Could something besides gallstones cause panreatitus?

[cwitt]

On Sat March 2, I woke up with a stomach ache (The night before I had indulged in a sausage hot link). By noon on Sat, I had chills and an unbleievable pain in my upper right abdomen (I thought I had the flu). Could not eat and everytime I did, the pain would get worse. On Mon Dr thought it was flu. Finally Tuesday at 4pm I had Untrasound of Gallbladder-nothing showed up. By 7 pm I was at emergency room- could not take pain any more. They put me on IV for dehydration & gave me pain killers. They ran blood tests-my amylase was 2100 & my Lypase was elevated (Pancreatitus (pancreatitis)). All other blood work was good. By Wed eve I was feeling better and needed no pain killers. Thurs they did CT scan & Hyda scan (which the dye made me sick)& Ultrasound. They showed nothing but Ultrasound showed slight inflamation (inflammation) in the Gallbladder & Pancreas. The Dr assumes this was due to a Gall Stone I may have passed & wants me to have an ERCP after things settle down. He also said, if you get one stone, you will get more so I should consider removing Gallbladder. All of this scares the heck out of me. I am a 33 yr old female, 5'8" & 135 lbs, in good shape & active. My diet is good, I did indulge once in a while but have always ate well. I wonder if the sausage I ate the night before triggered all this. I was released on Friday but still have this bloated feeling in my upper abdomen when I eat but am feeling better other than that. Amylace level has dropped. They want to do ERCP to see if a stone is blocking bile duct? I am scared to do ERCP, any other ideas on what this could be? Thank you.

--------------------------------------------------------------------------------

[pikamom]

My sister-in-law had pancreatitis with her gallstones and had her gallbladder out with a very simple "band-aide" surgery. The pancreatitis is more serious than gallstones so you should follow your doctors advice to have your gallbladder out. Another cause of pancreatitis is alcohol.

[imkindly]

You asked about the sausage triggering all of this, so I thought I'd give you a comment---
(fatty foods are something you should stay away from!)

My husband has "sludge" in his gallbladder, and once in a while gets a pancreatitis attack. Anything fatty can bring it on.

[cwitt]

What exactly is sludge in the gallbladder?  I am reluctant to just doing and ECRP and/or remove the gallbladder when they have not seen a sign of a stone thus far and are not even sure if thats the problem.  (you hear of so many people where they remove the gallbladder and they still have problems or stones & the ECRP can cause a Pacreatitus attack- so if I am not in pain now, why risk causing an attack).  I am interested in other things this could be.  They asked if I had ulcers but never looked into it any furhther.  I am interested more about what the sludge is?  Thank you.

[imkindly]

Hi cwitt
I was going to just tell you that "sludge" was little particles of ****, not big enough to be called stones. But that sounded terrible and not very accurate. lol
So I found some sites that explain it better.
Take a look at

http://www.gutdoc.com/gallstones.html
it says:
Gallstones vary in size. They may be as small as tiny specks, or as large as a small ball. The vast majority measure less than 20 mm, about 1 inch, across. Over time gallstones may grow in size and/or numbers. However, many gallstones remain the same size for years.
Gallbladder sludge occurs when multiple crystals of cholesterol and bilirubin pigments accumulate within the gallbladder but do not fuse together to form a gallstone. Gallbladder sludge typically occurs with fasting and resolves spontaneously. In some, but not all persons, gallbladder sludge can develop into gallstones. In the majority of cases, gallbladder sludge is asymptomatic. However, sludge may cause symptoms identical to those attributed to gallstones.

and
http://www.medterms.com/script/main/Art.asp?li=MNI&ArticleKey=8402
calls it "biliary sludge"

and
http://papa.essortment.com/symptomsgallbla_refb.htm
has some advice on foods to avoid

Hope this helps

[pikamom]

Yes, fatty foods bother a bad gallbladder. Another confirmation that your gallbladder is the culprit of your problem. Sure there could be complications of left behind stones, but that's pretty rare. Most of the time if they "suck" the gallbladder out through tiny holes, it's outpatient surgery with a very short recovery, I think around a week compared to 6 weeks for the old open surgery. They could do an ultrasound after your surgery to make sure no stone was left.

