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Dr. Ben
Dr. Ben, Doctor
Category: Medical
Satisfied Customers: 1252
Experience:  GP Partner, practicing Medicine for 14 years. I have broad experience with special interests in Dermatology, Paediatrics, Sexual Health and Oncology.
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My mum is far away from me. And I am concerned about her.

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My mum is far away from me. And I am concerned about her. She has lost a lot of weight and has stopped eating. When she tries to eat, she ends up vomiting. She has told me it is mainly green bile and also black bile. She has seen a doctor and had some tests and scans. The results showed kidneys and liver function were fine, though scan showed two small tumours in the vines on her liver. She says is in slot of pain and is extremely weak, from not eating. Would this cause her to vomit the green and black bile? even though liver and kidney function is good. Am worried about her.
Assistant: Are you keeping a personal medical record while dealing with this?
Customer: Only from what my mother is telling me.
Assistant: Anything else in your medical history you think the doctor should know?
Customer: She has lost 32kg in about a month and half.

Hello, thank you for your question. I’m Dr. Ben and I’m here to assist you today. Please allow me a few moments to review your question and I’ll be right back.

If you receive an invitation for a phone call, please know this is automatically generated by the site and has not come from me. Feel free to ignore it.

Customer: replied 8 months ago.
Ok thanks

May I ask some quick questions to help me give you the best answer today:

- How old is she?

- Any medical problems or previous surgery?

- Any medications?

- What is her height and weight (approximate is okay)?

- Does she smoke (or has she previously)?

- Has there been any investigation of the stomach or bowel so far (such as endoscopy)?

Customer: replied 8 months ago.
She is 68
Customer: replied 8 months ago.
Three surgery's from a car accident is 1988. Her pancreas was crushed against her spine.
Customer: replied 8 months ago.
Doctor at the moment for some reason has put her on liquid drinkable morphine.
Customer: replied 8 months ago.
She is about 5ft 8in, she was 98kg but now is 67kg about just a month and a half.
Customer: replied 8 months ago.
Does not smoke
Customer: replied 8 months ago.
No investigation of stomach, only CT scan and blood tests.
Customer: replied 8 months ago.
I think she once had surgery for a blockage in her bowel when she was very young.

Thank you.

Has anything been said about the nature of these liver tumours?

Where is she feeling the pain?

Do you know what is planned next?

Customer: replied 8 months ago.
She just said in her back in the right flank. Also she did had breast cancer hand had her left beast removed and had chemo therapy for it, and was give the all clear a few years ago.
Customer: replied 8 months ago.
She is having further tests to find out exacting what the tumour are. She still has a week to go till these tests.
Customer: replied 8 months ago.

Has she been forthcoming telling you about everything?

It is a natural (although typically misguided) instinct to want to protect one’s loved ones from difficult truths.

Customer: replied 8 months ago.
I am going up to see her next week before the test that she is going to have. And I have spoken to my father while my mum was not around a details are aligned.
Customer: replied 8 months ago.
I am very close to my mum and speak regularly on video call and was shock last time I saw her, as going from over weight to skin and bones in a month and a half.
Customer: replied 8 months ago.
Are there any other possible test that you think should be carried out, to check for any other issues regarding her symptoms?

There is certainly more than one explanation for these symptoms, however the combination of weight loss, pain, liver tumours and previous cancer means that (recurrent) cancer is going to be at or near the top of the differential diagnosis list for her doctors.

I expect the further tests are biopsies and an MRI scan to establish nature of these tumours and either confirm or refute this possibility.

I’m very sorry as this must not be easy for you to read or think about, but I do wish to be honest with you.

If these tests do not help to move things forwards then a Gastroscopy may well be helpful especially in view of the significant vomiting.

Is there anything else you would like to ask me?

Customer: replied 8 months ago.
Thanks for your advice. Also in your opinion do you think that these tumours would cause her to vomit, even though liver function is good.

No, if there are just 2 small ones that are not affecting liver function, it is very unlikely that they are the cause of the vomiting.

Customer: replied 8 months ago.
My understanding that vomiting black, is isodised blood, which I presume is been caused by her not eating, which causes the acid in her stomach to cause bleeding and when she eats she vomits the bit of food she has, and the black bile come up.
Customer: replied 8 months ago.
Could she be suffering another blockage in her bowel and the vomiting of the food and bile which a reaction of the body to get rid of the waste as it can not pass the blockage? Sorry about all the questions, as I am trying to make sense of her symptoms.

Yes, that is a plausible explanation regarding gastritis (hence my recommendation for a Gastroscopy).

A bowel obstruction can also cause these symptoms, however this usually causes very obvious and characteristic changes on an abdominal xray/scan - this does not seem to have been reported in the (?CT) scan she has already had.

Customer: replied 8 months ago.
No, nothing was mentioned about anything apart from the two small tumours in the veins on her liver.

So bowel obstruction seems highly unlikely, however gastritis remains a possibility.

If you would be kind enough to leave a positive feedback rating it would be greatly appreciated (it is the only way the experts receive any credit for the time spent helping people on this site).

I will still be here to answer any follow up questions you may have.

Many thanks.

Dr. Ben and 3 other Medical Specialists are ready to help you
Customer: replied 8 months ago.
Thank you for all you help, and helping me understand my mum's issues. Will talk to her tomorrow and see if there are any arrangements to have a Gastroscopy.
Customer: replied 8 months ago.
Many thanks.

You’re very welcome, I wish you all the best.