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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31321
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I had small sized tubular adenoma removed when I was age 29,

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I had small sized tubular adenoma removed when I was age 29, and last year, on my 42nd birthday, I had a 1cm sessile serrated adenoma removed from my ascending colon. I have been worried that I can develop an interval cancer before the scheduled 3 year follow-up, and am wondering if I should pursue more frequent screening.
In addition, I've developed other worrisome symptoms: constipation, reflux, mid-back pain, UQR pain, and weight loss. A CT scan in March was negative, but now, three months later, with increasing symptoms, my PC is sending me for an MRI to check for pancreatic cancer. I am extremely distressed by this possibility. I want to know if my symptoms (including weight loss) could be in keeping with IBS or some such benign condition. Thank you for your time.

Greetings Geneffa.


I am Dr. Phophalia and would answer your question today.

How much weight loss has occurred (in last three months)?
Are you anxious which is causing the loss of appetite?
How severe is your abdominal pain?
Any significant family history?

Dr. Arun

Customer: replied 3 years ago.

Hi Dr. Arun,


I have lost approximately 10 lbs in 3 months. I don't usually lose weight so easily.


I have developed Health Anxiety, and I may be eating less due to a feeling of food backing up in my system. I am concerned that the weight loss goes beyond IBS and is indicative of pan can.


The abdominal pain is not severe, but rather dull and nagging. It feels to be in the area of the transverse colon and is ever-present, along with mid-lumbar pain.


My masi died of gastric cancer (stomach and colon) at age 58. Uncle has had colon polyps. I, myself, have had a tubular adenoma at age 29 and then sessile serrated adenoma last year (age 42).


I am particularly confused that I have weight loss with constipation, and that it continues to stay low although I've been trying to eat more. I'm currently very scared that I've developed advanced pancreatic cancer since CT scan on March 1st.


Any insight you can offer would be most appreciated.


Thanks so much,

Geneffa Popatia Jonker

Hello Geneffa,

Thanks for the further information.

Few points to ponder;

1) With a CT scan being normal just in March, chance of pancreatic cancer developing just in less than 3 months is very unlikely.

2) Your family history and past history is significant, but with just dull nagging pain and weight loss are not the confirmatory signs of serious disease or cancer.

3) The most likely cause for your weight loss is anxiety and obsession about the diagnosis of cancer. Your pain is most likely due to IBS.

You should not be worried and start thinking positive. Let the medical imaging ascertain the cause of your symptoms. It seems, you are reading too much on the Internet and that is playing in your mind.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.


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Customer: replied 3 years ago.

Thank you, XXXXX XXXXX for your reassuring response.

I hope to be a happy hypochondriac!


Could you confirm if upper abdominal pain and mid-back pain are potential symptoms of IBS. Smile


I should add that in addition to the mid-abdominal and back pain (which are not where I've usually experienced IBS pain), I have: chronic constipation, copious gas, foul-smelling stool, feelings of nausea and food coming back up. Could all of these, in addition to weight loss, be explained by the IBS? What else could cause these symptoms? Any possibilities other than cancer would be reassuring to me.


Also, I have learned that CT scans can only detect advanced pancreatic cancer, so my fear is that the scan missed it in March, but since then, it has advanced to be symptomatic since pan can advances rapidly. What do you think?


Thanks again,

Geneffa Popatia Jonker



Hello Geneffa,

A CT scan is rare to miss pancreatic cancer. So I would not consider it and in three months it is unlikely to develop suddenly without causing a lump or Jaundice. Your symptoms are suggestive of;

1) Intestinal motility disorder; IBS and GERD are part of it.
2) Anxiety.

Following would help you;

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight, if overweight.

4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products

5) avoiding large meals. Eat 5 small meals in a day.

6) wait three hours after the meal before you sleep.

7) elevate head end of the bed by 8 inches.


Following may help you in excessive gas;

1) Avoid

a) Cabbage

b) Beer

c) Legumes

d) Cheese

e) Beans

2) This may help;

a) Bismuth subsalicylate

b) Activated charcoal

c) Simethicone; (Maalox, Mylanta); Simethicone causes gas bubbles to break up.

d) Beano; contains an enzyme (alpha-galactosidase), which helps to breakdown certain complex carbohydrates.

All are available without prescription.

Avoid foods that appear to aggravate symptoms. These may include milk and dairy products, certain fruits or vegetables, whole grains, artificial sweeteners etc. But this is based on the personal observation for the aggravating food.

Discontinue the following if you do them;

1) gum chewing,

2) smoking,

3) drinking carbonated beverages, and

4) gulping food and liquids.

You should also be looked for bacterial overgrowth syndrome and a stool culture and a stool exam for parasite would help.

It is privilege assisting you.

Dr. Arun
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