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Thread: Abdominal Pain and Acanthosis Nigricans diagnosis

  1. #1

    Update: test results - Abdominal Pain and Acanthosis Nigricans diagnosis

    Hi Everyone,

    This is my first post but Iíve read the forums for a bit. Iím not new to HA. Itís something Iíve dealt with quite a bit over the past decade or so. Iíve had it under control for the past few years but the pandemic seems to have damaged my mental state and Iím now spiraling downhill again, unfortunately. I know Iím not going to receive medical advice here, nor do I expect to. Weíre probably all seeking some sort of reassurance but I mainly am just looking to vent.

    Iíve had a pain in my upper abdomen for a while. The pain can be felt when Iím running, sometimes doing my yoga, and also when itís pressed. Itís much deeper than the muscle, as it feels like organ pain. The main area of pain is about 2-3 inches below my sternum and 2 inches to the right of center under my right rib cage. If you just tap there or push with a little bit of pressure it feels like a deep, deep bruise that radiates to my back. The pain is very intense when itís pressed and thereís nowhere else in my abdomen that feels like it.

    I have also recently noticed darkening skin under my arm pits, belly button, and groin. I googled and found acanthosis nigricans, which is mostly related to diabetes. However, it can also rarely be related to cancer of the internal organs, mainly stomach, liver, pancreas, etc. I know it says rarely but thatís where my mind went with my abdominal pain too. I went to my GP and he tested my abdomen and discounted the discoloration under my skin. Said itís darkened pigment from chafing. Now, I really like my doctor and try my best to trust him but I donít think my belly button can chaff. I also have darker knuckles and knees. I also believe my face is darkening around my nose and mouth. He wanted to investigate the pain and did bloodwork and a gallbladder U/S. Bloodwork came back fine as did the U/S.

    I had a dermatologist appointment scheduled for a face lesion and asked about my discoloration and she said itís acanthosis nigricans. So now I have two doctors with differing beliefs. She said itís likely hereditary. She said nothing about diabetes.

    Iím still having the bad pain in my abdomen and the discoloration is still there in all places. Iím constantly examining my skin for changes, which is driving me insane. I even have it on my genital area. The problem is that this is something I have stumbled on and I have no clue how long Iíve had it for. Iím admitting that. The malignant version is tied to sudden onset. I could have had this for a while but my mind wonít let me accept that because I truly donít know.

    Iíve also developed an odd taste in my mouth over the past 8-9 days. Itís tastes bitter or chemically almost. I asked my wife if our water tasted funny and she said no. Iíve been noticing it more and more and itís really annoying. I donít want to google anymore since itís already sent me so far down this path so I have no clue if it could be related to anything.

    I have a follow up with my GP tomorrow to discuss the continuation of this abdominal pain. In doing research, the Acanthosis Nigricans is highly tied to pre-diabetes, diabetes, or insulin resistance. Iíve never heard of insulin resistance but apparently you can have high levels of insulin with a normal blood glucose reading. Iím going to discuss this with my doctor tomorrow. The only diabetic type test I have ever had is a fasting glucose. Iíve been overweight most of my life. BMI 29-33 or so range. I do have some characteristics of the risks (belly size, blood pressure, etc). However, the pain and area of the pain has me very worried that I have a malignancy in my abdomen causing that pain whether it is my stomach or pancreas which is causing the skin condition. Iím tired of worrying and feeling like crap. I hope I can get to the bottom of my issues so I can work towards getting back to controlling my anxiety and enjoying life more than I have been.

    Sorry for the length of this and I appreciate you taking the time to read.

    Last edited by Az123; 21-06-21 at 02:25. Reason: Wanted to update the title since test results are in

  2. #2
    Join Date
    Jul 2011

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Hello, I immediately recognized the term Acanthosis Nigricans because I remember I had a diabetes scare almost a decade ago when I was around 21. My later father had diabetes and it was a time I wasn't managing my diet very much.

    Anyway, I would obsess over this dark line on my nape and thought that was it. Finally, I met a few doctors and said it wasn't AN. I guess the lighting just played with my eyes when I was taking photos of my nape.

    I still asked my doctor (the other one was a derma) for some blood test to test for diabetes as I told her about my family history. I had the FBS and the other test (which I forgot) and they came back fine. What I'm trying to say is perhaps you can push your docs to do simple blood tests to ease your mind re: diabetes? I remember the feeling when the tests came back fine and it was like a whole burden was lifted from me. From there, they can also test you with other things about the issues you fear you might have.

    As for the abdominal pain, I cannot say much, but I do have GERD and some tummy issues. I guess it comes and goes depending on what I eat.

    I trust your visit to the doctor will go well.

  3. #3
    Join Date
    Feb 2021

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Hey, quick comment from a person who is currently suffering from right upper abdominal pain + back pain, the location of your pain points toward a fussy gallbladder, maybe gallstones. I would recommend getting a gallbladder ultrasound to check for stones, and if that comes back normal, request a HIDA scan. Your pain is a bit different from mine, but gallbladder pain can be anything from sharp and stabbing, dull and constant, to burning (the type of pain I have).

