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Abdominal pain, fullness with previous GERD on ELAVIL.

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I am a 40 year old white hispanic male living in the U.S. For the past few weeks I have been experiencing upper abdominal pain and fullness. For the past 18 years old patientI have been diagnosed with IBS/GERD. I currently take 30MG of Prevacid daily to control the GERD and 50MG of Elavil to help with IBS. I also suffer from hypertension and am on two BP medicines. I am slightly overweight (about 15lbs). Over the years old patientI have had several upper endoscopies and lower endoscopies. My last upper was less than two years old patientago and all it showed was mild gastritis and a medium sized hiatal hernia. I also had an abdominal ultrasound that showed a fatty liver because I had a very mild elevation of my ALT (60 at its highest). I also must say that I supper from Health Anxiety (hypochondria - not officially diagnosed but I know I have it) and severe anxiety.. I have been fixated on thinking I have either gastric cancer or pancreatic cancer. I can't seem to get it out of my head and am very worried. I have never smoked and do not drink. I've read all the symptoms online and I can't help but get worried. Thank you.


Category: Gastroenterologist, Medical

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Category: Family Physician-GP
 22 Doctors Online

Expert:  Dr. Mayank Bhargava replied 4 Days ago

Hi,
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
Your abdominal pain us due to gastritis. You continue taking Prevacid.
Since it has been chronic I would advise you to get tested for helicobacter pylori infection.
It is less likely to be gastric cancer as you do not seem to have any red signs and previous endoscopy less than 2 years old patientago didn't show anything cancerous or precancerous.
You can get a CT scan of the abdomen which will show whether you have pancreatic cancer or not. With the information you have given it is unlikely that you have pancreatic cancer.
I hope that answers your query.
Let me know if you have any more questions.

Regards,
Dr.R.K


Patient replied :

Would it be unlikely someone my age (40) would have pancreatic cancer? I'm terrified and have no appetite because of the anxiety I'm feeling. I seem to be caught up with anxiety which is making me feel worse and not be able to eat. I'm sorry I'm just so nervous I can't even concentrate on anything else.


Expert:  Dr. Mayank Bhargava replied 3 Days ago

Hi,
Even persons 40 years old patientof age can have pancreatic cancer.
But your symptoms are not specific for pancreatic cancer.
If you are very anxious/apprehensive, you can get a CT scan done as suggested in the earlier post which will confirm that you do not have pancreatic cancer.
I hope that answers your query.
Let me know if you have any more questions.
Regards,
Dr.R.K.


Patient replied :

I am a 40 year old white hispanic male living in the U.S. For the past few weeks I have been experiencing upper abdominal pain and fullness. For the past 18 years old patientI have been diagnosed with IBS/GERD/Anxiety. I currently take 30MG of Prevacid daily to control the GERD and 50MG of Elavil to help with IBS. I also suffer from hypertension and am on two BP medicines. I am slightly overweight (about 15lbs). Over the years old patientI have had several upper endoscopies and lower endoscopies. My last upper was less than two years old patientago and all it showed was mild gastritis and a medium sized hiatal hernia (I was also tested for H. Pylori several times over the year - always negative). I also had an abdominal ultrasound that showed a fatty liver because I had a very mild elevation of my ALT (60 at its highest) - this was also done less than two years old patientago. I also must say that I supper from Health Anxiety (hypochondria - not officially diagnosed but I know I have it) and severe anxiety.. I have been fixated on thinking I have either gastric cancer or pancreatic cancer. I can't seem to get it out of my head and am very worried. I have never smoked and do not drink. I've read all the symptoms online and I can't help but get worried. Thank you for your attention to this matter.


Expert:  Dr. Mayank Bhargava replied 2 Days ago

Thank you for your query at DoctorSpring.com
I have reviewed your case-history.
You have been having abdominal pain and feel upper abdominal fullness.
Since your previous endoscopy was suggestive of gastritis, this pain is likely to be due to the same.
This is definitely not because of gastric cancer, as the endoscopy would have revealed changes in the epithelium, giving an indication of cancer. But it was done 2 years old patientback, and you can repeat an UGI scopy now to see the current status of the gastric epithelium. If it still shows evidences of gastritis, you can try a 2 week course for treating H. Pylori, which commonly causes chronic gastritis.
Regarding pancreatic cancer, do you have any family history of pancreatic cancern? It is extremely unlikely in your case, as in pancreatic cancer the pain does radiate to the back, causing intense pain, mostly on laying down. With no such history it does not seem like pancreatic cancer.
But, I will advise you a CT of the abdomen for further evaluation and follow-up with me.
Regards,
Dr. Bhargava


Patient replied :

I have no history of pancreatic cancer in my family at all. The abdominal pain actually seems to get better when I lay down and relax or turn to my left side and relax. The pain does not radiate to my back. I've always had slight back pain but it's mostly if I stay in one position for a long period of time.


Expert:  Dr. Mayank Bhargava replied 1 Day ago

Hello,
Thank you for elaborating your symptoms.
This does not sound like pancreatic cancer or gastric cancer. Always remember to watch out for weight loss which is one of earliest manifestations. Rather sudden unexplained weight loss is the first manifestation of pancreatic cancer.
I will request you to get a CT of the abdomen and follow-up. As of now, it seems to be only gastritis.
Best Regards.


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
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