Abdominal pain, which may also be known as a stomach ache, tummy ache, gut ache, or bellyache, is not uncommon and almost everyone experiences it at some point in their lives. It may be mild or severe, continuous or isolated, acute or chronic, but when it is particularly severe or lasts for weeks it is recommended that patients seek medical help. In the case of mesothelioma, it results from irritated tissue in the abdomen. Mesothelioma is caused by exposure to asbestos, a toxic material that was widely used in construction. When it interacts with other materials, toxic fibers are released into the air.
Weight loss as a symptom of pleural mesothelioma or peritoneal mesothelioma may be caused by numerous issues. In the case of pleural mesothelioma, weight loss may result from dysphagia or difficulty swallowing food and liquids. Patients experience these problems as the disease progressively affects the lungs. Patients with peritoneal mesothelioma can experience weight loss since the abdominal cavity is affected, causing pain and unwillingness to eat. Patients may not want to eat or feel pain while eating.
Abdominal distention is closely related to bloating, irritable bowel syndrome and constipation. The causes for abdominal distention can be related to excessive intestinal gas, exaggerated lumbar lordosis, recent weight gain, weak or inappropriately relaxed abdominal muscles, an inappropriately contracted diaphragm, and retained fluid in loops of distal small bowel. In the case of patients with peritoneal mesothelioma, patients usually start by experiencing some pain or swelling in the abdomen before abdominal distention.
In addition, abdominal distention, which can be followed by diarrhea or constipation, is often only a symptom when the disease is already in advanced stages. In the majority of the cases of peritoneal mesothelioma, symptoms are not experienced until tumors have spread. Given the fact that abdominal distention and other symptoms experienced are not exclusive to mesothelioma, the diagnosis may be delayed. In patients with other types of mesothelioma, abdominal distention may be experienced when the tumors have metastasized to the organs in the abdomen.
A hernia develops when an organ or fatty tissue are squeezed into an opening rounded by the muscle or tissue that keeps it in place. Due to the hernia, patients often have a lump, and experience pain or discomfort, weakness, pressure or a feeling of heaviness in the abdomen, and a burning, gurgling or aching feeling. In addition, physicians will often initially diagnose hernias when the patients are actually suffering from mesothelioma.
Loss of appetite
The first symptoms of peritoneal mesothelioma can be experienced decades after exposure to asbestos, and even then they may be mistaken for other conditions. Loss of appetite in mesothelioma patients is not completely understood, but its association may be connected to growth of tumors in the abdomen as well as buildup of fluid in the abdomen. Due to these factors, the organs in the abdomen are pressured and have less space to properly function. As the stomach shrinks, patients may experience loss of appetite. On the other hand, patients often face emotional problems like stress, anxiety or depression due to mesothelioma, which can also result in loss of appetite.
Feeling of fullness
This form of cancer affects the abdomen and the nearby organs. The feeling of fullness is not fully understood, but it can be related to physical reasons. When the tumors start to grow and the disease progresses or when there is a buildup of fluid in the abdomen, organs like the stomach can be pressured. This pressure affects the normal function of the organs and occupy its space, leaving less space in the stomach for food. In addition, feeling of fullness and lack of appetite can also be related to the emotional burden of the disease, which can cause depression and anxiety.
Abdominal swelling or tenderness
The study “Peritoneal Mesothelioma: A Review” analyzed the features of the disease and revealed that abdominal swelling is the second most common symptom of peritoneal mesothelioma, experienced by 31% of patients. It is among the consequences of irritated tissue in the abdomen due to asbestos exposure. When this material interacts with other materials, fibers are released into the air. These can be either inhaled or swallowed and travel throughout the body, as the body is unable to properly expel them.
In the case of peritoneal mesothelioma, they can either go from the digestive system to the peritoneum or through the lymphatic system to the abdomen. The cells in the abdomen become irritated, causing the thickening of the peritoneal lining and buildup of fluid. Despite the fact that the majority of symptoms are only experienced in advanced stages of the disease, abdominal swelling or tenderness is one of the first symptoms experienced. Patients feel the belly distended, which may be accompanied by pain and gas. Since abdominal swelling is a symptom of many diseases, diagnosis may be delayed.
Fatigue can be experienced by patients with mesothelioma for one of two reasons. It can take decades between asbestos exposure and the first symptoms, but as the disease progresses patients start to experience symptoms like weight loss, breathing difficulty, insomnia, anemia, hormonal changes and loss of appetite, which can lead to chronic fatigue. In addition, not only can anxiety and depression be related to coping with mesothelioma cause fatigue, but fatigue can also be the origin for anxiety and depression. Regarding treatments, it is common for patients to experience fatigue during and after chemotherapy or radiation therapy. Fatigue after chemotherapy or radiation therapy usually gets worse with subsequent cycles and can even last a year or two after the end of the treatment.
Patients with mesothelioma who experience fatigue may feel the need to spend more time resting and sleeping, too tired to work or conduction daily activities, tiredness even after sleep, lethargic after minimal exertion, as well as sudden and overpowering fatigue. Factors that contribute to fatigue or its exacerbation include pain medication, nausea medications, treatment-related weight loss, stress, poor sleep, depression, anemia or other blood component imbalances.
Abdominal fluid buildup
As the asbestos fibers reach the peritoneum and consequently irritate the cells, the process starts to develop with thickening of the peritoneal lining. Abdominal fluid buildup, a symptom also known as ascites, is usually the second one to occur. When there is a small amount of fluid, patients may not even notice it, but as more fluid accumulates patients may experience pain and bloating. In extreme cases, it can even cause shortness of breath. As the disease progresses, more tumors start to form and put pressure the organs. Possible complications from abdominal fluid buildup include a life-threatening infection of the ascites fluid known as spontaneous bacterial peritonitis, weight loss and protein malnutrition, mental confusion, change in the level of alertness or coma, and kidney failure.
Some people with mesothelioma do not experience bowel obstruction until the disease is in its advanced stages, or do not experience it at all. Bowel obstruction occurs when the abdominal cavity is affected, but it is not common and is often not reported. However, it is among the most painful and debilitating symptoms of peritoneal mesothelioma. Mesothelioma patients who suffer from bowel obstruction feel cramping and belly pain can vomit, have a bloated stomach, experience constipation if the intestine is fully blocked, or diarrhea when it is partly blocked. As a secondary symptom, it is related to the buildup of fluid in the abdomen, a problem known as ascites, which creates pressure on organs such as the bowel.
Nausea or vomiting
Different types of mesothelioma can cause a wide range of symptoms, but in the case of peritoneal mesothelioma, the digestive system is often affected. Peritoneal mesothelioma is the second most common form of the disease, accounting for about 20% of the cases, and it can cause nausea or vomiting. The abdomen and adjacent organs are affected and pressured by the tumors, which results in nausea or vomiting as one of the first signs of the disease. In other types of mesothelioma, nausea or vomiting can also occur as a secondary symptom due to chest, abdominal or heart pain.
All patients may experience acute nausea – which has a fast onset but it is not persistent or regular, or chronic nausea – which is unrelenting and continuous. In some cases, nausea can result in loss of appetite and difficulty eating. In addition to the disease, mesothelioma patients may suffer nausea or vomiting due to chemotherapy. Acute chemotherapy-induced emesis occurs during the day of the chemotherapy while delayed emesis occurs more than 24 hours after the treatment, and anticipatory emesis is a conditioned vomiting response related to a lack of proper antiemetic protection in previous chemotherapy courses.
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