pain after surgery still persists.He is on morphine.Could his symptoms be neurological?As far as we know his CML, which still is under control or his CML meds would not cause this severe gastro problem.No doctor has investigated a neurological problem.
Doctor's Answer
by Kevin Pho, MD, Jun 16, 2007 12:00AM
, Jun 16, 2007 12:00AM
There has been a comprehensive workup done, ruling out many of the major GI disorders. The CT scan and upper endoscopy would rule out things like an obstruction, ulcer, or inflammation of the upper digestive tract.
You can consider more specialized tests like a 24-hr pH study or motility study, but the yield of these tests would be low.
It may be possible for the hematologic issues to cause abdominal pain - and this should be discussed with your hematologist.
I am not aware of significant neurologic diseases leading to this GI picture.
These questions can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
You can consider more specialized tests like a 24-hr pH study or motility study, but the yield of these tests would be low.
It may be possible for the hematologic issues to cause abdominal pain - and this should be discussed with your hematologist.
I am not aware of significant neurologic diseases leading to this GI picture.
These questions can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
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