Low grade fever in chronic pancreatitis?

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Hello, everyone. I have an undiagosed problem, suspected by one doctor to be a CP, but not confirmed. I've had gallstones since I was a teenager. In my early 20s we took the gallbladder out, but several months later the duct got blocked. We did an ERCP and doctors cut the papilla. I developed acute pancreatitis. After I recovered from that though I continued having gallbladder/pancreatitis type of severe pain. Doctors shrugged it off since they didn't know why I'm having it.

During one of my ER visits in the beginning of 2013 the acho and then scan read another acute pancreatitis. But my amilase was normal, so doctors shrugged it off again. My ASAT, ALAT and GGT were elevated, so they said there was some temporary kind of block or spasm of the bile duct. Didn't put me on a diet or anyhting. After this hospital visit my health started worsening. I stated having very often, almost daily, low grade fevers in the aternoon with chills and sweating and all. Started feeling sick and throwing up in the mornings, feeling dizzy, getting tachicardia. Lost a lot of weight. Gradually developed severe chronic diarrhea. By the end of 2014 I was barely able to function, spending most of my time in the bathroom, feeling sick all the time, endlessly exhausted. And still very often in pain in my upper abdomen, also in the back. Very specific type of pain.

Some months ago I did an endoscopic echo and doctors saw enlarged head of pancreas, unhomogenous structure and scar tissue (or something like that). Also emlarged lymph node by the head of the pancreas. They said they can't be sure what it is - could be old scarring, could be something chronic going on. Gave me enzymes which help quite a lot with the diarrhea, which is a huge relief. But I still get the subfebrile fevers very often, still feel very tired...better than before, though. Does it sound like CP and if it does...what can I do to make it better (I follow a very light diet which is supposed to be very easy on the pancreas). I would be so greatful if you could share some experience...

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10 Replies

  • Posted

    Please get a second opinion I spent 6 years in and out of hospitals before they finally figured it out. I had many of the same symptoms as you. Now I have sever scarring of the pancreas with stone calciafication. I al sick a lot of the time. It is hard to diagnose CP. have them do an untra sound and an MRI what ever else it takes but don't give up! Best of luck sweetie.
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    • Posted

      Thank you very much for your reply. So sorry, such a terrible situation...

      Well, doctors said endoscopic ultrasound is the best test they can do and they do see some scarring on the head of the pancreas. Another doctor said he can actually see it also on a regular ultrasound. But I've had possibly two bouts of acute pancreatitis, so they said they can't be sure that it is not some left over scarring. They also said I cannot be having low grade fevers from CP (do you have those?) and also I shoudn't be with such a bad diarhhea, since if it is CP it is very early stage. But pancreatic enzymes that I'm taking are quite helpful, so I think this shows it is the pancreas after all. Doesn't it? But they also told me that even if it is CP, there's nothing we can do about it, besides the anzymes and a diet (which I am following). Is that true?

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    • Posted

      I hate to disagree with your Dr. but I do run low grade fevers with CP. And if you have scaring how can he say it is not CP. Enzymes do not help me but they do most people. I think you need a different Dr. Stomach problems both upstairs and down are common. Are you having any pain? For the most part yes enzymes and diet they try first. I may have to have a total pantectomy with isolet transplant. The lower the fat you digest the better. Good luck to you sweetie so sorry you are going through this I definitely relate.
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    • Posted

      About the fever...well, doctors tell me fever is nothing and I should take pills to lower it. But I'm feverish so often, I can't take pills daily. Plus, they don't treat the problem causing the fevers, they just mask it. And I've been to many, many doctors... They are a bit confused, because I obviously have some problem in that whole general area - gallbladder (now taken out), bile duct (now with cut papilla) and so on... So they kind of think I might have some chronic inflamation somewhere there, but they can't see it or pinpoint it. They do see some enlargement, mild scarring and enlarged lymph nodes next to the pancreas, but they said it might not be something progressive, but rather small damage from acute attacks of pancreatitis, that may not be causing the current problems. 

      For years I used to have very acute pain attacks that would take me to the ER. Those we probably gallblader attacks, since I had stones and it was getting inflamed constantly. When we took it out I continued having the pain - this time possibly stones in the duct (during attack my liver enzymes rise, suggesting partial blockage of bile flow). So they cut the duct, but I still get the acute attacks and rised ensymes from time to time. On top of that, for the past 2-3 years (since possibly the second AC, the fever and so on, I do get similar, but more bareble pain in the upper abdomen, penetrating to the back...). What is the pain like in CP?

      So what do you do if enzymes don't help? How do you cope? 

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    • Posted

      oh I know the frustration of multiple Dr trips. It took 6 long years of costant pain. wasting away and throwing up constantly for me to find the right Dr. by that time my pancreas was so damaged they told me to give up. Then i found a Dr. in Nebraska. I am currently seacking a new Dr. closer to me. The pain can be a burning sensation clear to a stabing sinsation mine goes from the middle of my upper stomach around my left side into my left shoulder blade and back. it is so bad I throw up sometimes because of the pain. please don't give up keep going to diffrent dr.s till you get that answer! All my best to you! PS I was told fever even low grade with pancreatitis suggests infection.
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  • Posted

    Hi Pompon,

    Sounds like you've been through a lot. Sorry you're suffering. I think you do need to see a different Dr. They use a criteria to score you on when using an EUS if you have 5 or more then they are confident of chronic pancreatitis. Did they use the scoring system on you?

    I can't be of much help to you but there's a group on Facebook called pancreatitis pals. You might find it useful to have a look. Many people in your situation are on there and there's a lot of knowledge.

    Gem

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    • Posted

      Thanks very much, I'll check it out.

      As far as I understood according to that criteria I'm somewhere on the verge...like it could be CP...but it is also possible that it is not. Doctor who did the EUS said to her it looks like an early CP. She said we should see it again in an year or two and check if it gets worse. I realize that is probably the only thing that can be done, but in the meanwhile I don't feel well, so it doesn't do much for me. smile

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  • Posted

    Hi! I see that you sent this 5 months ago, but I figured I'd still weigh in. I had constant vomiting, diarrhea and pain under my rib cage for months. I lost my ability to walk and lost my hair. I called an ambulance and was admitted. They found pancreatitis and severe liver disease. I'm hoping you are much better now. Did they also check your liver function? 
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  • Posted

    Hi I'm sure after all this time its been figured out but my thoughts:

    You have gallstones blockage and need to have your gallbladder taken out asap.

    Unfortunately the doctors waited to long trying to find a correct diagnosis so you have probably had numerous acute pancreatitis attacks, which may have resulted into chronic pancreatitis.

    All the tests you have described match up.

    Im not a doc just a person that got a 2nd opinion, thankfully

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