Worried about Pancreatic Cancer!

[GKGK]

I am male, 35 years old, 1.90cm and 135kgs. My firsts symptoms were late jan/12: vague lower abdominal discomfort (on/off) and soft/broken stools. At that moment I was working away from home for one month in another country. Almost every day the food was spicy (indian food). It is different from my normal eating habits. Then 3 weeks ago I returned home and thought everything would back to normal. But the stools remained soft/broken. Then last week, searching on google, I was terrified with the symptoms of Pancreatic Cancer. Since then, after searching on google, I have a lot of anxiety and think about it all the time! It is driving me crazy! Coincidence or not, I began to feel vague pain in the upper back (on/off), very small itches (sometimes) and lack of appetite (anxiety?). And the stools remain soft/broken, sometimes yellowish. Last week I did two ultrasounds and went to two doctors. All fine with ultrasounds, with the exception of stones in gallbladder (I know I have them for 3 years but never had symptoms) and soft hepatic steatosis. The doctors told me to stay quiet, that I had no problems, all is fine! But I am still stressed and think about it all the time! What bothers me is that the stools do not return to normal and about the vague back pains (on/off). Since then I am taking medicine for IBS. I did some blood tests. Everything normal, except for glucose (105), colestorol (250) and Trigliceridies (230). Questions: 1) If the symptoms are from Pancreatic Cancer, would have been detected on ultrasounds? Even if the Cancer is in the initial phase? 2) It is necessary to do a CT Scan or MRI? 3) The high glucose (105) can be a sign of diabetes which is one of the symptoms of Pancreatic Cancer? 4) My bilirubin test gave a total bilirubin of 1.34, with 0.19 (direct) and 1.15 (indirect). It is a problem? 5) My doctor said that my concern should be to lose weight (diet and exercise) to control glucose levels, cholesterol and triglycerides. 6) Should I be worried?

[GKGK]

Doctor,

The last update, just picked up the results from my stools checked (one sample). Negative for bloody but positive for fat in stools. Is it Steatorrhea?

The 3 days sample will check parasites/worms. The results has not done yet.

I am fine. Today the back pain improved and no other symptom. Just my stools seems to be worse (soft) again.

With a clean ultrasonography and MRI, can I rule out any problem in Pancreas?

What could it be?

Just remembering you I am from Brazil and stayed one month in Oman (not India) in early january.

Thank you for your kind attention.

[GKGK]

Doctor,

In my post yesterday I said my stools improved...but this morning the stools weren´t so good (soft ones). And I am on a diet!

And my back (lombar) keep in pain...mainly when I am seated!

Thank you for your attention.

[GKGK]

Doctor,

Thanks for writing back.

Last week my physician prescribed me for 10 days "Trimebutine Maleate". I am taking 400mg/day and since then my stools improved a lot! Now they are normal!

I also performed a MRI last week. All clean except 2 stones in gallbladder like showed in the ultrasonography. I know I had these stones since 3 years ago but they are assintomatic.

Now my back are my main worry. Depending my position I feel a pain (discomfort) in my back. It started 3 weeks ago.

1) I read back pain can be a symptom of Pancreatic Cancer. In my case, with a clean MRI, could I rule out Pancreatic Cancer?

2) Why these back pains appeared together the changes in my stools? Any special reason?

3) When I stop taking "Trimebutine Maleate", do you think my stools will keep normal?

I will check my stools for three days and take a multivitamin supplement including 5 mg folic acid!

Thank you for your kind attention.

[Poorna Chandra, SMD, DM]

Dear GKGK,

Thanks for writing back.

If diarrhoea is not a predominant symptom, you could be possibly suffering from a condition called tropical enteropathy. Here, there are some absorptive defects. Anemia, as such, may take some time to develop and diarrhoea could be intermittent as well.

I would suggest you get your stool checked for three days and take a multivitamin supplement including 5 mg folic acid. Also, it would be useful to follow the advice I gave you earlier. You should start feeling better within a month.

I hope I have addressed your concerns. I would be available for follow up queries.

Best Regards,
Dr. Poorna Chandra K.S

[GKGK]

Doctor,

Thank you for your attention. Just to clarify, Tropical Sprue has anemia and diahreia as symptoms, right? I don´t have anemia! And about diahreia it does not occur so often with me, just sometimes.

I stayed one month in Oman (Middle East)!

Best regards,

[Poorna Chandra, SMD, DM]

Dear GKGK,

Thanks for writing in.

I believe that you do not belong to India and have visited the country for a short work assignment. Your symptoms are suggestive of a condition called tropical sprue which is commonly seen in people from other countries who visit India and other tropical countries. This is seen especially when these people get back home. This commonly causes an alteration in stool consistency, bloating, discomfort and flatulence. It responds to topical antibiotics like rifaximin and multivitamins including folic acid. Avoiding milk also helps.

1)     Given your history, the likelihood of you having pancreatic cancer is low. Early cancers are not effectively picked up on ultrasonography.
2)      Early pancreatic cancers are better picked up on a contrast magnetic resonance imaging (MR) scan.
3)     Pain with diabetes is more often associated with pancreatic cancer. However, diabetes is a common disease and can be seen as a chance finding with any other disease. This must be kept in mind when evaluating a disease
4)     Even though your bilirubin levels are high, they would need attention if your liver enzymes are also affected. Meanwhile, take lots of fluids, have light and frequent meals and avoid alcohol.
5)     You should definitely be losing weight to take care of the high sugar levels and cholesterol levels. Even though you do not have diabetes, losing weight can help you cut your risk of developing diabetes by half. Dietary modification will reduce your cholesterol levels.
6)     You need not be worried. Speak to your physician about this and I’m sure you’ll respond.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Poorna Chandra

[GKGK]

Just updating...my last 2 bowel moviments were good! Nice consistent and colour (sorry for details). Maybe the medicine I am taking for 1 week for IBS?

My urine, sometimes in the day (not all time), mainly when I wake up, is a bit dark yellow.  Another thing I am feeling is minor noises in my stomach after eating.

Since the last 10 days I am on a diet to reduce my glucose, colesterol and trigliceridies!

The problem is I am to worried and paying attention in every little sign from my body! Still anxious...

Thank you for your attention.

[GKGK]

Just finishing my questions: 7) Could this symptoms are related with the gall stones? 8) Is it a good idea to do a gallbladder surgery even assintomatic?

Despite of my stools (soft/broken, sometimes yellowish)...the others symptoms are vague.

I am very anxious, I can´t put my mind at rest!

Thank you for your attention.