Severe stomach pain/No diagnosis/Leukemia

[Clo121]

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 (pneumonia) 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.

[Kevin Pho, MD]

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_

[JoyCollins]

I have heard of scar tissue pulling on the organs and causing pain.
My daughter has had severe stomach pain since Feb. She is on narcotic meds but they barely help. We have done all the test and nothing is showing up. She also has chronic nausea and at times stomach distention.

Please let me know if you find out anything about your husband. My email is ***@****

Thanks,

Joy

[dlhigh]

Request any GI tests that may not have been done:  liver, pancreas, also ask for an ultrasound to rule out Gallstones, kidney stones and Thoracic MRI for the spine.  I had moderate to severe abdominal pain for two years and was treated for IBS before it was determined that I have thoracic herniated discs, after I demanded an MRI be done.  I've heard there are some abdominal pains that are never diagnosed, but I believe this is due to lack of true concern on the part of some doc's.  Patience and persistance are necessary for the battery of testing involved in diagnosing abdominal pain, the most common complaint. For clo121:  I'm curious if your father is still in the hospital, since as you indicated that he is on morphine?  I'm hoping he was not released while on such a strong med without a determinite cause of the pain.  I'm not familiar with CML, but believe many symptoms can occur and the doctor seeing him for this may be of greater assistance than GI. Consult a second opinion if current doc sees no connection. Blessings for health!