[cwitt]

Thank you so much for the info.  I have decided at this point to wait it out and get a second opinion.  Even the regular Dr at the hospital did not agree with the GI Dr to just remove the gallbladder when we have not found a stone at this point.  Sludge would make sense.  I am comfortable and no pain.  My biggest concern is the feeling full/bloated feeling after I eat.  I have been on a strict diet (low fat-very healthy and taking herbs) and still eating smaller meals.  I have not talked to anyone who has had this happen before, to find out if they felt like this while they were still healing up.  My family keeps trying to remind me that my pancreas went through a lot and needs to heal & my stomach probably shrunk due to not eating all those days. I have been out of the hospital a week tonight, maybe I expected to feel better sooner.  When your husband had his Pancreatitus (pancreatitis) attacks did he feel full when he ate (while he was healing after the attack)?  I appreciate any info- if I knew this was normal I would not worry so much.  You can email me at ***@**** if you would like.
Thank you again.

[sugee]

Please, maybe I can give you some advice concerning your pancreaitis and you won'y have to go thru the samething I did. About eighy years ago I started having severe abdominal pain and after several hours of this pain and vomiting IMy DH took me to the hospital emergency room. At the time they were very busy and it had been eight hours before I finally told the desk clerk that I was going to sit right there and die and they weren't going to do anything about it! All of a sudden several nurses fook me in the back and the doctor started giving me pain meds. thru the iv and just a few minutes later I had three doctors with me,as I saw the third one come in I reconized him as he was a surgeon that my family used on accasion as needed.Well, for three days I new nothing since the doctor was keeping me medicated. On that third night my gastro specialist walked in and woke me up and told me he needed to talk to me. I was running a high fever and my blood pressure was sky high. He told me I had pancreaitis and he was going to have to run some tests on me which one was the ERCP. Well I finally started losing the fever and at midnight the next night he did the ERCP. He put me to sleep to do it so I didn't feel a thing. All together he did four in four days because he couldn't get into my pancreas he said it because the pressure in it was really high.He got in to it the fourth time but couldn't get out the other side.For about six months I lived in the hospital as I couldn't eat and the pain was so intense.I left that hospital and went to a well known hospital in Houston(at the medical their) to a doctor that promised me that he would do my surgeries as he cut one spinter and a week later he cut the other one. Of coures both surgeries caused my to go into an attack again and I was having day surgeries so both put me back in the hospital.Aweek later A surgeon came in on Easter Sunday and removed my gallbladder. I was told that I wouldn't have anymore attacks after that. Well, over the next year I kept having abdominal pain but the doctor kept running amylaes(sp)/on me and kept telling me I wasn"t having an attack. My DH and I moved to a small town with out the rescourses we did have. Then all of a sudden it severe pain that I once felt was back.Now I had to be transfered to a larger town by ambulance to see a gastro specialist. As things stand now is that I could have a pancreas transplant or I could have my pancreas removed. Two specia;ist can't get together and devide and I think at the time (now) I am doing okay and if I only have to be in the hospital more than 12-15 times a tear then I'll check my options and make up my mind.I take very strong pain meds and try to wait it out at home. If I can't I call my Family doctor and he contacts at least one of my specialist to see if he wants something special testing.I have never drank so that's out and my galbladder had alot of scaring on it so who knows? Please listen to me if I had have had my gallbladder removed when I was having about two attacks a year with it ( family doctor kelp telling me it was just an infection and it just needed to be treated with antibodics)so maybe that was what happened to my pancreas,and maybe we inherited some bad gene or something. Have your gallbladder removed don't take any chances for you just might be able to stop your attacks. God Bless you and Keep YOU from having these attacks. My thoughts and prayers are with you. By the way my Mother had her gallbladder removed the year before me and she calls it drive thru surgery. It isn't bad at all doesn't hurt near as bad as your attacks.Keep us informed about you. Sugee

[tbaird]

