CT scan with contrast

Hello,

In February I began burping after meals which is very rare for me. The burping slightly got better and then I noticed that I would just get a dull ache in the pit of my stomach and it would sometimes travel to the right side where my gallbladder is. I also was getting pain very high up in the abdomen directly under the breastbone. I decided to see a GI Dr. He sent me for complete blood work w/amlyse, abdominal ultrasound and upper endescopy. The blood work came back fine, abdominal ultrasound was normal and the upper endescopy showed Grade A inflammation/reflux as well as gastritis. In the interim, while we were waiting for the endescopy biopsy to come in from the lab, he told me to take Prilosec. My parents happened to have some extra Nexium which I started and it helped with the bupring.

Biopsy came back fine with no HPylori or Barrett's.It confirmed Gastritis and Grade A inflammation. My Dr ordered me a prescription of Nexium. After a week, I started to experience stomach and back pains and asked my Dr to prescribe something else, he gave me Protonix, which seems to be helping. I still sometimes experience an indigestion feeling in my chest and back and still sometimes have that breasbone pain but all and all it's better. I have never experiences the typical "GERD" symtpoms of burning throat, etc.

Me being a super obsessive person happened to be reading on-line about pancreatic cancer. I now have it in my head that this is what I have. My Dr assured me that I have nothing to worry about especially since my abdominal ultra-sound came back saying "parts of the head and body of the pancreas are seen and appear normal." I understand the ultrasound isn't the best imaging tool to view the pancreas since the abdomen contains a lot of gasses but luckily I'm a thin person so my abdomen is small and they were able to view some of the pancreas. I asked my Dr if there was any othe test for the pancreas and he agreed to send me for CAT scan with and without contrast, just to put my mind at ease. I had that done on 3/17/09 and that came back fine stating "the head, neck, body and tail of the pancreas are seen without mass or pseudocyst." I guess I should feel happy about that but I still have it in my mind that maybe the reading radiologist missed something, which is ridiculous in itself.

I guess my main question is a CT scan a good test and would it have showed something on the pancreas if it was there? I know that most of the time a person with PC doesn't experience any symptoms until the disease is way advanced, I understand the reason why the person experiences stomach and back pain is because the tumor is so large that it's pressing on the stomach and back since the pancreas is directly behind the stomach.

I guess my main concern is that this is just acid reflux and not something else. Thanks for reading all this and letting me ramble on.

[Chase1313]

You are describing my situation almost exactly, except that I've had an almost 15 pound loss of weight in the last 5 weeks and I keep having bouts of steatorrhea (loose, floating bowel movements).  I also had every test under the sun to see what was wrong and all have come back normal.  My GI is now pursuing theories of Giardiasis, bacterial overgrowth, or chronic pacreatitis.  It's that last one that scared the daylights out of me.  Sometimes pc can be mistaken for chroinc pancreatitis.  (not to mention chronic pancreatitis usually happens in older people and to people who abuse alcohol for a long time...I'm 31 and rarely drink!!!)  

The CT is one of the best tests to diagnose pc.  I think the only one that may be better is an Endoscopic Ultrasound.

Just yesterday I spoke to my GP and asked if I would be out of line to ask for a second opinion on my CT images.  Despite the GI "assuring" me that the issue is not pc, the doctors rarely look at the images themselves, and just see the radiologist report.  My GP (who has been awesome throughout this process) recommended that I first ask the GI if he would look at the images personally.  If not, I was to contact my GP again and she would make sure someone did.

My GI did agree to look over the images.  I haven't heard back just yet, but I'm hoping he calls today.

Long story short...you are well within your rights to ask for a second opinion of the CT images.  If you get any push back from the GI, ask your GP.  I the GP says no, find another doctor, because someone will do that for you.