Acute pancreatitis or Chronic pancreatitis?

Posted , 6 users are following.

This discussion has been locked due to a period of inactivity. Start a new discussion

Hi everyone first time posting but needed some advice. When I was 18 I was diagnosed with ulcerative colitis affecting my whole colon. I was in lots of pain and lots of bleeding at the time and was given mesalamine and corticosteroids. After 3 months of intense mesalamine 3g a day I had intense pain in my abdomen like a knife stabbing me through my abdomen going into my back. I went straight to A&E as I knew this wasn't my colitis but something much worse. The A&E did nothing no blood tests no scans got paracetamol and sent home. I then had the worst night of my life no sleep constant pain and went to my gp who saw the pain I was in and was sent to a specialist immediately blood tests were carried out showing my amylase and lipase being 10 times over normal. I then got a CT scan which showed acute pancreatitis with pseudocysts I was admitted to hospital for a week no food and lots of morphine. The exact cause of pancreatitis was not known, however I strongly suspect drug induced pancreatitis with mesalamine no further tests done. I have then been put on sulfasalazine and azathioprine which can both cause pancreatitis. Iam now developing dull pain on my pancreas going to my back and lots of nausea. Have I got chronic pancreatitis? As this is my second episode.

Thank you sorry it's soo long just need to tell you my whole situation. 😣

0 likes, 4 replies

Report

4 Replies

  • Posted

    Yours is an interesting story.  I had acute pancreatitis when I was 17 years old, which I was told was from a mononucleosis infection.  However, my pediatrician had put me on a Sulfonamide drug at that time, and I've also read that this drug can cause pancreatitis.  At any rate, after taking the drug while having mono, I developed the worst abdominal pain of my life - it took my breath away and my dad took me to the ER, where I was diagnosed with acute pancreatitis on the basis of amylase and lipase tests (my amylase was around 900 U/L if I remember correctly).  I got the nasogastric tube and the works and spent the next 1 1/2 weeks in the hospital.  Once, I got out of the hospital I continued to have occasional episodes of the severe abdominal pain, but my lipase and amylase never rose as high as that first time, although I've had acute pancreatitis a couple of times since the initial attack.  Then, in my late 30s, I begin having a dull pain in my abdomen that was different from the severe attacks and I went to the doctors several times.  They tested my lipase and amylase and the values were actually returning low, below the lowest value of the reference range.  I also had a fecal elastase test, which came back right around 200 ug/g.  At any rate, to make a long story short, I consulted a specialist and it turns out I now have chronic pancreatitis, which apparently can be quite difficult to diagnose unless you see a specialist.  The symptoms of the two conditions in my view are quite different.  Where acute pancreatitis causes the worst pain you can imagine, chronic pancreatitis can cause dull pain, severe pain, or sometimes no pain at all, but digestive issues and it cannot be diagnosed on the basis of amylase and lipase alone, because as the pancreas becomes more damaged, it can no longer produce these enzymes in sufficient quantities to aid in diagnosis.  At any rate, I have always thought that the first episode of acute pancreatitis was not caused by the mononucleosis - because I'd already been sick with it for two weeks - but due to the sulfa drug that my pediatrician prescribed.  He also prescribed Tylenol #3 with codeine and I have also read that codeine can cause pancreatitis in some cases.  I suspect that it was the combination of these drugs that triggered my pancreatitis, because, if I remember correctly, I had the attack on the second day of being on the medication.

    Report
    • Posted

      Hi, thank you for your reply. Sorry about the late reply but I'm sorry what you have gone through and I feel like I'm heading in the same boat. I'm starting to get dull ache in my middle upper abdomen with constant nausea. The pain is bad when it travels to my shoulder blade and is worse when eating. I'm starting to develop severe fatigue which is stopping me going outside and constant thirst which can not be overcome. I have had a litre of water with no solution to my thirst. I don't know what to do as if I tell my doctor I will be put on biological agents making my life even harder with severe fatigue and lots of side effects. I'm in university and can not risk that over such a hard illness to live with.

      Report
    • Posted

      It sounds like it should be investigated further.  My chronic pancreatitis came on quite a few years after my initial bout of acute pancreatitis and the symptoms have been different.  Your symptoms sound closer to chronic pancreatitis than acute.  The dull pains and fatigue are both  symptoms of chronic pancreatitis.  I'm not sure what causes the fatigue - possibly malabsorption of the fat-soluble vitamins, but I've experienced both of the symptoms you describe with chronic pancreatitis.  Excessive thirst is also common, especially if you are are pre-diabetic or diabetic, which can also accompany chronic pancreatitis.  I don't have much nausea, but I do have constant dull pain in my upper abdomen and bloating (which is often worse at night or after eating) and other digestive problems.

      Report
  • Posted

    I've had acute on and off for 16 years. They have yet to figure it out. The last lower gi I saw, did an EUS (endoscopy ultrasound) and saw damage or calcification to the panc. According to him ,he only declares chronic when he sees damage or your lipase is consistently over 100 for a long time. First time I ever heard that. If the pain for me is too much, I go to er and if my lipase is over 100-110, they can admit me, starve me for a couple days until it goes away. Sometimes it's under and they can't admit me. (Insurance reasons) NSAIDs used to work best for me when I used to be able to take em. (Ulcer now) 

    Report

Join this discussion or start a new one?

New discussion

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up