appetite loss

I have been under a lot of stress with my job transfer and a few months ago had a full blown panic attack. Prior to this had violent episodes of diarrhea after eating certain foods (food allergies?) I have since been diagnosed with anxiety and am currently taking Lexapro. I had a complete physical,CBC,thyroid,liver function tests after attack. All normal except elevated SGOT,SGPT. I am a hypochondriac so Im thinking liver cancer(no other symptoms). I obsessed with this while continuing to have anxiety attacks. Had a period of a month where I was off balance and had foggy head. Also had sinus infection. Dr. Still says I have inflamed nasal passages. During week of move(was sad about moving) gradually lost appetite. Also in a two week period lost 6-8 lbs. Experienced some chilled feelings off and on( no fever) had clammy neck and forehead. Thought maybe anxiety. Went to Dr. and had repeat liver tests done(returned to normal)Sed rate,H pylori test (all normal..negative for H. pylori). Abdominal sonogram done..normal. During the few weeks after move had no appetite. Looked up internet and got scared..thinking stomach,pancreatic cancers. Food tastes good to me and sometimes after eating I get mild nausea with some burping(also stomach gurgling). Lately have gained 4-5 lbs back. Went to Dr. and had upper GI and abdominal/pelvic CT scan. GI was normal with no masses detected and CT scan detected 3 benign renal cysts. also a " suboptimally distended stomach with no gross abnormalities" My Dr. thinks since I was fasting my stomach was smaller. everything else on CT scan was normal. So in my mind I have ruled out liver/pancreas cancer. Have been to the ER three times and all CBC's normal. Everyone is telling me anxiety/depression. I am seeing a counselor and am not working(mandatory). I would like to believe them but am very cautious. My Dr. is not concerned about my appetite and attributes it to stress. I am not so fast to do that. I do kind of feel depressed but have never had my appetite leave. Also a note..my routine is off since moving. Nothing has been same. I don't think I have stomach cancer but there is always that doubt. I know early detection is the key. Im thinking of going to another Dr. and having an upper endoscopy done. According to what I have read on the internet I would be in the early stages(better cure rate).Do you think upper GI was sufficient to rule out masses of stomach, I'm pretty worried as you can see and dont really understand what is going on. I dont feel sick just stressed. Also as a note when I would eat sometimes I would not feel full. Weird!!! It is like I had never eaten. But lately though started to feel satiety. Sometimes have bad taste in mouth. I think I have said enough. Please any advice would be appreciated...please be thorough. Thanks...

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation - including various blood tests, upper GI and CT scan.  

You're right, the upper GI is not comprehensive enough to rule out masses.  The test that would be most helpful would be an upper endoscopy - which is the most comprehensive test for this.

If negative, you can consider a more specialized test, such as a gastric emptying scan.  This can evaluate for gastroparesis - which can lead to your symptoms.  

Another option would be a 24-hr pH study with esophageal motility studies.  This would test for GERD as well as motility disorders which can cause the symptoms you describe.

These options can be discussed with you GI physician, or in conjunction with another GI opinion.

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.
Medical Weblog:
kevinmd_b

[sharpie97]

forgot to mention that i am a 30 yr. old male.

[beachie]

Hi I just read your question and have had some of the same symptoms/results.  Would you care to email each other regarding all of this and we could exchange info/concerns?