I have been reading everyone's stories and can definitely relate to the symptoms everyone is having.  I myself have just started experiencing the same sort of symptoms you all have mentioned.  And like you all, my doctors, after having an ultrasound done on my gallbladder, said that I have sludge in my gallbladder.  And that I would probably need my gallbladder out because once I have sludge, the sludge would form stones and then ultimately have to remove the gallbladder to avoid infection.  And they all said oh you might as well remove it, you really don't need your gallbladder anyway.  But it is funny, how of all the people I know that have had their gallbladder out, they still have problems and are pretty miserable when they might have eaten the wrong things or better yet the can 't eat at certain times, etc...But since I'm diabetic, my doctor didn't think that the amount of sludge reported from the ultrasound was enough to cause me all that pain so he wants to do a Hyda scan and send me to a GI doctor and in the meantime he gave me pain meds and nexium.  Mysteriously, my pain after a week of feeling like a dog and ultimately putting me in major pain, the pain has now gone away, my bloating is still there abit, my energy level is starting to pick up again, and for the most part, I am back to my old self again.  I can't eat alot at one time but that's probably a good thing.  I am not sure of what the Hyda scan will do so I would like to know the objectives of the scan if anyone out there has had one done?  However, don't you think that it is so strange that all the doctors say "oh you don't need your gallbladder anyway, your liver really does all the work so just go ahead and remove", you'll be better."  That comment did not set well with me.  My reaction, was well, if my liver does all the work anyway then shouldn't we look into my liver and see why my liver might not be functioning properly before we race to the operating room!  Since I felt like something did not sound logical with what the doctors had said, I decided to do some research and found out a few things.  I wonder if anyone out there has heard of the things I am about to list and if so can you respond.  For the most part in my research, if the gallbladder is starting to have problems then it is usually due to your liver being congested and causing it not to function properly and therefore can't rid itself of the bile that it produces.  And this in affect determines how the gallbladder functions.  So why wouldn't the doctors look at the liver to make sure it was working properly???  I came across another option before surgery, called a gallbladder cleansing and flush and a liver flush.  From what I am reading, this flush cleansing your system and rids the liver and gallbladder of all the bad toxins, including stones, and flushes everything out so that your liver and gallbladder can start working again.  From the responses, everyone feels 100% better afterwards if not better.  Has anyone outthere heard about this?  There are chinese herbs that one can take on a regular basis to keep your system clean, like Chinese bitters, Gold Coin Grass, etc.. Has anyone heard of these or taken these...?

[cwitt]

Hi- It sounds like we agree on it.  I feel the same way- if they have not found sludge or stones and I am doing better than why risk the complications of an ECRP or gallbladder removal.  If they found something or I continue to have attacks then yes, check my options.  I also believe its diet & I have totally changed that.  I have heard of too many people getting their gallbaldders out and still having so many problems???  I am also doing the cleanses and taking herbs to keep the enzymes working.  The bloating & full feeling is going away.  I actually ate a pretty good sized dinner last night (very low fat- veggies etc.) & felt alright just kind of gassy.  I take walks in the evening after dinner.  I am active- I ride horses etc,. and can't wait to get my energy back to normal but I feel better every day and attribute that to the diet & herbs.  Would love to visit with you more.  You can email me at ***@****
Thank you for writing and good luck.

[tbaird]

Thanks, What kind of herbs are you taking?  I haven't done the cleanses yet...I have read that you have to eat whole foods for one day prior, is that so?  Do you feel better after doing the cleanses???my email is:***@****

[Olliver]

Dear CWITT,
The most common cause of acute pancreatitis is gallpassage (blockage) or alcohol related (together they constitute 75% of the cases). The blockage isn't allways visible on ultrasound, as the blockage can be at the exact point where the pancreatic- and gallpassage duct unite with the small intestine (papilla vateri). In this case the blockage can only be visualised by ERCP. As no stones were visible on your ultrasound, it therefore seems like a reasonable next step to do an ERCP.
In 15-20% of the cases, the cause is never found (ideopatic pancreatitis). so your gallbladder could be completely innocent, I think you have good instincts, not just to accept to have it taken out!
Rare causes of pancreatitis include: Hyperlipoproteinemia, hypercalcemia (which they would have found in your bloodtests), pancreatictumors and pancreas structural abnormalities like pancrees divisum and pancreas annulare(which they would have seen on the ultrasound), sphincter Oddi dysfunction, pancreas, traumas (history), hypoperfusion due to i.e. vasculitis (SLE, polyarteriitis nodosa)(bloodtests for screening) infections: hepatitis, coxsackievirus (bloodtests), hereditary pancreatitis(family history) and finaly some paraasites (ascaris lumbricoides, exceedingly rare). 85 different drugs are known to be able to cause pancreatitis, the most common are: azathioprin and didansosin (history?).
Good luck, and don't worry about the ERCP. In experienced hands and with you history it seems well indicated!
Oliver

[Malayna]

My 2 cents:  

I also have been told that the pain I am experiencing is from my gallbladder.  A sonogram of the gallbladder showed no stones, thickening of the walls, etc.  I did conduct some internet research, and the pain I have is not exactly like that described on most internet sites.  I did have the HIDA scan, however, and it did show that my gallbladder is functioning at about half of what it is supposed to be doing.  I have been scheduled to have it taken out.  My GI doc says that some people get "diseased" gallbladders and never have stones.  I would have the scan done just to see what it shows.

