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One More Question And I Will Certainly Rate You Again
Posted on
Sat, 10 Aug 2019
Sat, 10 Aug 2019
Answered on
Last reviewed on
Question : One more question and I will certainly rate you again as a new question.
You have seen all of my tests; my Dr GI says functional abdominal or IBS. In fairness, I have had IBS for over 30 years although it has never persisted in essentially the same RUQ area albeit intermittent for 4 months. I do also get a few lower abdominal pains. Since I had ultrasound, abdominal mri, and endoscopy and colonoscopy also comprehensive bloodwork which was all normal would this pretty much rule out any cancers?? I have no other symptoms but I do always worry about cancer. I do see some white specks or small particles in my stool some. Thanks again Dr
You have seen all of my tests; my Dr GI says functional abdominal or IBS. In fairness, I have had IBS for over 30 years although it has never persisted in essentially the same RUQ area albeit intermittent for 4 months. I do also get a few lower abdominal pains. Since I had ultrasound, abdominal mri, and endoscopy and colonoscopy also comprehensive bloodwork which was all normal would this pretty much rule out any cancers?? I have no other symptoms but I do always worry about cancer. I do see some white specks or small particles in my stool some. Thanks again Dr
I should have possibly added no other symptoms including weight loss or gain. Stool does seem to move from soft to hard FYI. Can this RUQ persist for months albeit as I mentioned I do get some lower abdominal pains. Gas and belching
Thanks for your attention. And again all tests good.
Thanks for your attention. And again all tests good.
Brief Answer:
As detailed below.
Detailed Answer:
Thanks for your additional queries.
Noted the additional points well.
As you have rightly asked for whether normal investigations like colonoscopy, Abdominal MRI and so on rule out cancers: yes, these investigations could have detected cancer.
And this can be supported by the following ways:
Request for blood samples for ''tumor markers'' like Carcinoembryonic antigen (CEA), CA 19-9 for colorectal cancer, PSA for prostate and so on after discussion with your Doctors. If these too are negative will surely reduce your stress and anxiety about cancer and other parts of life which will directly help to get a control over IBS.
Stress and anxiety are the major instigating or enhancing factors in IBS.
Also take a note of foods and beverages that instigate or enhance the problems and stop these altogether. Helps a lot for most of my patients.
Getting the stool tested on three occasions when you find it not normal helps in getting other diseases that can cause colitis and can have specific treatment.
Pain in the same quadrant of abdomen with occasional shift here and there is known to occur. If the pain persists in the same are for such a long time then a neurolgical cause like pinched nerve supplying that area should also be remembered, can be post-herpetic or so.
Please feel free to communicate further.
I hope this answer further helps you to clarify your thoughts and helps in getting further diagnosis and management.
With Regards.
Dr T Chandrakant.
As detailed below.
Detailed Answer:
Thanks for your additional queries.
Noted the additional points well.
As you have rightly asked for whether normal investigations like colonoscopy, Abdominal MRI and so on rule out cancers: yes, these investigations could have detected cancer.
And this can be supported by the following ways:
Request for blood samples for ''tumor markers'' like Carcinoembryonic antigen (CEA), CA 19-9 for colorectal cancer, PSA for prostate and so on after discussion with your Doctors. If these too are negative will surely reduce your stress and anxiety about cancer and other parts of life which will directly help to get a control over IBS.
Stress and anxiety are the major instigating or enhancing factors in IBS.
Also take a note of foods and beverages that instigate or enhance the problems and stop these altogether. Helps a lot for most of my patients.
Getting the stool tested on three occasions when you find it not normal helps in getting other diseases that can cause colitis and can have specific treatment.
Pain in the same quadrant of abdomen with occasional shift here and there is known to occur. If the pain persists in the same are for such a long time then a neurolgical cause like pinched nerve supplying that area should also be remembered, can be post-herpetic or so.
Please feel free to communicate further.
I hope this answer further helps you to clarify your thoughts and helps in getting further diagnosis and management.
With Regards.
Dr T Chandrakant.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. You are so patient. Just two short follow ups: do the white specks I see in the stool mean anything? And, I note grumbling or I can place my hand in RUQ and feel movements but no where else only RUQ?
You are a very nice person I can tell
You are a very nice person I can tell
I found on an old test 2016 that foci in the left kidney could possibly be small stones? If so, could stones in left kidney cause RUQ pain
Final I promise my Common Bile duct is 3 mm but no issues observed in MRI or ultrasound. Is this okay? Why did they note the size
Brief Answer:
As discussed
Detailed Answer:
Sincere thanks for your appreciation.
The white specks and such things in stool have no clinical significance unless supported by clinical presentation and lab reports. Please get stool tests done as mentioned in one discussion.
Grumbling only in RUQ indicates that that part of colon is more active or goes into spasm and thus cause temporary pseudo-obstruction. If small intestine would have caused this then vomiting would be the presentation which you do not have. Gall bladder and related structures can not cause grumbling (being in same quadrant)
Since fresh Ultrasonography and MRI does not show any such foci, these small concretions or stones have passed - lucky again as they have not grown into larger stones. Stones in left kidney can not cause pain in RUQ pain.
CBD that is common bile duct of 3 mm is normal and noting it is the common practice - it gets dilated when there is obstruction to bile flow due to stone or pancreas and duodenum related problems which MRI can pick up well.
I hope all these answers further help you.
Feel free to ask for further relevant queries if you feel that there is a gap of communication.
With Regards.
As discussed
Detailed Answer:
Sincere thanks for your appreciation.
The white specks and such things in stool have no clinical significance unless supported by clinical presentation and lab reports. Please get stool tests done as mentioned in one discussion.
Grumbling only in RUQ indicates that that part of colon is more active or goes into spasm and thus cause temporary pseudo-obstruction. If small intestine would have caused this then vomiting would be the presentation which you do not have. Gall bladder and related structures can not cause grumbling (being in same quadrant)
Since fresh Ultrasonography and MRI does not show any such foci, these small concretions or stones have passed - lucky again as they have not grown into larger stones. Stones in left kidney can not cause pain in RUQ pain.
CBD that is common bile duct of 3 mm is normal and noting it is the common practice - it gets dilated when there is obstruction to bile flow due to stone or pancreas and duodenum related problems which MRI can pick up well.
I hope all these answers further help you.
Feel free to ask for further relevant queries if you feel that there is a gap of communication.
With Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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