Tummy troubles!

[Hojo81]

I am a 37 year old female who has had epigastric discomfort (not really pain, just a "gnawing" kind of pain that has come and gone for several months now.  It first presented in 9/07 and i had an abdominal ultrasound that was negative.  It then went away, and I didn't notice it again until around March.  Since then, I have had normal labwork with the exception of elevated Amylase (132).  I have had a HIDA scan with EF @ 20% and had my gallbladder removed 5/2.  After the pain continued i saw a gastroenterologist  tried Protonix meds 2x day without much help and  redid the Amylase and now at 150!  Everything else is normal.  He has ordered a CT for next week, but I am very freaked re: possibilities of Pancreatic cancer!  I also occassioanlly have back pain (which may be related to me bending to search the internet!)  Can you provide any reassurance as I head into these tests?  Thank you!

[Kevin Pho, MD]

I agree with the workup thus far.

The elevated amylase can be consistent with pancreatitis, which is most commonly caused by alcohol use or a gallstone.  

I agree with the CT scan.  If pancreatic cancer is of concern, an MRI or endoscopic ultrasound should be considered.

Another test to consider would be an upper endoscopy - which can evaluate the stomach and upper GI tract.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[hepati]

The clinical  manifestations of pancreatic carcinoma may be nonspecific and are often insidious.the most common presenting symptoms are epigastric pain and weight loss .the pain is usually constant ,with radiation to the back.Anorexia ,nausea ,and vomiting may also occur, along with emotional disturbances.
pancreatic carcinoma should always be suspected in elderly patients with abdominal pain or new-onset diabetes,depression associated with weight loss,acute pancreatitis without other know risk factors, or obstructive jaundice.The tumor marker CA 199 has a sensitivity of 80% to 90% and a specificity of 85% to 95% in diagnosing pancreatic cancer in patients presenting with signs and symptoms suggestive of pancreatic cancer

[ok2531]

I have had the exact same thing as you!!!  except my gallbladder was taken out 3yrs ago.  Still have elevated amylase my last one was 230 with the upper limits of 180 here at my lab.  It does scare the who hah outta me & searching the internet is the worst thing to do :)  I too had a CT Scan that showed everything normal.  My GI doc was thinking SOD. The only that is ever out of whack is the amylase my liver tests have been completely normal.  I had pain in the epigastric area back in Nov & Dec 07 then I had it all go away so they thought maybe sludge or small stones.  I since have had some left side discomfort...not really pain but a side ache it is at the ribcage & sometime in my back.  It is worse when sitting & slouching like you said "searching the internet" Just know you not alone.  I am 31 and a single mom so it stresses me out when I think the worst.  Holler if you would like to chat.