Why don't I have the pain to go along with the High lipase ?

I am not wanting the pain ..don't get me wrong - But my GI is talking about getting the ECRP done because my Lipase continues to be high

I have minimal ab pain - but am also have crohns disease so I attribute every pain to that - I have had MUCH worse pains than now - I do have alot of back pain - and am taking pain meds for that at least twice a day

What I don't understand is HOW can I have pancreatitis without the horrible pain I hear about associated with this?
How is it possible ...can the High Lipase results mean something else ? Doc so sure he dx me with Severe Pancreatitis ... and everyone where I work ( a surgery center ) came to me to see if I was okay and wanted to go home ... I was okay ???

Please is there anyone who can give me some understanding on this ...or am I just being spared the pain ??


This discussion is related to pancreatitis vs crohns-how can you tell?!?.

[boron]

In pancreatitis both lipase and amylase are usually elevated. Other tests (CT, MRI) are needed to confirm pancreatitis.

But elevated lipase doesn't mean you have pancreatitis. Or, lipase level doesn't necessary correlate with severity of inflammation.

ERCP was probably suggested because a small stone, either from gallbladder or pancreas can block pancrteatic duct - what results in pancreatitis. There's another, noninvasive investigation - MRCP, which could be done instead of ERCP.

Above are only my thoughts, it may help you discuss with your doctor.

[MsRie]

bORON....thanks !

I have had a CT scan ...and it only showed 2 small stones in my gallbladder which had been there unchanged since my last ct scan 3 years ago ..my GI when asked by my husband if we should get them out ..said no ..they havent changed in 3 years ...leave them alone ...

sooo...from what you are saying it is possible for my lipase to be that high and it NOT really be pancreatitis ?? I am so confused ... it seems so unclear to me ..

[boron]

When a small gallstone lodges on the end of the biliary duct, it may block the pancreatic duct (check in Google images for "biliary stones"). When pancreatic duct is blocked, pancreatic juice presses back to pancreas and causes inflammation, and lipase enters the blood. So, this is then also pancreatitis, but the primary cause is not pancreatic disease.

I can't say from here if you have/not pancreatic disease or not though. Main causes of pancreatitis are alcohol, and biliary stones, as mentioned. Or some drugs.

Gallbladder may stay intact, if it doesn't cause any symptoms, but it might be worth to check biliary ducts for stones - this is why ERCP was suggested. If a stone is found in the ducts, it can often be removed during the procedure. There may be other causes of duct blockage (inflammation, adhesion...)

[MsRie]

Thank you so much ..it helps to have some more understanding of the possibilities and what the ERCP could be used for ...

I am going to look at the gallbladder pics ...

[tenisholka]

Hi, I was just wondering what your Lipase levels were. I recently started having stomach pain on the upper left side of my AB, so after two weeks I went to the doc. All my blood results were normal except my lipase which was a bit elevated. But my Amylase (another pancreas test) levels are totally normal, so I am confused, could I have something with my pancreas or no?

Thanks...

[tenisholka]

I apologize I meant to direct my question to you not boron, but if boron has feedback i will definitely take it!! Thanks..