Pancreatitis?

[Arls]

I have had chronic gastritis or pancreatitis or gall bladder or whatever for many years (not sure which).  My pain was originally directly in my stomach (not "heartburn" up high, and not in the bowels, but right smack in the stomach).  It feels as if my stomach is eating itself.  Now I am finding my pain radiating into both shoulder blades, and sometimes RUQ.  It comes in waves, sometimes so severe I am doubled over for 2 or 3 minutes, and sometimes just chronically nagging at me.

I have a long history of alcohol abuse and currently drink one and a half litres of wine each evening.  I'm not stupid, in that I know for a fact that this is what is causing and/or making my symptoms worse, but here is my question.

On several occasions I have stopped drinking completely for as long as 5 or 6 days, and felt my symptoms get a little bit worse each day.  Not exactly the intended plan.  The only thing that seems to make this awful pain disappear in fact is having a few drinks.  Why is that?  Is it the "pain relieving" effect of the alcohol?  I can be doubled over in agony, writhing around, and I know that if I have a couple of glasses of wine it will disappear, until the next day, when it returns.

Had all the blood tests.  My "non-specific" liver function tests came back slightly elevated.  My lipse - normal.  Had a gastroscopy and no ulcer whatsoever.  

My next question, probably the most important one.  If I have chronic pancreatitis, will quitting drinking eventually make a difference?  Is this condition reversable?  Or will I have to put up with it forever???

Thank-you so much for this forum.

Hgielra

[Kevin Pho, MD]

Cessation of alcohol intake is imperative, particularly if this is the underlying etiology of pancreatitis. Abstinence does not always lead to symptomatic improvement; however, patients with alcohol-induced chronic pancreatitis who continue to drink have increased mortality.

Treatment for chronic pancreatitis primarily involves pain control - although it is sometimes stated that chronic pancreatitis "burns out" over time, the duration of time over which this may occur is highly variable, if it occurs at all.  

If medications aren't doing the job, then more specialized treatment may be considered.  Options for further treatment include endoscopic therapy, surgery, extracorporeal shock wave lithotripsy, celiac nerve block and surgery. As a general rule, the greatest experience has been with surgery. A drainage operation (ie, lateral pancreaticojejunostomy) is safest and most likely to be effective in patients who have a main pancreatic duct >6 mm in diameter. Resection of the pancreatic head may be of benefit for patients with smaller pancreatic ducts.

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

Bibliography:
Freedman.  Treatment of chronic pancreatitis.  UptoDate, 2004.

[TazLady]

Hi,

I have moderate-severe Chronic Pancreatitis.  Believe me, this isn't what you want.  Your symtoms do appear to be related to pancreatitis, but you could have a number of issues at stake that have nothing to do with pancreatitis.

As for drinking, if you have pancreatitis drinking is a no-no.  It causes more harm than good and the pancreas is a organ that cannot rejuvinate itself. Once damaged it is damage for life.

Please get yourself to a GI and have a more specific work up done to diagnose your condition properly. It may not be what your suspecting all along.

Best to you,
Sandy

[Arls]

Thank-you for your response.  May I ask what caused your chronic pancreatitis, and would you describe your symptoms for me a little, even if just to scare me off?

Thank you so much.

Hgielra

[TazLady]

Hi,

And sorry to respond so late. I know what it is like when you are very worried about something.  I have just had a scare regarding my son and it turned out to be really nothing.  So that is why I say to you to have a few tests done before you make up your mind what illness or disease you may have.

That said, I got pancreatitis from a bad gallbladder operation.  I didn't drink, I was overweight, I was under 35 and fertile and NO ONE believed I was sick at all.  I struggled for months with pain that was explained to be residual GB pain.  I was told I didn't handle my pain well.  What a crock!  Pain is pain.

I also suffer from Sphincter of Oddi dysfunction and until last year I couldn't tell the two pains apart.  Everyone suffers different pancreas pains but here is what I have.

BAD, horrific, excrutiating pain in the middle of the night.  Worse than childbirth.  These attacks always send me to the ER for pain meds.  On the whole for the day, it can be a burning, boring, radiating pain right where the ribs come together. It can also go to my lower back.  The best way to describe that pain is like when you've been bedridden sick for days and your back aches from laying down too much.  I also get pain from sitting in a chair or any 1 position for too long.  I used to htink I was leaning on my pancreas in a certaion way but I have talked to others who have the same pain so I know it is the pancreas.  You can get a stabbing pain or even a dull ache.  You know it's there and no matter what you do, it doesn't go away.

Pain is increased with fatty meals. Within 1/2 hour or so after eating butter, fried foods, deserts etc...the pain can start.I have been nausiated at times, but not always.  I usually have a oil slick in the toilet meaning I am mal-nurished and I have eaten too much fat and my body can't digest it. I get pain in the pancreas  when I excersize or try to move heavy objects. EXTREME tenderness when pushing in on the area between my ribs.  NO ONE is ever allowed to touch there as it hurts like crazy.  But that was also a symtom of gallbladder disease too. The pain can feel like pressure, throbbing pain, a stabing pain, or a jabbing pain.  It depends on how you want to charictorize (sp) it and what it really feels like to you.

I understand that alcohol makes the pain worse.  Some people claim to drink and not have any ill effect, but they are just playing with time on that one because the use of alcohol will one day catch up with them.  I have been advised to not even touch so called non-alcoholic beverages.  They do contain alcohol.  Very little, but it's there. I don't always have pain everyday.  I do have pain free days.

This could decribe IBS, GB symptoms or a number of other illnesses.  Believe me that you DO NOT WANT pancreatitis.  Please take my suggestion and do these few things.  Go to your PCP and ask for 2 bloodwork orders.  1 to check your Amylase and Lipase levels now, that day.  And one to go and do the same test when your experiencing pain.  Ask for a fecal fat test also.  This will check for mal-nutrition which is consistant with pancreatitis.  Stop drinking alcohol completly!  See how you feel. It may take weeks before you actually feel a difference.  Also please visit this website where I belong.  All of us ther have Pancreatitis and you can get great information, suggestions, help and support from all the great people there.  http://health.groups.yahoo.com/group/pancreatitis/
You will have to sign up to be a member, but I really think this would help you alot.  Please post a letter to everyone.  Say I sent you over if you'd like.  But we are all there to help and it doesn't cost anything.

Sandy

[jmess]

A related discussion, pain meds? was started.