Do all bile duct obstructions have to be cancer ?

My father a generally healthy 54 year old has recently been diagnosed with a bile duct obstruction after having and ERCP.  The doctor thought that it might be a gallstone stuck in the bile duct but as it turns out its not.  They have done brushings and so far they have been coming back negative for cancer? The doctor said still to not get our hopes up it still could be a carcinoma ? He has lost 30 pounds over the course of 2 months while all these tests have been going on but now after inputing the stent in the obstruction he is feeling better. Has anyone had problems with bile duct obstructions ?

[TazLady]

Hi,
Bile duct obstructions and pancreatic duct obstructions are completly common with someone who has pancreatitis.  Has your father been tested for this at all?  I have found that alot of doctors don't usually check for this unless certain conditions apply.  Such as over consumption of alcohol.  Having a pancreatic attack after having an ERCP is a fairly high percentage rate.

Ask your father to talk to the doctor about doing tests on the pancreas.

Sandy

[TechChick]

I was just told Monday that I had pancreatic duct cysts. I had an ERCP 2 months ago. I have to go back in 3 months and have another ERCP to see what they are doing.

[amyj]

Thanks guys! I am just trying to get some more insite on bile duct obstructions.  The doctor did say that in the ERCP his pancrese looks fine.  The only real thing that they have told us so far is that his gallbladder is bad and needs to come out and that the obstruction is a very tight one that most likely will have to be removed unless it is cancerous.  Is weight loss common with gallbladder problems ?  He never eats fast food anymore or drinks soda he was overweight before but not anymore!

[TazLady]

Hi,

An ERCP is a likely cause of a pancreatic attack.  The pancreas may have looked just fine when they did the surgery, but when he came out of surgery, he may very well have had a pancreatic attack that they are overlooking.  

A non-working gallbladder can mimic pancreatic conditions.  Mine was bad, they took it out...I had a pancreatic attack that the surgeon did not believe was happening and did nothing about. Now I have chronic pancreatitis.  I know 3 people in the last year who had their gallbladder removed and have had a pancreatic attack right after surgery.  ERCP's will do that to you.  It is a very common cause of that. Weight loss is extremly common in gallbladder problems and pancreatic problems.

A severe stricture can be helped with surgery.  I had a severe stricture in my pancreatic duct.  It took 3 surgerys to take care of it, but I'm doing much better.

I am not trying to "push" a pancreatic problem on you, but PLEASE don't let the doctors overlook this possibility.  Even if they said in surgery that the pancreas looks good, I would ask for a simple blood test of a amylase and lipase test to determine levels.

Sandy

[amyj]

Thank you sooo much!  I am going to have him ask the doctor about it.  Its nice to have advice from others.  His doctor is wonderful but sometimes sends him home and questions are left unanswered.

[TechChick]

I'm kinda curious, as I mentioned from my above post, my GI said I had pancreatic duct cysts. I'm really kinda freaked out my them. Before I have an attack(what I call them) I get pale floating greasy looking stool (sorry about being gross)and then the pain comes. When I do get pain its comes along with vomiting bile. I'm in my 20's, had my gallbladder taken out 2 years ago.

My main concern is what are they going to do about the cysts, when he did my first ERCP 2 months ago, de dilated a stricture in the duct to, plus cut the sphincter muscle to let the bile drain. I go back to him in 3 months for repeat ERCP. I'm at a loss here.

Thanks,

Heather

[mas77]

Hi Heather - I've been going through 'pancreas-related pain' since August (began a week before my 28th birthday).
Between seeing doctor after clueless doctor, I've taken to the Net, medical journals, and whatever else I can get my hands on to learn about pancreatic conditions. One thing I've found is that pancreatic cysts (often referred to as 'psuedocysts', I believe) are commonly associated with pancreatitis and are generally not a cause for alarm in and of themselves.  
I've really been amazed at the volume of posts at this site, many of them from 20-30 year olds, asking questions related to pancreatitis and vague pancreas-related problems. What's more disturbing are the difficulties several of us are having in procuring any kind of decent care, based largely on age, it sounds like. Totally sucks.
Just curious - is anyone here who's suffering from pancreas-related pain a vegetarian? I am, and eat a lot of soy products (gardenburgers and the like); I mention this as I've been reading lately about how eating a large amount of soy can actually cause (or at least worsen pre-existing) pancreatic problems, specifically acting as a trypsin (sp?) inhibitor (a pancreatic enzyme which assists in the breaking down of proteins).
I'm curious if anyone else knows anything about this? I'm REALLY hoping it's crazy propaganda being circulated by the meat industry or something :)
Take care - M

[TechChick]

It took 2 years for my GP to take me seriously. When my GP finally took me seriously, I was haveing a full blown attack, vomiting bile and horrible pain. She beleived me then. I immediately got an appointment to a GI, who then narrowed my problems down. The first thing he told me was that it sounded like liver or pancreas problems. He did an endoscopy, ultrasound then an ERCP, this all happned in a 4 month period. I go back again in March for another ERCP.

It sounds like more young people are having these types of problems, I just wish that doctors would take us more seriously, and not push it off as IBS or what ever floats their boat.

As for being a veggertarian, I love gardenburgers, but I also eat chicken, and very little beef. As for now, I'm trying to learn a little more about my problem, the doctor didn't say what kinda cysts they were yet, since they are in the duct, I worry about more obstructions. Thanks for the reply, it helped greatly

Heather

[mas77]

That's pretty scary that it took the doctors 2 years to take you seriously. I can't even imagine how frustrating that is. I feel somewhat fortunate in that my GI doc at least acknowledges that the pancreas sounds like the culprit, but rather than doing any further testing (so far, all I've had is a spiral CT months ago), he's trying several different prescriptions on me. Both doctors were completely dismissive of anything 'growing inside of me', cancer or god knows what else, which honestly hasn't comforted me much, as their opinions are based on one CT scan and amylase/lipase blood tests, and the fact I haven't turned bright yellow yet. I don't think it's unreasonable for me to want them to try just a little harder to rule out any serious problems, since anyone who's spent any time investigating this knows that CT scans miss pancreatic problems all the time, and normal blood test results aren't necessarily indicative of a problem-free pancreas. So, I'm gonna make the drive to another GI at Johns Hopkins in two weeks, hopefully one who will consent to doing some further investigating.  
Yeah, it is really weird how many younger people are showing up on this and other boards with what at least sound like pancreas-related disorders. Anyway, I wish you the best of luck in getting proper care and some answers regarding your cysts!
take care - M

[toBethany]

I passed a gallstone.  Now, I have pancreatitis. I have had both acute with a HUGE psuedocyst, now chronic, diabetes, as I am left only with about 25% of my pancreas... the earlier you have GOOD treatment, the better off you will be...

Do get checked out by a gastroenterologist.  It does sound like you have a problem with the pancreas, just what, I don't know.

When you check for doctors, find out how specialized they are with the pancreas.  

Do check out what the blood levels are for Amylase & Lipase. They are 2 enzymes the pancreas secretes.

Bethany

[TechChick]

My GI specializes in Hepatology/Pancreatobiliary Disease and Nutrition Support. I have not had any complaints about him so far. I'm just glad that he's not wasting anytime to find out whats wrong with me.

This probably sounds dumb, but I'm going to ask anyway. I went to a Christmas party this past Friday and I drank alcohol, I started hurting about 40 mins after that, and I hurt for 3 days. I normally don't drink, but being the holidays I drank a little. My doctor hasn't said anything about alcohol yet, nor has he gave me any dietairy advice yet. This is all new to me.

Thanks

Heather

[busybee527]

A related discussion, Change in bowel habits was started.