Question: Hello. I’ve just had an EUS showing parenchymal changes throughout my whole pancreas with a pancreas that is significantly atrophic now. My blood trypsinogen and trypsin levels are also significantly low now, less than 5, which is consistent with chronic pancreatitis. I have significant pain especially after eating greasy or fatty foods. I’ve had acute pancreatitis attacks over 30 years. My amylase and lipase levels would elevate significantly and dangerously when I first starting getting pancreatitis, but they no longer elevate when I have an acute attack. I have really bad pancreatic insufficiency which makes my stool appear pale, filled with fat, and hard to flush because it floats on top of the water. I have to utilize a plunger to flush it. What is your opinion after reading my story. Do you think U have chronic pancreatitis based on function (pancreatic insufficiency, low trypsin/trypsinogen) levels and based on structure (atrophic pancreas) parenchymal changes throughout the pancreas and a atrophic pancreas?

I’ve had acute pancreatitis attacks over and over again since 1990. I’ve had pain since I’ve suffered from my acute pancreatitis attacks. My amylase and lipse use to elevate really high after easy greasy or fatty foods, but they no longer elevate. I live with chronic pain since I have suffered from chronic pancreatitis. I really get really bad pain and nausea after eating greasy or fatty foods. My blood trypsinogen and blood trypsin levels were normal before I start getting acute pancreatitis, but since I’ve had so many attacks since 1990, my blood trypsinogen and blood trypsin is now below 5. For example if I went out and ate a meal of fried chicken, mashed potatoes with gravy, buttered cheesy biscuits etc. I would be doubled over in pain. I use to be able to handle greasy and fatty foods before I start getting sick with the pancreatitis over and over again. A colleague of yours on this website told me that chronic pancreatitis is irreversible. He also told me with a trypsinogen level of 7 or lower, that it is advanced chronic pancreatitis. My pancreas has shrunk tremendously. It is atrophic and has hyperechoic strands all through it and lobularity through is as well. One area of calcification was found in the head of my pancreas.

I have lobularity, hyperechoic strands and hyperechoic foci throughout my pancreas and an area of calcification in the head of my pancreas. I have many diagnoses of acute pancreatitis, chronic recurring acute pancreatitis and chronic pancreatitis. My pancreas wasn’t damaged and was completely normal until I started having acute pancreatitis attacks over and over again. I was pretty healthy until I start getting sick with pancreatitis. I’ve had the chronic pain ever since I’ve suffered from pancreatitis.