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[azraelmd]

hi guys,

 

thanks for the heads up. Been tracking my own medical history since I've been hospitalized twice this year due to pancreatitis and gastritis, so here are my questions:

 

1) my current episode started with severe diarrhea that provided the AGE diagnosis but it developed to my usual gastritis. A doctor friend says this is normal but it was the first time I experienced this combination. Question is whether this really occurs regularly or not?

 

2) my bloodworks had always shown high levels of lipase. Is it possible that this becomes "normal" for me or should I always lower it to normal levels?

 

3) are there studies wherein repeated bouts with pancreatitis resulted to pancreatic cancer? Like, how likely would a few bouts result to cancer and what would be the number that constitute these few bouts?

 

I'm a little paranoid so please do help me out lol thanks

1) yes...severe AGE may be accompanied by gastritis..due to " no/limit food intake to rest the enteric motility principle..hence yun paniniwala ng mga matatanda na wag kumain pag nagtatae" belief...also dehydration will lead to an increase in stomach acidity...resulting to gastritis...however if AGE/ gastritis becomes frequent or regular...it is not NORMAL...

2) lipase is an enzyme...meaning it breaksdown materials...in this case lipids...so abnormally high lipase is not NORMAL...the surrounding organs might get affected...

3)..this is very debatable between MDs...since any inflamation destroys cells but it is followed by healing process too...however repeated healing and destruction will lead to metastatic growth...just like in repeated liver destruction and healing will lead to liver death and or liver cancer...

4) why tramadol? Try antacids first or H2 blockers...maybe the pain is just a result of hyperacidity

 

And for your peace of mind...i would suggest you seek consult with a specialist...gastroenterologist to be precise...if youll be needing added exams or procedures..i.e colonoscopy etc...theyre be the ones to request it...

[azraelmd]

i'll let azraelmd answer.

Thanks miss rojo...but you helping and giving advices are very commendable for a non-MD point of view...they are very well thought of and very knowledgeable..

 

[ermita rojo]

Thanks miss rojo...but you helping and giving advices are very commendable for a non-MD point of view...they are very well thought of and very knowledgeable..

 

 

dear, i am an internist and a sub-specialist.

 

i'd rather not specify which subspecialty. That's too much info already

 

 

but yes, in all likelihood i've done more endoscopies than you.

 

 

 

but this is not a matter of who is better than whom.

 

as i've said, every MD is welcome to give advice.

Edited December 3, 2015 by ermita rojo

[Cap™]

4) why tramadol? Try antacids first or H2 blockers...maybe the pain is just a result of hyperacidity

And for your peace of mind...i would suggest you seek consult with a specialist...gastroenterologist to be precise...if youll be needing added exams or procedures..i.e colonoscopy etc...theyre be the ones to request it...

Because the usual H2 blockers I'm taking aren't really helping out with pain management (taking Nexium and Pantoloc).

 

Miss Ermi, I've told you who my gastro was at MMC and I was told at the ER that he's on indefinite leave. You know other gastros who are really well-versed with what I'm struggling with atm? Thanks

[azraelmd]

dear, i am an internist and a sub-specialist.

 

i'd rather not specify which subspecialty. That's too much info already

 

 

but yes, in all likelihood i've done more endoscopies than you.

 

 

 

but this is not a matter of who is better than whom.

 

as i've said, every MD is welcome to give advice.

Agree...everyone is welcome to give advice...

[miggyE]

was going to jump in, but seems Ermita Rojo already answered azraelmd. suffice to say, ermita has fellow attached in front of her Society/College, and has been posting here for quite some time.

 

truth do tell, she posts more often here than most of us old hands

[rifs2k]

 

how old are you and what physical activities do you do? in all likelihood that is just musculoskeletal strain.

im 31 yrs old po and wala ako masyado physical activities, upo lng po maghapon sa work for 12hours of duty.

[happybloke]

im 31 yrs old po and wala ako masyado physical activities, upo lng po maghapon sa work for 12hours of duty.

you need to start doing more physical activities... wag biglaan, but gradual increase in physical activity ie. exercise

[rifs2k]

you need to start doing more physical activities... wag biglaan, but gradual increase in physical activity ie. exercise

thanks po sa advice.

[happybloke]

thanks po sa advice.

