Is it Panreatitis?

I am 37. I was having upset stomach and slight pains in the upper left abdoment so I went to so a GP. because I have a history of hard drinking even though I have severely cut back he checked lipase and amylase. They both came back slightly elevated. lipase was 75 out of a high 59 range Amylase was also marginal.  He said he thought it was pancreatitis. I had a CT scan that was normal. Later levels came back down to normal ranges.  I quit drinking and about 4 months later I had problems again. The pains became quick, sharp  pains in upper left abdomen actually in the lower rib cage area. Bothersome but nothing major.  Levels were checked and again they were a little high. Later I went to a GE and levels were re-checked but they were normal but I was still having the pains.  We did an MRI of the pancreas and I was told there was no sign of Pancreatic disease.
He also said that he beleives that my levels run a little high of what is considered normal and I have to agree it doesn't sound like Acute pancreatitis. I do not feel sick. The pain isn't severe. Amylase and Lipase levels are never very high. Stools are normal as far as I could see (sometimes they float sometimes not).
I am guessing that if it was Chronic pancreatitis and the pain and my levels were not getting very high alot of damage would have been done already to the pancreas and the CT and MRI would show problems.
After a night of mod. drinking the pain is back but different, its below the rib cage(not under) still on left. Food sometimes agravates it, Beer doesn't bother it.
Endosopy came back normal as well

[Sarah23]

The pain that I am experiencing is similar, it also bothers me if I consume any alcohol...I'm only 25 though.  It isn't fun not having cocktails with my buddies so sometimes I do anyway but then the pain is horrific for me.  No doctors can figure out what is wrong either.  I have had blood tests and stool tests...I can't tell if food irritates it, but I do know alcohol causes the greatest pain....Good Luck:) I'll let you know if anything comes of my tests.

[ggart]

Thanks sarah.

Actually alchohol doesn't bother it. I guess I wasn't clear.

I guess what I am loooking for someone to answer is are slightly elevate amylase and Lipase levels okay?

and are negative MRI and CT scans enough to beleive that its not pancreatitis?

I'm sorry that you are having troubles.
HOw soon after you drink does it start hurting?
How long does it take to go away?
What are your lipase and amylase.
What tests have been done.


Guy

[mas77]

Hi,
As I've learned, even the best diagnostic imaging techniques (spiral CT, MRI, PET) are prone to miss pancreatic problems (be they calcifications, enlargements, psuedocysts, or even neoplasms) due to how 'hidden' the organ is in the body. Second, if you've been experiencing any sort of pancreatic problems for some time, your lipase/amylase isn't necessarily going to indicate a problem. Often times, there's either slight elevation, or none whatsoever.
I've been having the same upper left quadrant pain, occasional floating stools, sporadic lower back/flank pain, and fatigue for a few months. I'm 28, healthy, never a big drinker and haven't had a drink since the symptoms started. I've been through three radically different diagnoses ('back strain', 'kidney stones', 'IBS') from three different doctors, none terribly interested in pursuing the possibility of a pancreas-related problem in a healthy guy under 30. Finally got one to provide a spiral CT, came back clean, the symptoms remain. GI thinks it's pancreas but had rather give me more prescriptions than to do an MRCP or ERCP. It's just one of those things that doctors don't generally think of in young people.
I'm going to a second GI for another opinion, and hopefully a definitive diagnosis. Hopefully you guys will be able to get one too - just don't let the doctors off easy. And again, you may really want to strongly consider cutting out the drinking (as much as this may suck) since it's only damaging your pancreas more and worsenining whatever is going on.
Maybe we should start an email support for people with undefined, undiagnosed pancreas problems or somethin' :)
it's definitely good to know there's others out there.
take care - M

[Marlasinger3]

You think its hard being 30 and not drinking? Try being 20 and in college.  For 6 months I was told all my pain was in my head, then finally I found the right test to get results.  So they took my gallbladder out.  Now a month later all the same symptoms are back.  I can't drink alcohol, coffee, even oj. The drs refuse to believe its pancreatitis due to my age and won't even give me the amylase ad lipase tests again (I had them before my surgery, although they never told me whether they were elevated.  It's amazing how many people on here have the same unsolved problems.  Ask any dr and they'll say that never happens.  I wish you guys luck, tell me if ya get anywhere!
Brit

[groundhog]

That's funny. I have right upper abdominal pains and they're going to do a pancreas CT scan tommorow on me. I've had other tests such as the scope down the stomach and the radiation-liver-gall bladder test, plus some parasite, blood and stool tests. Maybe they're running out of ideas?

[Nanny]

Okay, I DO have chronic pancreatitis.  It was diagnosed a year and a half ago, and it was caused by an acute pancreatitis attack that doctors believe was alcohol related.  After that attack my condition became chronic.

Back in those days when I drank,  it did not hurt when I drank, but then 24-48 hours later a nagging pain would start.   It took several months before I could see any correlation between the drinking and the pain, I just thought it was just food-related discomfort.  My amylase and lipase levels were only moderately elevated, and now seldom show any elevation at all.  High fat meals would trigger pain that would start within an hour of eating.  This did not happen all the time.

