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Gastroenterology (Expert Forum)
33 year old with Pancreatitis and constant stomach pains
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
33 year old with Pancreatitis and constant stomach pains
by LBJ, Mar 04, 2004 12:00AM
In October of 2003 my Dr. put me on 150mg Diclofenac for severe degenerative disk pain in my upper back. In late November and early December, I would have colon spasms almost everyday, especially in the morning. For 2 weeks in December, I had soft, extremely foul-smelling stools throughout the day. Around Christmas I had several episodes of diarrhea and periods where I felt extremely bloated. I went to the Dr. after Christmas and had stool test and blood work done. Everything but my lipase level was normal. My lipase was at 87 and my Dr. diagnosed me with Pancreatitis. I am not an alcoholic and an untrasound showed no gallstones. My Dr. took me off of Diclofenac in case it caused the Pancreatitis, doubled my Protonix and referred me to a GI Dr.
In early January, I started having pains in the center of my chest blow my breast. Then all over abdominal pains began. I would have extreme pain on my left side (wrapping around to my lower back) that eventually would move to my right side. I have sharp shooting pains (that do not feel like gas) around my navel. I have pains where it feels like someone is pinching inside my abdomen and I have rumbling in my lower abdomen. There have been times when it just hurts to touch my abdomen and even near my ribs on my back. I have acid reflux disease too, but the belching and flatulence has gotten worse. I will have diarrhea for a while and then be constipated. My GI Dr. put me on a liquid diet to get rid of the pancreatitis and put me back on just 40 mg Protonix. Eventually she switched me to Nexium. The last blood work showed my lipase at a normal level. I have had stool test, blood work, urine test, ultrasound, abdominal CT scan, Endoscope, colonoscopy, MRCP scan and a small bowel series to find the cause of the stomach pains. Everything has come back negative but I’m still having constant stomach pains. My Dr. took me off birth control in case the estrogen caused the pancreatitis and she put me on a low-fat, lactose free diet. There are days when I am extremely fatigued and my voice becomes strained and a few days my temperature has been 99.5.
I got better for about a week. My Dr. doubled my Nexium because of regurgitation problems that started. After 3 days of a double dose, the sharp abdominal pains and diarrhea started back. I went back to 40 mg Nexium and she has me on Carafate before and after dinner. I also take Acidophilis before breakfast and dinner and I occasionally take a Lidocaine/Donnatal/CVS Antac mix for pain in my center chest. I am in pain everyday and I don’t understand why no one can find anything wrong with me. I am 33 years old and this is affecting my life to the point where I can’t go out. What should I do???
In early January, I started having pains in the center of my chest blow my breast. Then all over abdominal pains began. I would have extreme pain on my left side (wrapping around to my lower back) that eventually would move to my right side. I have sharp shooting pains (that do not feel like gas) around my navel. I have pains where it feels like someone is pinching inside my abdomen and I have rumbling in my lower abdomen. There have been times when it just hurts to touch my abdomen and even near my ribs on my back. I have acid reflux disease too, but the belching and flatulence has gotten worse. I will have diarrhea for a while and then be constipated. My GI Dr. put me on a liquid diet to get rid of the pancreatitis and put me back on just 40 mg Protonix. Eventually she switched me to Nexium. The last blood work showed my lipase at a normal level. I have had stool test, blood work, urine test, ultrasound, abdominal CT scan, Endoscope, colonoscopy, MRCP scan and a small bowel series to find the cause of the stomach pains. Everything has come back negative but I’m still having constant stomach pains. My Dr. took me off birth control in case the estrogen caused the pancreatitis and she put me on a low-fat, lactose free diet. There are days when I am extremely fatigued and my voice becomes strained and a few days my temperature has been 99.5.
I got better for about a week. My Dr. doubled my Nexium because of regurgitation problems that started. After 3 days of a double dose, the sharp abdominal pains and diarrhea started back. I went back to 40 mg Nexium and she has me on Carafate before and after dinner. I also take Acidophilis before breakfast and dinner and I occasionally take a Lidocaine/Donnatal/CVS Antac mix for pain in my center chest. I am in pain everyday and I don’t understand why no one can find anything wrong with me. I am 33 years old and this is affecting my life to the point where I can’t go out. What should I do???
Doctor's Answer
by Kevin Pho, MD, Mar 05, 2004 12:00AM
, Mar 05, 2004 12:00AM
One consideration would be a 24-hr pH study to evaluate where there is GERD. This is the most comprehensive test to evaluate for this.
If pancreatitis continues to be an issue, without a clear source, you may want to consider pancreatic enzyme replacement. Pancreatic enzyme supplements relieve pain in some patients, are generally safe, and are thus a reasonable next step for patients with continued pain. Treatment may be more likely to be successful in those without involvement of large ducts and those with idiopathic pancreatitis. Patients with alcoholic pancreatitis may be less likely to respond.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Freedman. Treatment of chronic pancreatitis. UptoDate, 2004.
If pancreatitis continues to be an issue, without a clear source, you may want to consider pancreatic enzyme replacement. Pancreatic enzyme supplements relieve pain in some patients, are generally safe, and are thus a reasonable next step for patients with continued pain. Treatment may be more likely to be successful in those without involvement of large ducts and those with idiopathic pancreatitis. Patients with alcoholic pancreatitis may be less likely to respond.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Bibliography:
Freedman. Treatment of chronic pancreatitis. UptoDate, 2004.
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