How reliable is Abdominal ultrasound?

Those are similar to me but a different side. I don't know what you've got going on but seems more like Gallbladder or Liver than Pancreas. 

I have my doubts Chronic Pancreatitis shows up clearly on an ultrasound. They seem to have difficulty diagnosing pancreas problems. 

Been an absolute nightmare, ask for the calprotectin test. Apparently it tells if you have inflammation in your bowel 

Hey Shortie79, remember me? I finally see the pancreas specialist at Elkins Pancreas Center in Houston the middle of May.  I hope he will do a MRCP to look more closely at the working of my pancreas.  I really don't want to do an ERCP, unless absolutely necessary.  All my tests have come back normal except my lipase and amylase were a little high.  I saw my GI last week, and it was a joke of an appt.  I asked him about the pancreas divisium, and he said not to worry about it. I told him I can only drink ensure milkshakes and couldn't eat solid foods, and he didn't seem the least bit concerned.  He said that he would send a script to help. The pharmacist told me it was a muscle relaxer.  Go figure!  I told him about the constipation, and he told me to justkeep taking the Dulcolax since it was working.  I told him I was addicted, and he smiled and said you can't get addicted.  He didn't say anything about trying to find out why or if there is a more serious problem I know different from experience.  This guy is the head of gasto at Methodist Hosp. and supposed to be the best.  The nurse told me he didn't want to see me for 6 months.  Looks like I'll be looking for another GI that might care.  This is my second one, and some on the forum have said they have gone through several before finding one that that wants to help.  Maybe I'll get some answers at Elkins.  The only reason that I'm going is because you said all your tests came back normal and yet you were diagnosed with pancreas divisium and CP. I hope that's not what it is, but I won't be satisfied till i get the MRCP.

Hi Lindy,

Forgive me for my memory but were you already diagnosed with Pancreas Divisum (PD)? If so, then unfortunately, in my experience, the next step is an ERCP. However, if you have PD then an ERCP will be nothing as far as pain. I had a slight pancreatitis attack with my first ERCP but it only lasted a day and they keep you in the hospital for observation just in case of an attack (it also depends on what they have to do during the ERCP). I’m going next week for my 5th one, it’s like a drill for me now. If you’ve had an endoscopy, it’s the same experience, in my opinion. During the ERCP they can biopsy and that’s how I was diagnosed with chronic pancreatitis. As for your GI doctor … sounds similar to my experience except my GI thought my symptoms were IBS related and not the PD. I said I wanted a referral to a pancreas specialist because I knew I was in too much pain and losing too much weight for it to be IBS (especially since I was always constipated).  I had been dealing with it for about a year at that point and needed answers. The pancreas specialist took one look at my chart and said he wanted to perform the ERCP to see if there was an obstruction in my ducts, if not then place a temporary stent. Now when I go, my ducts are dilated to prevent them from getting clogged. They have helped me but I’m still in pain. Stress seems to be the biggest trigger. Keep me posted on what your specialist says. I hope you get the answers you need. I wish you all the best sweetie. 

Hi Shortie79,

Yes, the cat scan showed the PD.  On the report it says "incidental pancreas divisium". Do you know what that is?  Did your scans show that the ducts looked normal?  Mine did.  I really don't have the pain I was having.  I'm still on Ensure milkshakes, so I don't have the nausea except when I try to eat something solid every once in awhile.  My fecal test came back normal.  I'm sure sorry that you have to have the ERCPs so often.  Do your intestines ever just burn, feel like they're on fire?  This causes me excruciating pain.   So, the MRCP would not show enough to then, if necessary, do the ERCP.?

Hi Lindy,

It was the MRCP that caught my PD and yes it showed my ducts working fine. However, my pancreas specialist advised me a MRCP is a great noninvasive scan but it doesn’t show everything. It won’t show if the ducts have sludge and even if your ducts were working at the time of your test doesn’t mean they’re working correctly now. I think the “incidental” just meant that they happened to find a congenital abnormality. PD is a rare condition that’s normally found in autopsies. Only 5% of the population are born with it. I don’t think GI doctors understand it can cause chronic pancreatitis. In our case, we have symptoms of pancreatitis but not necessarily an attack on an everyday basis (that’s how it was explained to me). You’ll know the difference between an attack and the symptoms. I also have horrible burning sensation in my stomach almost everyday. I can’t seem to get rid of it. As for the other pain, I take it one day at a time. This past month hasn’t been the greatest for me and I’ve been under a lot of stress. Due to the stress I’ve experienced more pain and symptoms. I know the ERCP sounds scary because it did for me before I had my first one but after I had it, it really wasn’t a big deal. I actually felt better because I knew the doctors would be looking at my pancreas and then I would be getting treatment. Remember ERCPs are used as treatment methods for our condition, not diagnoses methods. I’m not going to lie, you’re not going to feel 100% better, it’s a long process but I do feel a lot better now then when I originally started. I’m able to eat more solid foods now (until I’m stressed out) and my symptoms aren’t half as bad as they were. I don’t know if you’re on digestive enzymes but that might be something the doctor may put you on even if your fecal test came back normal (my did too) and I’m on enzymes. We’re all unique in our condition but in my experience only a well versed pancreas specialist should be looking at you with your condition. 

But I don't have the pancreatitis pain like you do.  I have the burning in my stomach and intestines and back pain.  Do you ever feel like your intestines are on fire? Do you think this could be connected?  I'm sorry that it has been a rough month for you. Nowhere to go but up.  I hope this happens soon for you and thatat the stress decreases.  Yes, I would be nervous about doing an ERCP.  I'm concerned that he will do the test and won't find anything to help me and I'll end up having an attack or even worse to get CP.  Then what?  I know I'm borrowing trouble, but that's what's on in my mind right now.  No, I'm not on enzymes.    Also, do you have trouble with constipation?   As you can see, I have lots of questions.  Thanks for answering them as I ask!

I have the same issues you do sweetie. I don’t necessarily have pancreatitis pain all the time, it’s the symptoms of pancreatitis. Being nauseous, getting full after a few bites, bloating, constipation, fatigue and weight loss (it’ll fluctuate). When I have an attack, I have debilitating pain and uncontrollable vomiting with the rest of the symptoms but they’re so much worse and you don’t want anything to do with food. During an attack I’m crying and bellied over and I’m already on pain meds for another unrelated condition. The pain meds don’t touch this pain but I hardly get attacks now. My blood work never shows anything so I can only go on what my body does. My blood will elevate but not out of the normal limits. Usually with chronic your blood levels decrease over time. There’s also certain things that can affect your blood results like an estrogen patch and if you have high cholesterol that has an affect too but I don’t remember what. As for the ERCP they’ll most likely want to place a temporary stent to get adequate drainage. It’s not about finding anything it’s about controlling your ducts size. They’ll need to clean and possibly put a balloon to dilate them. Our ducts are narrow because they never fused into one regular size one. So in our case they can get clogged and bile backs up causing us to feel symptoms until the bile goes through. There’s no quick fix but they do help in the long run sweetie. The risk of an attack isn’t that big either. I’m just one of those … if it’s going to happen it’s going to happen to me type of people LOL. The attack after the ERCP wasn’t even bad, they knock you out for most of it. Oh and yes re constipation, I get it bad when I don’t eat enough. I found once I started eating more the constipation was going away. I had to get the right amount of fat in my diet too. I’m always here if you have more questions.