Hello - thanks for asking your question.
Your lipase is elevated. An elevated lipase is fairly specific for pancreatitis. To further evaluate this, I would obtain a CT scan to evaluate the pancreas. If there are positive findings, an ERCP or MRCP may be considered to see if the biliary tree is normal or if a blockage is causing the pancreatitis.
You note a normal endoscopy - this would make dyspepsia (i.e. ulcers or gastritis) less likely.
Another test to consider would be a CCK scan. This can measure the gall bladder ejection fraction. If low, then there is a possibility may be acalculous cholecystitis - which can cause your symptoms without having gallstones. People who have low gall bladder ejection fractions may require removal of the gall bladder to improve symptoms.
In summary, I would pursue an abdominal CT to evaluate the pancreas. If negative, I would consider a CCK scan - discuss these options with your gastroenterologist.
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.
The name of the scan referred to above is a HIDA scan (which is the radioactive stuff they inject); CCK is usually given during the scan, because it causes the gallbladder to contract, which can be useful in allowing to see how it functions, and also to see if contraction causes the symptoms in question.
I guess I forgot to mention that I had my gallbladder removed already 2 years ago. Thanks I ended up having the ERCP done because the CT showed the ducts to be dialated. This was done on Sunday and I was released from the hospital Wednesday. However, I'm surprised that my back area seems to still hurt but so far I'm thinking it is probably normal or because I tried to go back to work today. Nice to know I did the right things though so thanks.
My daughter is in the hospital right now for similar pains. Abdominal pains that center on right side close to the belly button and radiates thru the back. She has been in the emergency room numerous times with the same thing. She has gastro bypass surgery 2 years ago, her gall bladder removed 1-2 months after the gastro bypass and kidney stones approx 3 months ago. Since the gastro bypass surgery, she has had problems with not being able to eat without becoming sick, abdominal pains so severe that they double her over, constipation and diareha. She has seen several different doctors and has had an endoscopy twice with nothing being noted. She will be released from the hospital today with no answers to this condition (once again). We are at our witts end trying to find a doctor who will take the time and interest to help her find out what is wrong. Intially she was told that an ultrasound showed her pancreas to be inflamed as well as her lower intestine, but no tests were run on these. I am looking to find a doctor who can help us.
If anyone knows of a doctor in the Houston TX area I would appreciate their name(s).
A related discussion, Pancreatitis yes or no?