Frustrated in CO

[Fletch12]

Here is a quick overview of the last three months of my symptoms:

Lower left abdominal pain, not sharp but dull and achy.  Nothing that disabled me.  I continued to run 40-50 miles per week.  Went to PCP and he sent me to Urologist (I was urinating more frequently).  Negative tests.  Urine OK.  Pain continued.  I went to GI and he ordered colonoscopy after I started to have intermitent fevers.  That test was negative.  Also had endoscopy and uppper GI, all neg.  Had a lower torso CT scan, all negative.  One of my blood tests showed up with a slightly elevated lipase level (400) but it had lowered to 273 a few days later.  I even had my LDH tested, and it was normal.  I had a chest CT scan which was normal. I continue to have the left side pain and now I have a slight loss of appetite.  No nausea yet.  I go from constipation to some diahrrea.  I am still having fevers occasionally (I think...I get warm, but my temp is never over 98.3).  I have had some trouble sleeping recently as well.  My PCP wants me to see an oncologist and also to have another CT of pancreas.

(Just in the past five days have I begun to have an upset stomach.  No vomitting as of yet.  Reduced appetite.  I have also had some lighter colored stools.  I am also seeing a bit of redness, sort of like hives, that come and go on my chest).  


A few questions:
1.  What does a normal LDH reading rule out?
2.  Doe my lipase level dropping back to "normal" signal that the pancreas is ok?  Would pancreatic cancer or pancreitis have higher levels?  My amalayze was normal, by the way.
3.  Could this be IBS?  And could stress create these symptoms? (this past year I have lost my mother, moved to a new city, changed jobs and got engaged- not to mention the fact that I got a DUI)
4.  Any ideas or suggestions of what this could be?  I am very frightened that it is pancreatic cancer.

Thanks in advance.  

Chris in CO

[mikcin]

Wow sounds like you have been thru some tests.  Have they considered anything with your CBD or gallbladder.  Lighter colored stools sometimes means a liver or CBD disorder.  Maybe question this and in the meantime I would ask for a refferal to a good gastronenterologist.  I had to see 3 different ones before I got my pain, bloating, etc to go away.  I had impacted stones in my CBD and diverticlitis.  It took 5 years with much pain, and trips to the ER and hospitalizations to get this all cleared up.  Hope you get some answers real soon.

[Jatech]

My guess is you have diverticular,all the best.

[Kevin Pho, MD]

To answer your questions:
1) A normal LDH is not-sensitive enough to rule out specific disease.

2) A normal lipase level would make pancreatitis less likely.  Imaging the pancreas with a CT scan can be considered if there still is concern.

3) IBS is possible, especially if the bulk of the testing is non-revealing.

4) I would consider IBS, given the bowel habits you describe and negative colonoscopy.  Stool tests can be sent for analysis and culture to exclude malabsorption or colitis.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com