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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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Hi. I am really worries I am a 56 year old lady. For the past

Resolved Question:

Hi. I am really worries I am a 56 year old lady. For the past 18 months I have had various tests for upper stomach pain. I first presented with bowel problems although always had discomfort under ribcage and tightness. Colonscopy revealed mild diverticulitis. Small bowel scan normal. Endoscopy revealed stomach and duodenal mild erosion. I did take omeprazole now take pantaprazole. Still have indegestion heartburn. Had ultrasound recently of liver kidneys gall bladder and pancreas normal. See specialists Monday still in duscomfort had a 147 serum amylase reading. Stomach hard to touch worse as day goes on laying flat appears to help. Sometimes after walking feel like I have got a stitch. I have gradually lost some weight over the past year. Very dry sour tasting mouth. This has taken over my life now and I am really afraid that I may have pancreatic cancer. Help
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Dr Basu :

Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

Oancreatic cancer is very unlikely.

Dr Basu :

By 18 months pancreatic cancer would have spread all over and would have been apparent in all these tests.

Dr Basu :

These symptoms can also be due to the gallbladder problem.
Excess bile acid will cause intestinal irritation.
When the gallbladder is not functioning well, the bile flow to the intestine may increase causing these symptoms.
This will result in bloating, belching and also diarrhea especially after meals.
These symptoms can be treated with a medication called Cholestyramine 4 gram twice daily will meals.
Malabsorption syndrome is another strong possibility.
Malabsorption syndrome includes the follow possibilities:
1. Excess bacterial overgrowth in the small intestine known as SIBO syndrome.
This is not usually diagnosed by the colonoscopy.
Small intestinal aspirate can be sent for bacterial count.
Carbohydrate breath test ( D xylose) is a simple test to diagnose this condition.
But, the treatment is much easier.
A 14 day course of Rifaximine improves the symptoms dramatically/
2. Lactose intolerance--- regular milk, dairy products.
3.gluten senisitivity or celiac disease--- Wheat based products.
4. Chronic pancreatitis --- deficiency of the digestive enzymes produced by the pancreas.
You should consider following low fermentable sugar diet ( FODMAP diet) to reduce your symptoms.
Please go to this link for detailed information:
http://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf

Please also include prebiotics like Inulin daily to keep your colon acidic which prevent gas producing bacteria.
Also take a probiotic ( lactobacilli, bifidobacterium) daily.
Lastly, there can be chronic infections like C difficile, Giardia, Amoeba, Aeromonas etc.
These infections may be diagnosed by checking 3 stool samples taken on successive days.
They will require proper antibiotics for the treatment.
Please discuss these possibilities with a gastroenterologist.

It was my pleasure to help you today.
I am Dr Basu experienced in Gastrointestinal Diseases.
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Customer: Many thanks. Gall bladder showed up as normal on ultrasound. I have been tested for celiac normal. Yes I do have excessive bloating upper and lower stomach. Tend to eat softer food as hard food stcks in upper stomach. Stools have been much more frequent recently. Tightness also in chest seems to b more to right side lots of fluttering in upper stomach. Feel very full after eating small amount
Dr Basu :

Ok

Dr Basu :

I believe your problem lies in dietary intolerance.

Dr Basu :

It is better to try out the above recommendations which help immensely in conditions like yours.

Dr Basu :

Best wishes,

Customer: Many thanks I wll bear your comments in mind when I see consultant on Monday. I will let you know what he says
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