Ascites or Colon cancer?

Hi

My mum is 53 years old and was diagnosed with ovarian cancer in 2007. She had surgery (ovaries and womb removed) and has since undergone several bouts of chemo which has more or less kept any Ascites at bay. However after her last line of chemo on the 24th of June she has started experiencing severe bouts of abdominal cramps and excruciating pain around her rib cage/ stomach area. This has been accompanied by bloating which has left her tummy sticking out and feeling rock hard (She kinda resembles a pregnant woman). She also experiences alternating bouts of constipation and diarrhea and occasional vomiting. The weird thing is these combination of problems all come together at once and last for 1 or 2 days then goes. It has happened about 5 times now.  After a cat scan last week we found out the amount of fluid in her abdominal region and beyond had sky rocketed, her oncologists attributes this to her cramps and pains. However a mass of 65mm was also found in her rectouterine pouch, luckily it wasn't found to be cancerous and her onc says it should go when she resumes chemo.

After reading a few posts on Ovarian cancer and Ascites I havent come across anyone complaining about a combination of constipation and/or diarrhea or severe pains from cramps due to an Ascites problem. The mass which is probably a benign tumour, bloating, abdominal pains and constipation/diarrhea, occasional vomiting seem to be symptoms more related to colon cancer. Then again she has been on Lyrica for 5 months now to help relieve neurophatic pain in her legs and apparently some of the side-effects include vomiting and constipation.

As you can imagine I am quite confused about all this and whats going on with my mum so I was just wondering as the diagnosis of colon cancer is no straightforward procedure if it is worth pursuing the matter further and seek a diagnosis just as a precautionary measure?

Any help would be much appreciated

Many thanks

[Annekathryn Goodman, M.D.]

Dear Helene,
thank you for your question.

Abdominal distension can occur from:
ascites
tumor
dilated intestine.

If the problem is just ascites, drainage of ascites with use of chemotherapy will improve the problem.

However, I do wonder if your mother is experiencing intermittent blockage of her intestine.That would explain the pain, change in bowels, and vomiting.

To make the diagnosis, it is helpful to get a CT scan at the time of the pain and symptoms. This will show dilated bowel and the area of blockage.

If she has a partial bowel obstruction, surgery might be considered to fix it.
best wishes