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Acute Pancreatitus or Not?

Hello All,
     I have been a mess the past four months. I had a bout with Lyme Disease. This problem put me on Doxycycline 200 mg/day for six weeks. I finished the Doxy 19 days ago. Lyme Disease made my anxiety/nerves reach a point I never knew existed. It gets even better. I had surgery for a Superior Semicircular Canal Dehiscence two weeks ago. The Lyme plus the inner ear problem causing vertigo just put me to the max. My job performance was poor, and my wife and I are expecting in three weeks. About one weeks after I started treatment for the Lyme I noticed my stomach was uneasy (nausea and pain sometimes.) I excused this problem as a Lyme symptom. However, this problem has worsened and diarrhea was added to the equation. I went to my local ER two days ago and explained the problems. They ran blood work to check my gallbladder, kidneys, liver and pancreas. The only elevated level was my pancreas. The blood test for the pancreas was a Serum Lipase. Normal is between 22-51. I was at 68. Everything else was normal. I received an ultrasound as well. The liver, gallbladder and kidney on my right side were all normal - no stones. They couldn't get a good enough picture of the pancreas. The Doctor told me that he is going to write up the report as Acute Pancreatitus - Mild. The Doctor also added that he could be wrong and It's not pancreatitus. He said my blood work was elevated such a little bit that I shouldn't worry, but I do. I drank in college but now for the most part I drink less than Socially. My questions are:
Can my nerves be the cause of this stomach problem?
Are the results of my blood work that of Acute Pancreatitus?
Should the results of my blood work cause a great worry?
Can an ulcer or any other colon/stomach problem cause the pancreas level to rise?
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233190 tn?1278553401
To answer your questions.

1) Anxiety and nerves can cause GI symptoms - but before attributing it to this, you have to rule out more serious causes.

2) The sensitivity of serum lipase for the diagnosis of acute pancreatitis ranges from 85 to 100 percent in various reports.  However, there are several other diseases that can raise the lipase as well - including medication side effects, pancreatitis masses, ulcers, bowel obstruction or cholecystitis.  I would also see if the serum amylase was elevated as well.  Note that doxycycline can cause various GI complains such as dyspepsia, diarrhea and nausea.

3) I would follow the lipase, amylase and other liver function tests to see if they decline.  If so, then I would be less worried.

4) As stated above, there are a variety of causes that can elevate the lipase and amylase.  Some of them are listed above.

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.
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