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Suffer From Chronic Pancreatitis. Serum Test Showed Trypsinogen Level Was 24. Stool Is Pale And Hard To Flush. Suggestions?

Posted on Tue, 24 Sep 2013

Question: Hello Doctor. Yes I do have a question. I suffer from chronic pancreatitis. It's been confirmed via a serum trypsinogen test. My serum trypsinogen level was 24, but has dropped to 7 which indicates chronic pancreatitis. My GI doctors in the past made a chronic pancreatitis diagnosis based on my low trypsinogen level alone and my symptoms.I've had multiple EUS's done on my pancreas which shows lobularity, hyperechoic strands,hyperechoic foci, accentuated lobular patterns, calcium,atrophy, and a coarse texture. These are the parenchymal changes that have been showing on many EUS's done on my pancreas. My stool is pale and hard to flush down the toilet. I had an EUS today and the doctor told me that it was normal with none of the changes shown in my other EUS's. He doesn't think I have chronic pancreatitis now. I asked that doctor if it was normal to have an atrophic pancreas.That same doctor told me that all old people's pancreases become atrophic. I am 49 years old. My other GI doctor told me before that the changes in my pancreas were irreversible. Should I believe her? Based on what you read, should I get a second opinion from a pancreas specialist?

Answered by Dr. Amit Jain (1 hour later)

Brief Answer:
It is chronic pancreatitis only

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

Multiple EUS showing lobularity, hyperechoic strand and foci, deposition of calcium and atrophy and coarse echotexture confirms the presence of chronic pancreatitis beyond any doubt. And chronic pancreatitis is irreversible process.

Stool difficult to flush may suggest steatorrhea so I will advise you to get stool examination especially for fat. If it is present then you may have to start pancreatic enzymes oral preparation with meals. Also check your blood sugar levels

So to conclude I will suggest you to visit a pancreas specialist

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

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