IS IT POSSIBLE

[indian sam]

In 1978 I was diagnosed with post-operative pancreatitus (pancreatitis), following a repair for a blow out frature to the left orbit. I am a non-alcohol drinker. In 2001, I began to have stomach cramps,diarrhea, back pain, vomitting. I was admitted to the hospital over a dozen times with my amalayse and lipase elevated over 2000 one hour, back to normal the next, and then back up over 2000 the following hour. I had denied any history of pancreatitis because I was not aware that the post operative pancreatitis had occured, until I had recently received copies of that history.  I had also brought up the question if the medicine BAYCOL, which I was taking at the on set of my illness and the FDA had just removed from the market, could be responsible. I had a pancreatitis attack following an attempted ERCP.  The ERCP was not completed because the physician said he was unable to navagate through the canal. He raised the question of a possible lesion blocking the canal.I was hospitalized for nine days. I also had three large post operative cyst.  After the cyst dissipated, I had another physician perform an ERCP whom also reported difficulty navagating the canal. A stint was placed.  It was at this time that the physician determined that the condition of my pancreas was consistant with chronic pancreatitis. I have since retired.  My  current condition is MANAGED through diet and medications.  I had a very stress full job at the time and since retireing, I have been doing better, pain wise.  Is it more likely than not,that my sudden re-occuring pancreatitis is related to my earlier history, some 23 years earlier? Can my ageing (aging) have caused the pancreatitis to reocccure? Could the high levels of stress caused the pancreatitis? (stress levels never expericed before)

[Kevin Pho, MD]

Tough to say.  Although possible, I am not aware of stress being directly linked to pancreatitis.  

The two most common causes of pancreatitis would be alcohol or a gallstone.  If the ERCP cannot be completed, you can consider an MRCP to evaluate the biliary ducts.

More uncommon causes of chronic pancreatitis would include a hereditary component, or systemic diseases like lupus or hyperparathyroidism.  

I would be evaluated for these other diseases before attributing your pancreatitis to aging or stress.

Followup with your personal physician is essential.

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, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

I assume that even though you didn't mention it, your gallbladder has been evaluated: gallstones are the most common cause of pancreatitis other than alcohol. Stress is not a known cause. Once you have pancreatitis, from whatever cause, there's a chance of getting recurrances because of damage caused by the first attack. People who have recurring episodes need to be sure there are no gallstones (some recommend gallbladder removal no matter what, in cases of recurring pancreatitis), that they are on no medications that can affect the pancreas, and that they totally abstain from alcohol. You could also be sure you don't have abnormally high calcium levels in the blood, which is a rare cause. There are operations for people with severe problems with recurring pancreatitis, but they are reserved only for certain anatomic situations, and are considered the last resort, for people debilitated by chronic pain, mostly.