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Digestive Disorders / Gastroenterology Forum
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Avatar universal

To BaseballMom, TazLady

First, I hope you are both feeling better.  It sounds like you are, & I am so happy for you.  I can't believe how hard-to-detect pancreatitis is!

  
In a recent post BaseballMom said that blood tests & ct scan are helpful in  diagnosing pancreatitis...  What blood tests are run?  What elevates, anything besides Amalase & Lipase?  How high do these levels need to be if it were pancreatitis? What would the ct scan show in a case of pancreatitis? Would a ct of abdomen & pelvic check the pancreas?  


Also, Taz... Recently you explained how a blood test, during an attack, showed elevated levels, indicating pancreatitis.  Could you please explain this for me, in detail?  I have been in pain since April.  I have had all the tests.  So far, nothing shows up.  Recently the doctor told me to have blood tested DURING an attack, he suspects pancreatitis.  I am soo afraid of going to the hospital for the blood draw & having nothing show up-again. Please advise me when to have the blood test.  How soon after one of these 'attacks' begin, do blood levels increase?  Do I need to have a super-attack, or a super-dooper, for blood levels to rise?  What if the pain subsides by the time of the blood draw - will levels stay elevated? For how long?


BTW, doc does not want to do ERCP - yet.  Anyone that has any info that could aid in diagnosis will be greatly appreciated.
Thank you.
7 Responses
Avatar universal
Hi - I'm not sure exactly how to answer your questions.  Here are a couple links to sites that explain a little more about Pancreatitis.

http://www.niddk.nih.gov/health/digest/pubs/pancreas/pancreas.htm

http://www.gastro.org/public/pancreatitis.html

I believe that the Amalase & Lipase are the only things that are elevated.  I believe that the pancreas would show to be abnormal in size (i.e., larger) and yes a CT Scan of the abdomen would be the one to have done.  But the doctor needs to make sure they "concentrate" on the area of the pancreas when they are doing the test.

I recently got over a bout with Acute Pancreatitis from having the ERCP done.  The onset of Pancreatitis was followed by the most gut wrenching pain you could ever imagine.  Worse than any labor pains I ever had with my two boys.  Best of luck to you.  Happy Holidays!
Avatar universal
The sites that Baseball Mom sent are excellent links and should explain a lot.  One thing I did want to add is that there are some people who can have an acute attack and not show elevated a&l levels, usuallly they have had the condition a long time and the pancreas is so damaged that their levels do not change. I don't think this would apply to you because you would most likely have been hospitalized, as the pain is excrutiating, gut-wrenching pain.  With treatment, it resolves within a few days, and a&l levels drop down.   Normal amylase should be about 80.    

An abdominal and pelvic CT scan should show if there is any inflamation, tumors, damage or pseudocysts present in the pancreas.  When the disease becomes chronic pancreatitis,  the pain is less excrutiating, and it can come and go.  As the gastro site fully explains, repeated flareups can cause further damage to the pancreas, so treatment is necessary to minimize the flareups and control the pain.  A gentleman posted earlier that he disagreed with my statement concerning the fact that further damage occurs, yet perhaps he did not realize I was referring to chronic pancreatitis.  I speak from personal experience, as I have had acute attacks and now have chronic pancreatitis.  My GI has a ct-scan done every 4 months to monitor the status of my condition.  My levels are still "slightly" elevated.  

An ERCP is very invasive and often causes an acute inflamation, so I would be hesitant to choose this as the only diagnostic remedy.  The ct-scan should show the presence of any problems.  Good luck.
Avatar universal
Hello 5678, I would urge you to have blood tests done, even if you think you might have pancreatitis, if you have a acute attack
and do nothing you might end up with problems, not to worry you too much!but please summon your courage and have tests and a cat scan it is painless and will show if you have inflamation, then
if you have you can have the correct treatement, it,s just bed rest i.v. fluids and not much more! just to give your system a rest, you can recover and just avoid alcohol and too much fat.
I hate Hospitals but they really helped me, the very best
howard
Avatar universal
Hi,
I have had the blood work done during "painful" times and they didn't show too elevated of levels.  The times my levels have been elevated have been when i had to be hosptalized.  Once they did blood and they were elevated, but not enough to be hospitalized (or   it was before I was diagnosed.  The ER thought I was passing kidney stones)  I can tell you they pain is worse than giving birth.  I had a ERCP with sphincter of Oddi monometry done.  It sent me into an attack that put me in the hospital for 10 days.  No food.  Only ice chips and morphine for the pain.  I will say that the ERCP helped with the pain.  It had too, because I had not had an attack requireing hospitalization for almost 5 months now.  The attacks were coming every 2 or 3 months that sent me into the hospital.  At least, I am hoping it is because of the ERCP.  I will also tell you (and anyone else with Pancreatitis will atest too) I am SOOO scared of having another attack that I am on a mild tranquilizer at night.   Most bad attacks occur at night.  They wake you right out of a sleep.  I am scared everytime my belly hurts and my back starts aching, that another "big" attack in on the way.  I am too scared to sleep at night without taking a tranquilzer.  Yes, I know thats may sound stupid, but it's true.  I guess in my mind by me taking one, it is helping me to avoid one.
I say to have the blood work done now.  And then if you should have an severe enough attack to send you to the ER, then have the blood drawn again, BEFORE any pain meds are given.  My last attack my levels were 1999 and 5000.  WAY TOO HIGH, and just to boot, the hospital released me anyway saying I was fine.  I was back the next morning and spent 9 more days there.  I begged to go home and didn't use the morphine for the last 6 days I was there because I wanted to go home.  It took me about 3 weeks to re-coup from that attack.  I have daily pain.  Stabbing, aching, bruising pain that can last for hours or just come and go.  
Hope this helps you.  Stay away from all alcohol.  Even O'douls, nyquil liquid.  They have alcohol in them and thats liable to trigger an attack.  Maintain a low fat diet (less that 25 grams a day...do your best, no ones perfect) and get on enzyme pills.
Write with more questions.  It's good to know I am not alone in this, although I am VERY sorry anyone else every has to feel this.
TazLady
Avatar universal

