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Severe pain attacks that mimics Pancreatitis.
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Severe pain attacks that mimics Pancreatitis.

I hope someone out there can help me.  For 14 years, I have suffered abdominal attacks in my diaframe very high up in the area between my rib cages.  The pain mimics pancreatic pain.  The pain is so horrible that I almost wish I could die.  It usually lasts 20 to 30 minutes, but can be longer. I am paralized during these attacks & can't move. They usually occur 4 to 6 times a year with milder attacks in between the more serious attacks.  Lately, they are becoming more frequent.  I've gone to the ER 4 or 5 times over the years.  The second trip to the ER, I was told I had the symptoms of a gallbladder attack & within a weeks, had my gallbladder removed.  There wasn't a single stone found, and two weeks later, I had another severe attack at work minutes after taking my first Vicodine ever, for shoulder pain.  My co-workers thought I was having a heart attack.The Dr. said I might have a hiatal hernia & gave me Nexium.  The attacks continued for 9 more years. Then during a very severe attack 6 years ago, my family took me to the ER & I was definitely diagnoised with pancreatitis for the first time.  However, after endless tests of every kind during the past 5 years during & after very similar attacks, my pancreas appears healthy & no other cause can be found.  I recently had an ultrasound, colonoscopy & endoscopy due to a bout of diverticulos 3 months ago but again, no problem found.  I do have a hiatal hernia but it isn't severe & shouldn't be the cause of my pain.  I don't have ulcers. I have noticed, that about half the time that I have attacks, I had taken Vicodine or another pain medication for my degenerative disk an hour or so before.  Once, I was eating a grapejuice bar.  It seems as though many things can trigger attacks. Sometimes, I just feel strange after eating & know that I might have an attack.  Every Dr. tells me that the pain medication shouldn't cause these attacks & even though I once had pancreatitis, they don't think this is the cause.  My Dr., who I like very much, has explored the possibility of anxiety or my personality type.  However, most of my anxiety in life, is the result of these attacks. I'm afraid to plan outings or vacations because of the probability of an attack.  I've even gotten to the point of being affraid of eating because there might be some foods that trigger attacks.  I don't drink alcohol or smoke, so I know these things can't be the cause.  My Dr. gave me a Bentyl 10 MG Rx, & told me that during the next attack, to take one tablet & an Ativan tablet & to call him & go to the ER.  He didn't prescrible regular usage of Bentyl though, which I thought was more for IBS.  I usually have to wait a couple of hours at the ER before they see me & then the attack is over. Please, does anyone have a similar problem or can make a suggestion?  I am desperate!
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Avatar_f_tn
Hello, I am not sure if I can help you but it DOES sound like pancreatitis.  Did they check you for gallstones or any blockages in your bile ducts?  How about your Liver?  Did they do any blood tests on it at the time you went to the ER?  Have you tried going to different ERs?  Maybe a different one will see you right away and test you correctly.  I had my gallbladder removed last year, but before that, I had the same pains.  I had gallstones and they got stuck in my bile ducts every time I had the attacks.  When I had them, the only thing that made it stop was constant hours of puking.  Every time I went to the doctor or ER they told me I had anxiety or GERD.  But I had none of that. I just had anxiety about when the next time I would get the pain.  Its a pain that feel like someone just stabbed you with a sword that has been put into fire.  Its terrible.  Mine happened every month, for almost a year.  They finally did an ultrasound on me and found out what the problem was.  Anyway, your problem sounds similar to mine when that happened.  It hurt all the way to my back.  If the doctors wait that long to test you, then maybe when you feel like you may get an attack, then go to the ER and have them test you and do a CT scan on you so that they can see if you are having a pancreatic problem.  Also, have they checked out your spline?  It could be that too.
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Avatar_f_tn
It may be related to your gallbladder and bile duct. There is a condition called SOD - sphincter of Oddi dysfunction - that mimics a gallbladder attack in severity and pain. And one of the things you said rings a bell. You said you had taken narcotic-based pain relievers in some cases before an 'attack.' Narcotics should be avoided in cases of SOD because they'll increase the pressure in the ducts and cause or prolong pain.

Please read through the following: http://www.hopkins-gi.org/GDL_Disease.aspx?SS=&CurrentUDV=31&GDL_DC_ID=320F4EDD-0021-4952-83D7-8B0C67B47BFF&GDL_Disease_ID=7AB086B0-AB01-446E-B011-2E67CAFEF96D

You may want to discuss this with your doc and if the doc doesn't know much about it - many don't - please seek out someone who does understand SOD.

