Chronic Pancreatitis / Elevated Lipase

[steve]

My wife has been battling pancreatitis for approximately the past 2 years.  After our daughter was born, she had cholecystitis with a subsequent laparascopic cholecystectomy.  She experienced no problems for the first few months after the lap chole., but has since been experiencing recurring bouts of pancreatitis, for which she had 3 ERCP's with a sphincterotomy on her third one.  She did well for approx. 6 months when she again started with the mid-epigastric pain radiating to her back.  She was eventually referred to a neighborng city where she had her fourth ERCP by a pancreatic specialist.  (We refer to him as Dr. Pancreas).

The procedure went well, with another sphincterotomy performed and pancreatic stent placement in her duct.  The stent was recently removed without problems.  However, my wife continues to have mid epigastric pain, without the radiating pain to the back.  I aksed the GI doc to take a closer look at her stomach during the stent removal, and he also diagnosed gastritis, for which he prescribed prevacid.

The pain has continued despite taking the prevacid for almost a week now since the stent was removed.  The pain does get better sometimes after eating.  However, during the stent removal, her labs were also drawn and her Lipase remains elevated at 292.  (Her lipase has been elevated now for the past few blood draws, but at one time had been normal)

The question is... What could be the significance of the elevated lipase even after the stent had been in place and "done it's job"?  I feel that the GI doc is doing a thorough job and that the gastritis may be to blame for the pain, but the elevated lipase still has us wondering and worrying that there still may be something going on with the pancreas.

Are there any suggestions??

Thanks for any help.

Steve  RN  BSN

[HFHSm.D.-Gastro-rf]

Sorry for the delay in responding to your question.  Are the pancreatic enzyme tests still elevated.  Manipulation of the pancreatic duct can cause transient elevations of the tests without indicating longterm problems.  If your wife is having pain, it is appropriate to search for other possible causes for the symptom.  IF the cause is persistent pancreatitis, therapeutic options include a trial of pancreatic enzymes or treatment with adequate analgesics to control the symptoms.  

This ionformation is presented for educational purposes only.  ASk specific questions to your personal physician.