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Gastroenterology  (Expert Forum)
 | 
Upper GI Pressure, pancreatitis and divriticulitis.
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

Upper GI Pressure, pancreatitis and divriticulitis.

by Rshe64, Jan 31, 2007 12:00AM
Here is my recent history.. I had upper GI pressure about 2 months ago.  It seemed to subside and a few days later I got lower left groin pain.  I go to my doctor who does some blood work and my Pancreatic enzymes come back several times normal.. Dr. sends me for a CT and they say I have divreticulitis.   The pancreas looks normal, splean slightly enlarged.  Dr. says I also have Pancreatitis, but can't in any way relate the 2 together.  Put me on Levaqui and Flagil.  Seems to make things better for a while. Continue to have blood work drawn and the pancreatic numbers continue to fall, but the liver enzymes are slightly elevated.. Have a colonoscopy done and all is OK per the Dr., only a small benign polop.  

I started getting the Upper GI pressure again about a week and a half ago.  Go in for blood work and numbers look OK.  Go in for another CT and there is only some "residual" swelling due to the divriticulitis.  Have a Hypobilliary with CCK done and results come back normal.  Going in next week for a endoscopy anthing I should ask/look for.. Any ideas to relate these symptoms?

I notice the symptoms are more pronounced when sitting.  Seem to go away at night, when I am laying down.  I don't feel the acid coming up in my throat, like reflux.  I have noticed (and people hae even said something) when I eat I feel my stomach gets distended.  I am very gassy and sometimes feel like it would help to burp, but can't.  I am male and 42 years old.

by Kevin Pho, MD, Feb 01, 2007 12:00AM
You have had a pretty comprehensive evaluation.  

I agree with the upper endoscopy.  This would rule out several upper GI disorders like an ulcer, GERD, or inflammation of the upper digestive tract.  

To further evaluate the pancreas, an MRI of the abdomen, or an MRCP can be performed to look at the biliary ducts.  

More specialized tests can be considered if the results continue to be non-revealing.  This can include a 24-hr pH study (to rule out GERD) and a gastric emptying scan (to look for gastroparesis).

These options can be discussed with your personal physician.

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.
kevinmd_
Member Comments (8)

by Rshe64, Feb 01, 2007 12:00AM
To: Forgot that one
Had a sonogram done that showed no issues with the pancreas or bile ducts.

by Tami3D, Feb 06, 2007 12:00AM
To: Rshe64
Here is my history.  Jan. to March of 06' I had constant nausea and urq pain.  I had my gallbladder out March 20,2006.  Still felt urq pressure/discomfort.  went to Gastro. Dr. in July 06'.  Had endoscopy Aug.06' and that was fine.  The Dr. said we could do more tests and I said no.  I wanted to believe it was all in my head!  Had to go back to Dr. in Oct.06'.  The discomfort was worse.  I had a Hida scan done.  It showed my sphincter of oddi wasn't working right.  Dec.1,06' I had an ERCP (sphincterotomy) done.  HORRIBLE!!  I had acute pancreatitis right after the procedure!! Worst 7 days of my life!! I still had discomfort. 5 weeks later,Jan. 06', I was back in the hospital for 3 days with elevated pancreas enzymes. Painful! I had a colonoscopy a week ago and that was normal. Now, I am going to have an MRI of abdomen and MRCP done this Thurs. to look at the biliary ducts and make sure they are ok.  Next week I am scheduled for a Gastric emptying test.  All this because I have ruq pressure/discomfort,full feeling.  My stomach gets distended when I eat.  It's an odd feeling.  Nothing seems consistant. I've tried to connect it with WHAT I eat but there doesn't seem to be a connection. It's WHEN I eat but not always!  Very frustrating.   My stomach feels better when it's empty, except for the hunger pains.  I am also more uncomfortable when I sit too. I am a 39 yr. old female.  I would like to know how your situation turns out. Good Luck.

by Rshe64, Feb 08, 2007 12:00AM
Your symptoms sound very similar to mine.. I am going for an endoscopy this afternoon..

by Rshe64, Feb 08, 2007 12:00AM
Hit enter to fast..  I am going for an endoscopy this afternoon.  I will report back if they find anything...Thanks.

by Rshe64, Feb 08, 2007 12:00AM
Got the upper endoscopy today and of course they found nothing obvious.  The Dr. took several biopsies and will report back to me on any findings.

by Tami3D, Feb 09, 2007 12:00AM
To: Rshe64
HI. I went for my MRI/MRCP and couldn't go through with it!  I rescheduled for next Wednesday and am going to take volume before the test.  I didn't realize I was claustrophobic!  My gastric emptying is Tues.  I don't have a Dr. appt. til March.  I'll be checking back to see how you are.  Tami

by ellienor1510, Feb 18, 2007 12:00AM
I have had stomach pain/problems for 8 years now.  It comes and goes.  At times it gets so bad it hurts all the time and I loose 10 - 20 lb.  This time the pain has been from.... JUne 2006 till now, with about 6, 5 day stretches of relief.  This effects my sleeping, ( cant sleep thru the pain ) and I have gone from 126 to  116 in the past 2 months.  
I have a detailed food diary.  I think it does depend what I eat - sometimes.  For example if i ate spagetti, coffee, sweets, any raw vegetable, more than a small bite of meat, it would cause a major flair and i would have to go on the brat diet for a week or more before the pain lets up. The softer the food the better.
I also warm everything up, cause cold food is hard on the stomach.  I warm almond milk and drink it while I eat to get the heat into the stomach.  Sometimes this helps, but not now.
My last endoscopy was may 2006.  they found in-active gastritis, lots of inactive inflamation (inflammation) and redness around the hiatal hernia area.  Esopagus is ok.

I am sooo tired of this.

I have tried lots of natural things.  DGL, slippery elm, various gentle digestive enzymes, L- glutamine and some stomcah formulas geared to heal the lining of the stomach. Sometimes I think they work,, but now nothing is releiving this pain.  
It is even very tender to the touch.  Right under the breasbone, when I press, it is very inflamed and sore.  Sometimes i pull that area down gently, to get the stomach down, and once it helped so much I had NO pain for a week after that.  Maybe food gets caught up there and rotts?

I take dandelion and small amounts of ginger to stimulate digestion.
I am on 20 mg of nexuim.  When I take a full dose of it, my digestion slows to the point that I never hear my stomach churn, and the food sits there until i get a putrid nausea feeling on top of the pain.

Yesterday I tried putting 1/2 tsp of apple cider vinigar on my dinner, and I got some relief last night. Could this be low stomach acid problem?
I am afriad to try too much vinigar cause my stomach is so raw.
They wont do another endoscopy yet.  they want to do a 24 hour ph test. I already tried that 3 years ago and I couldnt tollerate that thing in my throat.
Should I have a gastric emptying test?
I am going to post this as a new post.
Thanks for any ideas.
ellie

by Tami3D, Feb 28, 2007 12:00AM
To: Rshe64
Hi.  I had my MRI and it came back unremarkable!  It said something about one duct being undialated.  I have my Dr. appt. March 7.  I went and picked my results up at the hospital because I couldn't wait.  I'll see what the Dr. says at my appt.  I was actually disappointed with the results!  I wanted it to show what's wrong so we could fix it and I could move on. I think the Dr. is going to say this was the last thing we could do and I have to live with the discomfort the rest of my life!!! Any suggestions on where to go or who to see if that's the case?  I'm frustrated and discouraged!!  
Let me know how you are doing and if you've had any other tests and what your results were. I hope all is well.  Tami
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