You could have had SOD before the gallbladder was removed, although it's often associated with GB removal. But the possibility of SOD needs to be looked into.
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Avatar_f_tn
Your posting has been very helpful.  After reading everything I could find on SOD, it makes the most sense to me.  I believe this is what I have.  Maybe my gastroentologist has already considered this but just didn't give it a name.  He mentioned to me those tests that would have to be done in order to look further into my case & said that they were invasive & could trigger attacks & might not even be able to properly diagnose my condition.  Depending on what was discovered & treatment given, I might still have the problem & it could become worse.  He said that I had to weight my present pain against these further proceedures before making that decission.  I don't know what I'll decide at this point, but thanks to you, I believe I at least, now have a good possible name for my condition.  I only wish I could be given a medication that would stop or lessen the attacks when they occur, or at best, something I could take regularly so that the attacks could be prevented in the first place.  I'm 67 years old and have already been through too many surgeries.  I also have several medical problems with diverticulous, kidneys, back (DDD),& osteo-arthriitis in my feet & knees.  I see specialists constantly.  
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Avatar_f_tn
Thank's for your reply.  Did you read CalGal posting?  I think she has given us both a good lead to follow-up with.  You seem to have many of the same problems that I've experienced.
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Avatar_f_tn
You are having pancreatitis attacks. With chronic pancreatitis, amylase and lipase levels may not elevate. It is common for them to only elevate in an acute attack. Often, enzyme levels will rise in the first few hours and then come back down. Since doctors think that elevated amylase and lipase levels are the only indicators of pancreatitis, they will not diagnose you if the enzymes are not elevated. The best thing advice that I can give you is watch your fat content and pray. And know that you are not crazy. It is your pancreas. Learn what works best for you and do it. You can buy multi enzyme tablets in the herbal section at Wal-Mart. These tablets contain pancreatic enzymes. Take three before each meal. They should help. The Bentyl minimizes pancreatic secretion, so it should help with the pain when you are having an attack.
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Avatar_m_tn
In the month of December 2008 I underwent a laproscopic cholecystectomy only to wake up in the recovery room with
uncontrollable upper abdominal spasms/pain.  At the time thinking this was due to the procedure
here it is 16 months later numerous visits to several general practitioners and 2 general surgeons.
Even though I followed the due process within the medical systems
I still live everyday with constant abdominal pain, nausea and taking pain medication this cannot be a healthy way of life
for anyone or an extended period of time.  When the spasms start the pain is so intense literally collapsing to the floor,
unable to speak or move lasting anywhere from 20 mins. to 4hrs.  
The original general surgeon when informed of the ongoing issue in Jan 2009 & May 2009 stated "not my surgery".
The second reputable surgeon did however run some tests Hida Scan proved to be beneficial which showed
a slow bile movement from the duct into the intestines and slow movement of the
solution was also noted in the bowel.  The test results were reviewed with me in Oct 2009
at which time the surgeon suggested a kidney stone was discovered which should be removed first before proceeding
with an ERCP I was instructed to call once this was taken care of the surgeon thought this could be the issue.
The Urologist however did perform a laproscopic procedure inserting a stent only to discover the stone was imbeded
and this would not be the root of the abdominal pain associated with I was experiencing.
I called the prominent general surgeon in late Jan 2009 only to discover he was in Haiti assisting Kudos to him.
I was yet again sent to the ERCP expert here in London ON to perform the ERCP which was conducted on Feb 10 2010
the procedure failed as the catheter would not make it's way through the Ampulla Vater continually collapsed.
Another ERCP procedure was performed on Mar 10 2010 this time 3 attempts with different size catheters
were tried only to fail.  Several hours proceeding the procedure I was admitted to hospital with pancreatitis
also at this time a pseudo cyst was discovered on the pancreas I was treated for 2 weeks in hospital.
Even the hospital stay was morally degrading within the first 3 days of my stay from medical professionals.
I attended the prominent surgeons office on April 21 2010 to follow up on the pancreatitis, previous issue even
though he was not the attending physician during the hospital stay.  During the visit he was informed
of the previous hospital stay stating the pseudo cyst could take years to before it is gone.
The Hida Scan results were again reviewed offering a possible solution a duct bypass explained the
procedure approximately 6 sentences later stated this probably will not work for you only a 50 50 chance
and you will probably be in the 50% that it does not work for.  What I experience everyday is not due to anything
I imposed on myself but I believe the cholecystectomy therefore if I chose to consent to the bypass
and it did not work than I would only have myself to blame.    
The surgeon explained how he wanted me to deal with this problem "take regualr strength tylenol, buscopan,
lie down for 30 minutes think of how you want to start your day over, antidepressants to numb the nerve endings for 6 months"
as the body may heal itself.
I asked at this time the problem is physiological the surgeon stated "NO I just read the results
to you there is a problem but I cannot help you and really don't know anyone who can".
Leaving there visibly upset, frustrated with the Canadian medical system which I currently pay for with in my working taxes taken weekly.
If we could heal physical medical issues through thought process, why would we need to seek assistance from the Canadian medical doctor's?
I have attended walk in clinic every 3-4 weeks to renew medications, take blood tests for this problem as no general practitioner wants
someone in their practice with ongoing medical issues so filing out applications if there were any doctor's taking patients seems futile.  
I have also attended emergency depts. several times when the abdominal pain/spasms were unbearable only to be informed to follow up with
the prominent surgeon.  
Tell me in the year 2010 with a real physical issue can a person be brushed off/lost in the medical system, like this is a third world country.  I believe
the the Canadian population expect to be taken care of/cured when paying for medical care.  At this point the medical doctor's
involved in my care do not even know why the duct is possibly blocked could be anything stone, tumor or worse yet Cancer.  
What kind of quality of life is this for any human being especially in Canada?
Why does a medical system fail in this day & age?  Do you think the medical profession has become a business/tax grab?
The profession seems to have lost all sense of why they became doctor's to CARE for the sick and impose treatments to maintain quality of lif
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