Does Pancreatitis Cause Exhaustive Diarrhea?

Posted on Sun, 19 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 19 Jan 2014 Answered on

Tue, 4 Feb 2014 Last reviewed on

Question : My question is not about any medical problem I have. Rather it is for a family case that is over 100 years old. A great uncle died in 1903 at age 23 after a several weeks illness. I found an ancient letter from his physician with the following quote: "And I would say in regard to your brothers illness that he came to me saying that he had had a diarrhea for nearly three weeks. During the last week of illness he suffered pain at stool only and at no other time otherwise. It was an exhausting diarrhea due to wasting of the pancreas. At an early call he told me of a very tight foreskin and that it had become very sore. Later this became so much worse that it necessitated operation. The healing was rapid at first but his skin in general was much weakened by disease and healing was retarded. " Mind you this was in 1903. My question is what does this sound like, and what would today's diagnosis be for the symptoms described?

Answered by Dr. Poorna Chandra K.S (1 hour later)

Brief Answer: Answered Detailed Answer: Hi and thanks for contacting XXXXXXX I have my limitations in interpretation as the understanding of medicine has changed since 1903. In 1903 there was no specific investigation to either visualise pancreas or to test its function appropiately. Chronic Pancreatitis can lead to diabeties and fatty diarrrhoea. The diabeties may explain the slow healing. But diarrhoea is usually indolent and lasts for months to years. Further pain in chronic pancreatitis is usually continious with increases after eating. The other possibility is an inflammatory bowel disease with balanoposthitis. In this illness pain can be only during or just before defecation. However even here the diarrhoea is long lasting. The other possibility is of HIV infection with associated debilitating diarrhoea and genital infection. I hope this is of some use Regards Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Poorna Chandra K.S (4 hours later)

I can't be certain, but I think his health was excellent just a few weeks prior to his fatal illness (there is a surviving letter from about 1 month prior to his illness that makes no mention of any health issues). His last three weeks were spent in a hospital in Minneapolis, so he did have medical care and support during his last illness. I think your suggestion of an inflammatory bowel disease with balanoposthitis sounds plausible. I don't think HIV was likely (maybe not even possible in 1903?), but could his symptoms have been caused by some other sexually transmitted disease? Would it be possible for the bowel inflammation to arise from a general acute infection of his whole system, one from which he was unable to recover?

Answered by Dr. Poorna Chandra K.S (2 hours later)

Brief Answer: Answered Detailed Answer: Hi again Of all the three possibilities, HIV associated problems is the one most likely to be associated with a considerably good premorbid health. HIV associated diarrhoea can be watery or mucoid while that associated with panceatitis or Inflammatory bowel disease are mucoid. HIV has been in circulation for ages and first noticed in late 19th century. Other STDs except rarely syphilis donot affect intestines. Beyond this it is difficult to deliberate. Regards Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Poorna Chandra K.S (2 hours later)

I did not know that about HIV, so it could have been the cause. One final question - the family lore said that he probably died from a ruptured appendix. However, when I read the note from his doctor, it did not sound like that to me. So my final question is: could his symptoms been caused by an untreated ruptured appendix, or a severe and prolonged case of appendicitis?

Answered by Dr. Poorna Chandra K.S (14 minutes later)

Brief Answer: Answered Detailed Answer: Hi again Ruptured aapendix is a medical emergency and the person is usually very sick and febrile. They usually have continious right lower quadrant pain. It can alosi cause diarrhoea but sice the other things are not there it difficult to conclude on the same Regards Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar