Chronic Pancreatitis?

[Milo99]

Male: 42
Long History of Binge Drinking.
about 6 years ago began getting severe diarrhea and headaches after prolonged periods of sitting. This lasts for several days. I avoid sitting at all costs now. I work on the computer and even do that standing up now.

9 months ago after a 6 hour car ride (again with the sitting)  I got severe diarrhea but this was followed by chronic abdominal pain which to this day has not subsided. With my history Gi Doc suspected chronic pancreatitis but...

ultrasound, bloodwork for Amalyse lipase, CT with contrast, then finally an MRCP were all clear. 4 years ago I had an upper GI (where they put the camera down your throat not sure what it is called). Looked normal except doctor noted that I had red splotches on my stomach. Not open wounds like an ulcer just like something was irritating my stomach. Had the procedure done again in Feb/09 and same finding. Also had colonoscopy I.5  years ago (normal).

In the last 3 months I have lost 22 pounds and have begun noticing oil in my stool. So chronic pancreatitis confirmed and just start taking digestive enzymes right?... Not so fast. Doctor prescribed Cotazym-ECS 8 and I have tried all different types of dosing. I have also experimented with 2 over the counter enzymes from the drug store. These actually make my condition way worse, cause severe abdominal pain, diarrhea and the oil in my stool increases 2 fold. I cannot even take simple vitamins without getting severe abdominal pain.

What am I to do now? I already have another appointment with my doctor. Are there other options for pancreatic enzyme replacement? When I sit it feels like the blood supply or something (like when your foot goes to sleep)  to my abdomen is being cut off and this is causing more and more damage. What is being missed here? Not sure  how much more weight I can lose.

Should point out that I have completely quit alcohol for 5 months now.

  

[Kevin Pho, MD]

I agree with the workup thus far.  If the diagnosis continues to be elusive, you can consider a second GI opinion.

Causes other than pancreatitis can be considered.  Malabsorption and celiac disease can also cause mucous-based and oily stools.  Sending the stool off for such analysis, along with obtaining blood tests to exclude celiac disease can be discussed with your GI physician.

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.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd

[Milo99]

another unusual symptom for Chronic Pancreatitis is that eating actually eases my pain for hours after I eat. When my pain is at it's worse I usually look for something to eat.

[aar1151]

Has your gstro doctor looked at a twisted intestine or colon?  aar1151

[Milo99]

Well I had a colonoscopy about a year ago. My current doctor is going to send me for a test for my small intestine. I am not sure what this entails but he said i would be taking a capsule of some sort then they take pictures. Have you had this done? I m about out of tests to do. Fortunately I live in Canada and all of our health care is covered or I would be in the poor house by now ;-) Your explanation makes alot of sense to me. I have yet to find another person with this problem. Imagine standing up the entire time you are awake it's not fun.

[Ileana918]

My father, 67 is having a similar situation going on right now. He is a heavy drinker and staring having abdominal pain which radiated to the back with nausea and diarrhea. He has lost a total of about 20 pounds which really worries us. He was admitted to the hospital where an endoscopy, colonscopy, CT, MRI and ERCP and US where done all we normal. He told due to his history chronic pancreatitis was possible and was given enzyme supllemnts which do not help the pain. Ive read chronic pancreatitis might not show up in these imaging tests but the severe weight loss and pain are continuing. Please keep me updated on ure condition since it sounds quite similar to my dads.