I've learned a lot since those days because when I developed chronic pancreatitis I developed a disease that has taken total control over my body and my life, and nothing is the same as it was before.  I've learned that each time alcohol was consumed it did more and more damage to the pancreas which cannot be corrected or healed.  If I'd known the damage that was being caused I would have stopped, but I didn't have any clue as to what was happening.  I belong to a chronic pancreatitis support group and will tell you that many of our members are young, in their early 20's and early 30's, some are even children.  There is no "right" age for the onset of this disease.  Also, contrary to public belief, most of the members of this support group are NOT people who consumed alcohol!  Many are people who were originally misdiagnosed as having IBS, until they found doctors who would look further when their problems only got worse.

Unfortunately CT-scans, x-rays, ultrasounds and MRI's sometimes do not detect pancreatic problems as mas77 said.  They are USUALLY good diagnostic procedures, but not always.  Some technicians are better than others.  Because of the obscured location of the pancreas, it can be very difficult to see clearly.  An ERCP is supposed to be the best diagnostic procedure to check pancreatic problems, yet this is a highly technical procedure that should only be done by the most experienced professional.  And it's one procedure that is often not done because of the incidences of it causing yet another pancreatitis attack.

So I would suggest that if you even suspect chronic pancreatitis, DO NOT DRINK, start eating a strict low fat diet, and keep looking for a gastroenterology specialist that will take your symptoms (pain, nausea, floating stools, discomfort after eating, fatigue, etc.) seriously and keep searching for the answer.  Once a specialist can properly identify your condition, you can get treatment that will bring you some relief.

Good luck!

[Bailey123]

Just curious how you were eventually diagnosed. My experience sounds a lot like yours. My dr. has diagnosed me with IBS, but I am not convinced this is the problem. I have had CT scans, blood test and everything comes back normal. How do they know what's the problem if everything looks fine?

[Suziepie]

The floating part of your stools is possible malabsorption. You can look up the symptoms to these:

Malabsorption can affect growth and development or can lead to specific illnesses. Some of the causes of malabsorption include:

cystic fibrosis (the number one cause in the U.S.)
lactose intolerance
celiac disease (gluten-induced-enteropathy, sprue)
Whipple disease
Shwachman-Diamond syndrome
bovine lactalbumin intolerance (cow's milk protein)
soy milk protein intolerance
acrodermatitis enteropathica causing Zinc malabsorption
biliary atresia
abetalipoproteinemia
Vitamin B-12 malabsorption may be due to:
Diphyllobothrium latum infestation
juvenile pernicious anemia
parasites:
Giardia lamblia
Strongyloides stercoralis (threadworm)
Necator americanus (hookworm)

You can also look up Malabsorption on WWW.merck.com

[Sarah23]

I haven't been drinking lately...3 days...that's sounds bad. I still have some pain, but the truth is I do have a lot of passed trama and abuse that happened to me...I don't even want to tell my GI because I'm afraid she'll be convinced that my pain is just stress.  So I am also seeing a natural healer, she is amazing so far.  The first visit was painful because she adjusted my ribs and did some presher points etc.  But the pain has really lifted.  Still I continually feel tender on my left ribs and sometimes as bad as someone punching me.  No oil in stool since the massage therapy:)  We'll I guess we'll see.  My GI is doing a test for fatty substance in the stool?  I guess I will just wait.  But at least I get to wait with a massage:)

[Nanny]

I was diagnosed by having an acute pancreatitis attack.  Within a matter of hours, a rock-hard abdominal mass was visible in the left of my abdomen, just up from the navel.  Ultrasounds and a CT-scan showed that the mass was caused my multiple pseudocysts, about the size of a grapefruit, which caused my pancreas to be enlarged and inflamed.  CT-scans showed the pseudocysts, a dilated pancreatic duct and calcification and scarring at the head of the pancreas.  The condition became diagnosed as chronic with two weeks, yet the specialists felt that the chronic condition had been present for some time before the hospitalized acute attack.  I also suffered from drastic weight loss and frequent fatigue and nausea.

Your case sounds more difficult to pinpoint since your bloodwork and scans appear normal.  But as I said, I know many who also had clear scans and normal bloodwork that did eventually end up with the CP diagnosis.  Some of them had to have ERCP's to confirm this, and for some it was discovered by EUS procedures.

[bikerblue]

I also believe I have symptoms of pancreatitis and my doctors think it is IBS.  I have the left sided upper abdominal pain, pain radiating to the back and diarrhea almost everytime after I eat.  I am getting so frustrated as it just seems to be getting worse and worse but no one seems to be listening to me.  I also don't the classic symptoms as I am 30 years old, in good physical shape, not a drinker and so don't even want to check me for it other than running an amylase and lipase which have returned normal.  I otherwise have had five attacks of extremely severe pain over the last year in which I could hardly move and thought I was literally dying.

Does anyone else have the symptoms of diarrhea???  I am just so frustrated with the whole process and don't know where to turn anymore but I truly believe this is what is going on!!!!!

[Suziepie]

I understand your frustration completely.  It's amazing how the patient's symptoms become invisible to the doctor.  It sounds like you need to dump your MD and find a real doctor.  It makes a huge difference when the doctor starts know's how to help you and gets you better.  It seems as though there are so many bad doctors.  If you have a valid complaint you can write to the ethics committee with the medical board.  I think patients need to take the necessary steps to advise the medical board when you have a problem with a doctor.  They need to know this. If more people did this, the doctors wouldn't be able to get away with NOT doing their job and still getting paid for it.

[pamo]

It's amazing to read all the stories here and how similar they are to my husband's.  He has finally been diagnosed with chronic pancreatitis.  He had acute attacks in the past and even though he quit drinking 1.5 years ago, he started getting sick again this last march.  He's been hospitalized three times since that date when the attacks got really bad and has been in constant pain for over 8 months.  

I guess I have a question directed towards Nanny.  After you were diagnosed, what options were you given?  My husband had two pseudocysts, 1 went away and the other is too small to be removed according to the GI.  The common bile duct is 'somewhat' enlarged but they claim that is not something that needs to be dealt with unless it gets worse.  He also has 'sludge' in his gall bladder but they don't think that is contributing to the excruciating pain.  Their only solution is to keep taking medications and hope the pancreas 'burns itself out' after a while.  He's lost over 40 pounds (wasn't heavy to begin with) and CP has taken over his life too.  He takes pancreatic enzymes, zantac, anti-nasea meds and pain meds daily.  Were you given any more help than pills?

[debb]

Pancreatitis is a thought. Have you tried drinking Maalox to see if that eases your pain (to determine if it is ulcer-related)?

[toBethany]

Pancreatitis - inflamation (inflammation) of the pancreas, hurts like H EEE double hockey sticks.  if you don't have it, you don't want it. If you have it, you don't want it.

Me? Acute and Chronic, then I have even had acute attacks of the Chronic Pancreatitis...
CT scans usually pick up pancreas inflamation (inflammation) as long as the inflamation (inflammation) is greater than 1 cm.  

If you drink alcohol, it IS possible to develop pancreatitis after only a short period.  I have heard recently that if there is a slight deformity in the pancreatic duct where it merges with the common bile duct, is why folks who drink develop the disease.  

It is MY SPECULATION that if you did not have your enzyme levels checked within the first 48 hours of the onset of the pain, your enzyme levels will not be at there peak.  If your levels were checked a week or more after the first pain, then I would make sure you have a "standing order for blood draw" to be able to walk into the blood lab on the onset of the pain, so that your doctor can check it out.  If you cannot obtain that standing order, then go to the ER and they will draw blood and check the levels.  

If you do drink, stop!  Remember that with each and every attack, there will be damage... so prevent it!

Further, the main foods that will aggrivate the symptoms are FATS!! The next is proteins.  Amylase and Lipase are the enzymes that digest and break down the fats, and somewhat on the proteins.

IF you have CHRONIC pancreatitis, the chances of your enzymes being elevated are slim.  You can confirm this by searching various web sites, the University of Liverpool, verifies this claim.  I went through 2 GI docs and lots of ER visits before finding my current GI.  He finished my sentence when I stated that my enzyme levels have not.... "have not been elevated, nor will they be elevated if you have Chronic Pancreatitis."  He's a keeper.  If you are in the Dallas/Ft Worth area, I you can email me for his name, address and phone number, he is at Baylor Medical Center.


Chronic Pancreatitis does NOT show up on CT scans.

I wish you enough.... of whatever it takes that you can live a pain free life!

Bethany (***@****)

[hrtbtds]

I have had pancreatits 3x this yr.since June. Had my gallbladder taken out at the 1st attack, since it wasn't working good. Had an ERCP a week later due to stii having pain. They cleaned out sludge in my bile duct. While in hosp. i had a blood clot form and busrt near my duct. Dr. said i was the 2nd case in 17 yrs. Anyway, still kept having pain, until in Nov. my GI DR. sent me to a specialist in Charleston, SC, to have a procedure doen where they checked my pressure in a pancreatic duct. It was completely closed off. They cut it open, cleaned it out , and put in a temporary stent. Stent was removed 3 weeks ago. Was doing wonderful, and now for the past week, i've been hjaving pain again. Amylase, and lipase were normal after 5 days of hurting. But the pain is getting worse, with alot of belching, and sewlling in my upper abdomen. belching does not releive the pain. Does it sound like i have pancreatitis again? If i do, after about 2 more weeks of pain, i say that they will put me in the hosp. on strict IV fluids, and NPO(nothing by mouth). the pain is not as bad as it used to be, but i'm afraid that it's heading that way. Am i scared for nothing? Or could it be trying to be pancreatitis again??.. ***@****

[hrtbtds]

I forgot to mention that i am a 39/f who doesn't drink, and i'm sorry for my bad spelling. I type to fast!!!!