Chronic Pancreatitis vs Gastroparesis

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How can you tell the difference between these two diseases? They have many of the same symptoms.

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  • Posted

    I would say the only difference would be how the pain affects the person. Usually with pancreatitis the abdominal pain radiates to the back and it's more on the left side. There's also certain tests for both diagnoses. I just had an ERCP done for Pancreas Divisum. I thought it was a diagnostic procedure but in my case it was more like a mini surgery without cutting me open. The doctor cut one of my pancreatic ducts and put a stent in it. I have to go back in four weeks for another ERCP  to have the stent removed. I had to spend a week in the hospital for observation. An ERCP is no joke but it's the only real test that looks at the pancreas. The MRCP is another great test too. I know there's specific tests for gastroparesis but I have not experienced any myself. I have had a doctor tell me I might have gastroparesis but because I have other medical issues I can't be taken off my medications to take the tests. 

    • Posted

      Hi Shortie79. I wondered what happened to you after all this time. Sounds like you have been through the mill. I'm glad you are doing well after everything. I didn't go off any of my meds to do the gastric emptying test.  You eat scrambled eggs with radioactive material, along with toast and juice.  Then they watch how it moves for basically 4 hours. I definitely have the Gastroparesis. I've been living on Ensure milkshakes for the last 6 weeks. I had my second real meal today. Feels like a ton of bricks! I just do better on liquids.As I sit here, I'm experiencing pain in my upper left ab around to my back. It's all so confusing. I don't even know which specialty dr to deal with.

    • Posted

      Hi Lindy,

      The GI specialist told me in order for me to have the gastroparesis test I would have to stop my pain medication and I have what's called Complex Regional Pain Syndrome. It would be too much on my body to go off my pain meds. The reason why they told me I would have to go off my pain meds is because it also slows down the digestive system … therefore I couldn't be on my meds. I don't believe my nerve meds would affect the test. I had the MRCP which showed I have Pancreas Divisum (rare congenital abnormality where you're born with two pancreatic ducts that don't fuse into one). Pancreas Divisum can also cause chronic pancreatitis and I have atrophy of my pancreas but I haven't been diagnosed with chronic pancreatitis. The pancreas specialist told me he cut one of my pancreas ducts, dilated it and put a stent in it because during the ERCP he saw that my duct had an obstruction in it. He said it's like a mini surgery without being cut open. I didn't realize how big of a procedure an ERCP is. I expected to have it done and go home the same day … boy was I wrong. I was admitted to the hospital and observed for a week. When they do an ERCP they do an EUS at the same time and the dye they inject for the X-ray is what can cause a pancreatitis attack after the procedure (hence the observation period of time). I have to go back for another ERCP on the 25th to have the stent removed. The doctor said I've been basically in pancreatitis mode for the entire time (it took a year for a diagnosis). I'm supposed to be protected from pancreatitis now that I have a stent in place but I'm still vomiting however the pain has gotten better. I'm still dealing with the procedure pain. The ERCP is a delicate procedure and in CA only a few doctors can perform it. If you really want your mind put at ease then ask for a MRCP. They won't do an ERCP unless they see something on the MRCP because they are too many risks with the ERCP. I would look for a pancreas specialist not just a GI specialist (I see a pancreas specialist). I hope you find answers soon. 

  • Posted

    Pancreatitis as the name suggests relates to the pancreas and Gastroparesis relates to the stomach.  Two totally different issues with some similar symptoms sort of.

    With Gastroparesis food stays in stomach longer because the stomach muscles don't function properly, they don't push the food out as quickly as they should so digestion is affected and some symptoms like nausea occur. 

    With Chronic Pancreatitis the pancreas is the culprit not the stomach, and whilst nausea, pain and discomfort can occur as it does in Gastroparesis it happens for different reasons.  

  • Posted

    Certain tests, blood work and what you present with in a clinical arena will tell you. Pancreatitis has a very distinct anomaly of its own. Your Dr. will be able to differentiate the two. 

    DJRN

    • Posted

      Unfortunately you can't always count on blood work for pancreatitis. If your pancreas is atrophied then it stops producing the enzymes and won't show up in blood because the pancreas has started to digest itself. Instead of your enzymes going up, your enzymes might go down. Furthermore if you have high cholesterol your blood work can also appear normal 

    • Posted

      That's why I said what you present with along with other tests. It's not difficult to differentiate Pancreatitis from gastropiredis. 

  • Posted

    When I went to the ER last month, I was in excruciating pain left side of my stomach radiating to left side and back. The ER doctor said it was Acute Pancreatitis, but the blood work came back normal, lipase a touch high. The on call GI said it was Gastroparesis, (which I do have--diagnosed through a stomach-emptying test).  If so the symptoms are pretty much the same. No appetite, nausea, vomiting, pain. I really want to find a Gastro who will do an EUS and/or the MCRP. Only after that will I be assured that it's not pancreatitis.

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