Thanks so much for the info!  Wow, you are all great!  If you don't mind I have some more questions.  -- You have first-hand-experiences, so I feel that you are the best source.  The websites were great, too.  Lots of info.  Now I'm thoroughly convinced that I have pancreatitis, probably chronic.  I think my pancreatitis comes from a problem with a duct. I believe this because of the spasm-type pain I sometimes get in addition to the pancreatitis-type pain.  Doctors don't think it's a stone because ultrasound & 2 HIDA scans came out fine.

I had an abdominal & pelvic ct scan.  It barely mentioned the pancreas.  So if my doctor sends me for another ct scan, this time I'll know that it needs to concentrate on this area.  (See, I would never have found out that fact from research alone.) Providing ct scan is concentrated in this area, are they able to view the biliary ducts?  The sphincter of Oddi?  Can they 'see' if there is dialation in the main ducts?  Or is ERCP for those ducts?

I've had the liver enzymes blood tests (3 times).  So far everything is within normal ranges.  I have an Rx for a blood test 'when symptomatic'.  That's why I was wondering about the timing of having this blood test.  I'd like to have blood drawn during a bad attack, that way, levels of amalase & lipase will be elevated, right?  Previously, - even though I was ill & in pain at the times of those blood tests, the levels were normal.  

Could it be possible to have pancreatitis & NOT have increase in A&L levels?  Isn't there a specific blood test that measures the pancreatic functioning?  Like a pancreatic enzyme test?  

Finally, I'm wondering...  What could happen, if you had acute pancreatitis, didn't go to the doc or hospital & it became chronic pancreatitis - with flare-ups of acute pancreatitis.  Due to the nature of the chronic condition, blood levels (A&L)don't rise. Therefore, you never get a diagnosis of pancreatitis, so,... you never get treatment for the pancreatitis.  (Whew!) What would happen?

Thanks again, in advance.
Avatar universal
Hello again 5678, I hope your feeling a little better, by chatting to folk, it,s a great way to releive some of the stress
problems. everytime I had an attack of pancreatitis I would end up down the A+E dept, amalese levels high etc, then I had a cat
scan done and they found a cyst, normally they resolve on thier own but mine did not, I,m pretty sure they would have found that as it definitely would show up on a ct scan, your right that when
your having a attack of pancreatitis your levels go through the roof, can I ask if your dr has given you a prognosis? you should
really get to the bottom of the flare ups, I feel for you it,s a
very unnerving process, as for the tranquillisers, whatever gets you through although, some can be addictive so please be carefull
When I was having my operation to remove the cyst, a very wise
lady consultant told me that the pancreas was the rottwieller
of the GI system once woken, how true that is! I hope the doctors
find a way to treat you soon and you get some relief. finally
in the UK they have a procedure I had, called a pap test, it involves drinking a not too unpleasant drink about a pint of liquid, then you pee into several small containers over a period of time, these go off to various labs to be tested they show the
functionality and all enzyme levels in the pancreas to determine
damage and long term prognosis, I.m not sure if this is available
anywhere else, but you may want to ask your doctor,I hope you manage to find some relief and the right treatment very soon
take care, and a merry xmas to all in here
Avatar universal
Hi again,
It is my understanding that pancreatitis starts as being acute and when you have frequent flare ups over long periods of time, then becomes chronic.  Hope for acute pancreatitis.  It is the lesser of the 2 evils.  I have had attacks and had my enzyme levels normal.  That would be true now if I went to do blood work.  I am in pain now, but not in a MAJOR attack.  The levels really rise when you have a MAJOR attack.  You will know when this is becasue you will not be able to handle the pain.  The ER will be your ONLY choice to releave pain.  As far as I know, they can only check your Oddi Sphincter when they do an ERCP.  No other test can see it.  You will not have to worry about not being diagnosed with this.  It may take some time, but the doctors will eventually diagnose it.  It took mine years.  Thats why I now how chronic pancreatitis.  My advice is for you to adhear to a low fat diet, avoid all alcohol (including nyquil, o'douls, etc.) and avoid as much stress as possible.  You will get through this.  My first dr. told me thre was nothing wrong with me.  This included when I was in the hospital the first time and my levels were elevated and the ct scan showed a "plump pancreas".  He was a jerk and I quickley disposed of him.  I eventually got to a Univercity and medical treatment has gotten better.  Try really hard NOT to overeat.  This makes me hurt so bad.  I try to stop when I am starting to feal full.  If you are offered enzyme pills, take them.  They do offer some pain releif.  I hope this helps.  Write again with any questions you might have.
TazLady
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