at wit's end

I am a 51-year-old male, heretofore healthy, though a good 35 pounds overweight. Five weeks ago, my bowels seized up and I became filled with dread. Within a week, I developed abdominal pain and severe acid reflux. Extensive bloodwork was "picture-perfect," my GP said; a colonoscopy showed only a few pockets of diverticula, and an endoscopy disclosed a hiatal hernia and gastritis (no infection). The gastroenterologist put me on Carafate and counsels patience. But I don't feel much better than before. While my bowel function has rebounded pretty well, I have (mild) pain, most often at the navel, at the sternum and under the right ribs. I hardly eat -- low appetite and nausea after meals -- and sleep is very difficult. This week brought a heart scare: An EKG came back abnormal. A subsequent EKG was normal, and I am skedded for a stress test and electrocardiogram. I've done some reading and am terrified that I might have cancer of the pancreas. I'm not jaundiced. What should be the next step? Thank you,

[Kevin Pho, MD]

I agree with the comprehensive testing thus far.  Many of the major GI diseases would be ruled out with the endoscopies.

Imaging the abdomen should be considered with a CT scan or abdominal ultrasound.

More specialized tests can be done with a 24-hr pH study and/or a gastric emptying scan, looking for GERD or gastroparesis respectively.

These options can be discussed with your GI 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.
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