    About acanthosis nigricans, I wouldn't worry too much about it. I have it, one of my friends have it. Neither of us have cancer. What I do have is PCOS, which predisposes me to insulin resistance and diabetes, so there is that.

  4. #4

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Thank you both for the replies. We had the abdominal ultrasound completed and it did come back clear. All of my bloodwork is clear too (CBC, Comp, a1c, etc.).

    The doctor thinks that the AN and the stomach issues are not related but he said that my symptoms do warrant further testing. No matter what I read online, he told me that he sees AN and there is usually no dark reason behind it. Just as the dermatologist chalked it up to nothing but hereditary. I truly believe you can google any symptom you pick and track It down to a death sentence if you look hard enough.

    I have to get an abdominal CT scan but must wait 10 business days for insurance clearance(I hate that). The doctor looked me in the eye and told me he is not worried about or looking for cancer. My white blood cells, red blood cells, liver work, and/or platelets would have been off for most cancers in those areas. Basically, something wouldnít have looked right with those. There could be many reasons why I have this deep pain and heís going to help me get to the bottom of it. I appreciate my doctor very much. He informed me that my gallbladder could not show stones but still be plugged with sludge. If the CT scan doesnít show anything, I will be referred to a specialist to run specific tests. I assume this will be for the HIDA scan and potentially something with my stomach.

  5. #5
    Join Date
    Feb 2021

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Glad you are getting everything figured out!

  6. #6
    Join Date
    Jul 2015

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Honestly friend, I also have diabetes scares. Being asian, our food is primarily starch and alot of carbs. So I made a lifestyle change to eat less starch and sugary drinks were cut out from a decade ago.

    Also started exercising and bringing my BMI down to 26. I was 27-28 when i first started 2 mths back.

    Apart from feeling healthier, I do notice a change in symptoms, from feeling less anxiety to a better stomach.(I had bloatedness, gerd and all sortsÖ)

    So friend, stay healthy! It will help you alot to stay active too!

    Sent from my iPhone using Tapatalk

  7. #7

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Thank you for the reply. Yes, Iím working on my diet and have been exercising regularly. I recently got my BMI down from 32 to 29 and plan to keep going.

    Iíve been really struggling over the last several days. The anticipation of this CT scan is bothering me. I still have to wait 8 more days. The other issue I am dealing with is that Iíve pretty much given myself a death sentence here. Damn you Dr. Google. I really wish I can remove what I read from my head regarding malignant Acanthosis Nigricans a few weeks back. Diabetes has been ruled out. I havenít checked straight insulin resistance but my doctor doesnít think itís necessary.

    A key factor in malignant acanthosis Nigricans is that it usually affects your mouth, lips, and/or tongue. I have been diagnosed with acanthosis nigricans but obviously not for malignant reasons. Read my first statement above for details. Aside from my dark armpits and navel, and my dark thickened inner thighs/groin, Iím getting a rough patch of skin on my bottom lip. Itís really small but Iíve been obsessing over it. It feels like a small callous when I rub my tongue or top lip over it. Itís been there for a few days now or more and I donít have it anywhere else on my lips. Lip balm is not helping. On top of the bitter taste Iíve been having on my tongue Iím really struggling (hoping this is from reflux due to the constant stress and anxiety I have been under). Iím driving myself insane with body checks and now freaking out that the spot is AN spreading to my lips with skin thickening.

    I guess the key here is that I wouldnít even have a worry with any of this if I just stayed off of Dr. Google. Iím still hopeful that we can figure out the root of my abdominal pain and that my acanthosis nigricans is not related to an internal malignancy but the anticipation is tough. Iím trying hard to be rational but itís been so difficult.

  8. #8

    Re: Abdominal Pain and Acanthosis Nigricans diagnosis

    Iím back with an update. As mentioned above, my liver bloods (bilirubin, ALT, AST) all came back in normal range. My ultrasound showed no issues with my liver or gallbladder. Iíve had just had the CT scan and received the results Friday afternoon. The doctor told me that my CT scan looked good and there was no issue with any of my organs. A hernia was found around my bellybutton but thereís no pain/issue and not causing my issue.

    He did mention that the scan showed my liver is borderline close to being ďlargeĒ but itís still within normal limits in terms of size. So I suppose this would be considered the high end of normal. He also mentioned that this wouldnít cause my pain but I question that. When the doctor pressed on my liver it was tender at the last few appointments so Iím pretty sure thatís where the problem is.

    Iím not sure the next course of action here. I assume the bloods, ultrasound, or CT would have picked up something regarding fatty liver, fibrosis, cirrhosis, or liver cancer if any were present. The fact that my liver is ďlargeĒ makes me believe I have some sort of inflammation there coupled with the tenderness. Iím kind of lost here at the moment. I wonder if I could just have a tender liver?

    The dark skin is still present on my armpits, navel, and groin. My taste is still off. Mostly bitter, sometimes sour.

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