As for the HIDA scan itself, they inject you with some type of radioactive isotope.  You then lay under an x-ray type maching (not an x-ray machine though)  that takes pictures/video of your gallbladder.  They take a picture about every 15 minutes, watching your gallbladder fill up.  After about 45 min.  they inject you with something else that makes your gallbladder empty.  THey watch this and the computer/Dr. observes the rate and amount that is squeezed out of the gallbladder.  Other than the IV stick, it's painless.  

I would have the scan done, just to see if your gallbladder is actually functioning within normal limits.  Good luck to you!

Malayna

[Malayna]

Clarification:

My comment above was directed to tbaird who asked about the hyda scan in his/her post.

Malayna

[Kat2u]

Please dont wait if you need your gallbladder out! I ignored symptoms I had back in the mid 90's. The symptoms finally went away... what I didnt know was that smaller stones hurt more than bigger ones!

Three years ago I started getting very sick. They threw every test in the book at me and couldnt find anything. I got better for about a 1 1/2 years and then came down very sick again this last November. More and more tests. But nobody thought to check my gallbladder because I wasnt having the pain. And of course by the time all those tests come back negative they start thinking its all in your head.

Finally, as a last resort my GI decided to do an abominal C-scan. I wasnt feeling too bad at the time, he told me it was "optional" if I wanted the test done. I decided to go for it. I scheduled the appt on a Wed for the following Wed. But Friday AM I woke up soooo sick. But still my gallbladder didnt hurt, it felt like appendicitis.

Needless to say once I finally had the test done, they found several large stones and the next day while getting ready to go talk to my Doc about surgery, I got even sicker. I could not stop throwing up and that is when the gallbladder pain finally kicked in.

My Doc took one look at me and sent me straight to the hospital. I was very dehydrated and they also put my on IV antibiotics. My surgeon of choice just happened to be available to operate the next day and he did. I had a really rough time with the surgery, mostly because my blood pressure was too low and I had quite a fever. The gallbladder was quite enlarged and was actually causing the appendix like pain. One of the bile ducts was blocked.

I had chronic diarrhea before this and now a week later, I still have it. But it seems different and I know that if it doesnt go away they can give me the questran.

The good news is I can breathe again! I have no pressure on my stomach anymore (they told me I had GERD and too much stress, where is the rolling eye icon? LOL) I didnt even realize how hard it was for me to breath (not from pain but from pressure) until after the GB was gone.

Many other good changes have happened too. No more of those almost unindentifiable aches and pains, my hands and feet are warm again! I dont feel "sick" anymore!

I went through 3 years of some serious suffering, yes, to the point where there were many days I couldnt get out of bed. If only I had gone to a Doc back when I first had that pain!

Please dont wait until you get sick before getting your gallbladder removed! Doctors dont recommend the surgery unless they really think you NEED it.

[cwhinocp]

Hi:  I've have been reading all the comments to this subject.  My husband just came home today from having this procedure done at the hospital.  ERCP.  He was gone for about three hours.  He explained it was uncomfortable, did not particulary like it.  Although he had no pancreatitus (pancreatitis) attack during the procedure.  He was very fortunate.  As his GI explained to him that it was possible that they might have to make an incision where the duct openings are to the pancreas and bile if in fact they found any blockage.  Nothing was found and he stated he had only a sore throat.  My husband has had an attack about four years ago.  This is second bout now that he is experiencing.  It happened in March and is still going through a load of testing.  They cannot find what caused his pancreas to inflame.  They ruled out gallstones. He has had a ton of bloodwork, he has had a Cat Scan, Biliary Scan, RCB Liver Scan, ERCP today, Ultrasounds(two to three), who knows what will be next.  His pain has dissappeared but I believe when he eats fatty foods this triggers the problem.  He was eating Wendy's fast food and drinking Tim's coffee the day when he got the attack and just as he finished his supper he told me he could feel that awful pain coming back after so many years.  He said it radiates from the front to the back, so painful that he was buckled over on his knees.  He has to go immediatley to the hospital to get on pain meds.  They hook him up on IV and give him Demerol shots to help stop the pain.  He ends up staying in the hospital for a day or so.  His first bout of this, he had a very high fever. This time he didn't.  I really hope that his Specialist can tell us something after this ERCP today.  It gets pretty scary when you don't really know why all this is happening.  They gave him pills to take to reduce the acidity in his stomach as well.  He takes those before he eats.  They seem to help him.  But I truly believe that this problem is triggered with your diet.  Good luck with health, and if you have any information that you think might be of interest to me, please feel free to share it with me.