If you need help, sabihan mo lng ako. Remember, a single step is better than not stepping at all

[omegared]

hi guys,

 

thanks for the heads up. Been tracking my own medical history since I've been hospitalized twice this year due to pancreatitis and gastritis, so here are my questions:

 

1) my current episode started with severe diarrhea that provided the AGE diagnosis but it developed to my usual gastritis. A doctor friend says this is normal but it was the first time I experienced this combination. Question is whether this really occurs regularly or not?

 

2) my bloodworks had always shown high levels of lipase. Is it possible that this becomes "normal" for me or should I always lower it to normal levels?

 

3) are there studies wherein repeated bouts with pancreatitis resulted to pancreatic cancer? Like, how likely would a few bouts result to cancer and what would be the number that constitute these few bouts?

 

I'm a little paranoid so please do help me out lol thanks

Elevated lipase in multiple episodes is bad news, something is going on. Acute pancreatitis is relatively common, majority will go away with bowel rest and pain meds, most are with alcohol or stones, there are also a lot with no readily identified cause, most are one time deal.

Chronically elevated lipase can be a sign of chronic pancreatitis, which increases your tisk for pancreatic cancer. The cause should be investigated as the long term outcome is not very good. It can lead to malabsorption, diabetes and yes, cancer is a possibility.

2 very difficult cases I have seen to illustrate this difficulty, one had good outcome the other although not fatal was debilitating.

 

A 20ish guy keeps coming back to the ER, always with elevated lipase and lots of abdominal pain. Multiple ERCP's eventually had his gallbladder taken out, he keeps coming back with stays between a week to 2 weeks, usualy on narcotics, always with lots of pain, elevated lipase and nausea and vomiting. I eventually gave up on him as drug seeker. Sent him to 2 prestigious teaching hospitals, they repeat our tests, MRI, ERCP, serology markers, they came up with the same diagnosis. He disappeared for a while, I thought he overdosed. I saw him in ER 3 years later. He was there for a different problem. He has not had pancreatitis for over a couple of years, he was diagnosed with autoimmune pancreatitis, put on low dose prednisone and has a "normal" life.

 

Obvioulsly I felt guilty about thinking he was just a "drug seeker".

 

Second case:

[omegared]

This is a very nice healthy Veteran that comes for regular check up. All his tests were good, he is in good shape for late 60's. He had a bout of abdominal pain, I eventually diagnosed him with acute pancreatitis. He did good went home but on discharge lipase was still high normal. I decided to follow up labwork at the office and his lipase will go up and down, never going over 120, without symptoms. MRI, serologies and nothing. He eventually had ERCP to look for mass or anatomic abnormality, an abnormal duct morphology was a possibility. First ERCP was negative, second was negative, third was negative. His lipase is either a little high or normal, he has not had any pain all these time. 3-4 years later he became diabetic, a year later he needed to take pacreatic enzymes for digesting food, his lipase remained elevated. His Xrays has started to show calcifications, he later lost so much weight and I eventually diagnosed him with pancreatic cancer, I sent him to hospice about 7 years after I first saw his elevated lipase.

 

Both cases are not common but illustrate need to be dilligent in looking for a cause, it's never normal.

[ibirp]

i think there should be a new thread for Sports Injuries

[ermita rojo]

This is a very nice healthy Veteran that comes for regular check up. All his tests were good, he is in good shape for late 60's. He had a bout of abdominal pain, I eventually diagnosed him with acute pancreatitis. He did good went home but on discharge lipase was still high normal. I decided to follow up labwork at the office and his lipase will go up and down, never going over 120, without symptoms. MRI, serologies and nothing. He eventually had ERCP to look for mass or anatomic abnormality, an abnormal duct morphology was a possibility. First ERCP was negative, second was negative, third was negative. His lipase is either a little high or normal, he has not had any pain all these time. 3-4 years later he became diabetic, a year later he needed to take pacreatic enzymes for digesting food, his lipase remained elevated. His Xrays has started to show calcifications, he later lost so much weight and I eventually diagnosed him with pancreatic cancer, I sent him to hospice about 7 years after I first saw his elevated lipase.

 

Both cases are not common but illustrate need to be dilligent in looking for a cause, it's never normal.

 

 

no MRCP done before? CA 19-9?

[omegared]

Multiple MRCP's, maybe 4 or 5, CA markers, all normal.