Common problems?

  I am 35 yrs. old and I have Idio. Chr. Pancreatitis, Gastroparesis, and IBS.  My blood counts are very seriously out of
  wack.  My pancreatitis sometimes shows itself in blood work and sometimes does not.  I have recently had a positive test for Lupus.
  How common is it for these things to occur together and do you have any suggestions based on your past cases?  I am grasping at straws!
  I rarely eat and when I do it is to keep away from TPN.. I am getting close to allowing them to use TPN and would like any suggestions I can get.  
  I do understand these risks my LIVER has recently also been noted as functioning improperly.  I guess it might be from the pain meds.
  I need to take to eat or function at all. ANY AND ALL INFORMATION you can supply me with will help at this point!  I have been told before that tube feedings were the only
  way for me to live.  I have avoided that for two years with only 6 months of TPN when the Pancreas went crazy!  My enzymes elevated with water and stayed
  up in the 1000's for several months.  They are down now but the pain and other symptoms live on!!! I have heard that there may be a link to other young women getting so "lucky"
  to have all these problems at once.  Is this true and is there any possible places to source for a cause?
__________________
Dear Beth,
Lupus is a cause of pancreatitis.  The vasculitis of lupus causes local ischemia of the pancreas which initiates the inflammation.  Although most cases of lupus-assocuated pancreatitis are acute episodes, there have been two reported cases of chronic pancreatitis.  It is important to remember that there can be other causes for the pancreatitis.  For example, if you are receiving treatment for the lupus, the medications may be causing the pancreatitis. Other vasculitides, gall stones etc must be excluded.  If your problem is lupus-induced pancreatitis, you should ask your doctor about trials with immunosuppressive agents.
Abdominal inflammation can also be associated with impaired motility which can include gastroparesis i.e. the pancreatitis can cause gastroparesis.  Again, it is necessary to rule out other causes of gastropatresis e.g. thyroid or renal disease.
I can not provide any suggestions regarding nutrition.  It is preferable to use the gut for nutrition.  this means that enteral feedings are better than TPN.  If, however, you can not eat a sufficient quantity, then you will need TPN.  The specific types of enteral nutrition to try would be determined by a series of trials.
This information is presented for educational purposes. You should always consult your personal physician for specific medical questions.
If you wish a second opinion at the Henry Ford health system, you may wish to contact Dr. Muszkat, our expert in nutritional problems.  You can arrange an appointment with him by calling the Physician Referral Line at [phone]
HFHSM.D.-rf
*keywords: lupus, pancreatitis, gastroparesis
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