Digestive Issues: When to Worry About Cancer Symptoms

Suspected gastrointestinal cancer?

Hello Doctor, since July 20, I have been experiencing abdominal bloating, intermittent abdominal pain, hip pain, lower back pain, gastroesophageal reflux, nausea, loss of appetite, and a weight loss of 3-4 kg (originally 48 kg).
My bowel habits have changed, and my stool color has been darker.
This morning, I even had black-green stools.
Currently, I am taking Gask tablets, Tylenol, and magnesium oxide, which seem to make my stools unformed.
For the past few days, my stools have been loose and show visible fiber, but I feel no urge to defecate, as if my intestines are obstructed.
I did not have a bowel movement for two days (I usually go once a day).
Then, a psychiatrist prescribed Sennosides, which helped me have a bowel movement, but as mentioned, it was diarrhea with noticeable fiber.
During the medical evaluation, I had an abdominal ultrasound that showed no issues, and an abdominal X-ray (interpreted by an emergency physician) indicated fecal retention and excessive gas.
Two days ago, I had an abdominal CT scan without contrast, and yesterday, during a follow-up visit, the doctor said the report looked normal with no tumors, only mild dyspepsia.
1.
I would like to ask if the results of the abdominal CT scan without contrast are accurate for tumor detection? A gastrointestinal endoscopy is scheduled, but I have to wait until the 24th of this month, and I am very anxious every day...
2.
I want to know if my increasingly narrow stools (today they are black-green and thinner) could indicate an intestinal obstruction, or am I overthinking it?
3.
Yesterday, when I was bloated, I felt a hard area in my abdomen that seemed to press on my intestines.
Could this be impacted feces? Can the CT scan also determine if I have an intestinal obstruction?
4.
While palpating the very hard area of my intestines, I felt some small lumps.
Could these lumps be pressing on a tumor, leading to today's black-green stools? Additionally, I woke up feeling very fatigued today, and I am unsure if this is due to anemia or the effects of the psychiatric medication, as I did not feel this fatigued yesterday.

Ran, 20~29 year old female. Ask Date: 2023/08/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

The symptoms reported are not necessarily indicative of gastrointestinal cancer, so there is no need to worry.
If necessary, a stool occult blood test can be done first (which provides quicker results), but a gastrointestinal endoscopy is more accurate.

Reply Date: 2023/08/09

More Info

It sounds like you are experiencing a significant amount of anxiety regarding your digestive symptoms and the potential for serious health issues, including cancer. It's understandable to feel this way, especially when dealing with symptoms that are uncomfortable and concerning. Let's address your questions and provide some context regarding digestive issues and when to be concerned about cancer.

1. Accuracy of CT Scan Without Contrast: A CT scan without contrast can still provide valuable information about the abdominal organs, including the presence of tumors, but it may not be as detailed as a scan with contrast. Contrast agents help to highlight blood vessels and certain tissues, making it easier to identify abnormalities. However, if your doctor reviewed the scan and indicated that there were no tumors, it is a positive sign. It’s important to trust your healthcare provider's assessment, especially if they have experience interpreting these scans.

2. Changes in Stool Appearance: The changes in your stool, including the black-green color and the consistency, can be concerning. Black stools can indicate bleeding in the upper gastrointestinal tract, but they can also be caused by certain medications, foods, or supplements (like iron). The fact that your stool is becoming thinner could be related to changes in your diet, hydration status, or gastrointestinal motility. While these changes can be alarming, they do not necessarily indicate a blockage. However, it’s essential to monitor these symptoms closely and report them to your healthcare provider.

3. Abdominal Hardness and Potential Obstruction: The feeling of hardness in your abdomen could be due to gas, stool, or other factors. A CT scan can help identify signs of obstruction, such as dilated loops of bowel or the presence of fluid. If your doctor has ruled out obstruction based on the imaging studies, it is likely that your symptoms are related to functional gastrointestinal issues rather than a physical blockage. However, if you continue to experience significant discomfort or changes in bowel habits, it is crucial to follow up with your doctor.

4. Palpable Masses and Fatigue: Feeling a small lump in your abdomen can be concerning, but it’s important to remember that not all lumps are indicative of cancer. They could be benign structures, such as lymph nodes or fibroids. If you are feeling fatigued, it could be due to several factors, including anxiety, medication side effects, or even dietary changes. It’s essential to discuss these symptoms with your healthcare provider, who can evaluate your overall health and possibly conduct further tests if necessary.

Addressing Anxiety: Given your ongoing anxiety about these symptoms, it may be beneficial to incorporate stress-reduction techniques into your daily routine. Practices such as mindfulness, meditation, or gentle exercise can help alleviate anxiety. Additionally, discussing your fears with a mental health professional can provide you with coping strategies tailored to your needs.

In summary, while your symptoms are understandably concerning, many factors can contribute to digestive issues, and not all of them are related to cancer. It’s essential to maintain open communication with your healthcare providers, follow through with the scheduled tests, and seek support for your anxiety. Remember, you are not alone in this, and there are resources available to help you navigate these challenges.

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