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Suggest Treatment For Mild Pancreatitis

Posted on Wed, 9 Jul 2014

Question: I just came back from the XXXXXXX Clinic and had an assessment of my abdominal pain, which has been consistant since January. My endoscopy shows mild gastritis, and my MRI and MRCP shows two side branch lesions around 1cm. The Gastrenologist feels my pain is not likely coming from the gastritis but could be a case of mild pancreatitis. He said scans would not detect mild pamcreatitis and suggests a EUS. He also feels my pancreas cysts are too small to cause any symptoms and says they are common and not to worry about them. But, how serious is mild pancreatitis and can it be cured?

Answered by Dr. Ajit Naniksingh Kukreja (1 hour later)

Brief Answer:
Mild pancreatitis can be treated medically

Detailed Answer:
Hi

Greetings of the day

Mild pancreatitis can be well treated medically

Do you have any other symptoms like pain radiating to back; nausea ; problems with your motions?

I would order for complete blood panel ; liver panel ; serum amylase and serum lipase before going for EUS. Discuss about it with your treating doctor.

Hope this helps
Do revert back with your reports

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ajit Naniksingh Kukreja (48 minutes later)

Dr Ajit, I have had several blood exams and all have been normal since January. I had a comprehensive one about a month ago. I have had back pain, but mostly upper back. This pain does move around and when I mentioned it to a pancreatic specialist, she did not feel I had pancreatitis. I have no nausea and no limit on motions. I think the doctor, after looking at all the reports felt that may be the only thing left that could cause my abdominal pain, since all the exams seem to not indicate anything else. I have had pain in the upper right quadrant also.

Answered by Dr. Ajit Naniksingh Kukreja (7 hours later)

Brief Answer:
Get an abdominal scan done

Detailed Answer:
Hi

Thanks for writing in

Thanks for the precise details

I feel an abdominal ultrasound will be of great help in coming to a conclusive diagnosis

As you have pain in right upper quadrant there are chances you have gall bladder disease which again is partly responsible for pancreatic disease

Get back to me with the report and I will help you out
Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (1 hour later)

I had an ultrasound in December, a ct scan,MRI, MRCP, and a Hida scan. No gall bladder issues according to these exams. I have seen many doctors and other than a gastritis diagnoses, it does appear mild pancreatitis is a possibility because of the symptoms and it is my understanding,scans, except a EUS, can't detect this condition. It is a little surprising an MRCP can't find any inflammation, and isn't any pancreatitis show inflammation? When I talked to one of the doctor's nurse she said no real treatment is available, other than diet and some basic vitamins.

Answered by Dr. Ajit Naniksingh Kukreja (3 hours later)

Brief Answer:
Unlikely that all these will miss Pancreatitis

Detailed Answer:
Hi

Thanks for the information

It is very unlikely that all these investigations will miss pancreatitis

With my clinical exposure of 27 years as a gastrointestinal surgeon we usually come to a clinical impression on taking the history of the patient

Yet it would be conclusive that you go for a EUS and confirm the diagnosis

Would eagerly await the report to learn more from the interesting case that yours is

There are some pancreatic enzymes available which help in controlling symptoms apart from antibiotics and antiinflammatory agents

Wishing you a healthy life ahead

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajit Naniksingh Kukreja (1 hour later)

I will keep you updated, but what is a clinical impression?

Answered by Dr. Ajit Naniksingh Kukreja (3 minutes later)

Brief Answer:
Provisional Diagnosis

Detailed Answer:
Hi

Greetings of the day

Would provide my inputs once you update me

Clinical impression is a provisional diagnosis which can be arrived at without any investigations and reports

Hope I have been able to satisfy you, do write back in case of concern
Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajit Naniksingh Kukreja (10 minutes later)

Last question before update, would you suspect mild pancreatitis in my case? I also had two upper barium exams and and I said in a previous query, I have had numerous blood exams. And I always thought pancreatitis shows some inflammation.

Answered by Dr. Ajit Naniksingh Kukreja (51 minutes later)

Brief Answer:
With the information provided NO ....

Detailed Answer:
Hi

It is good you are concerned about your health

I will surely help you out once you have the final EUS report

But with the information I have from you I would not jump to a diagnosis of Pancreatitis

Yes it does show inflammation on Ultrasound, CT and MRI

Hope this helps

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajit Naniksingh Kukreja (2 days later)

Dr Ajit, we discussed an EUS test, but in reality, if my liver, gall bladder, and pancreas do not show any tumors, inflammation or malfunctions. All blood test are normal. I have been diagnosed with mild gastritis and I have a lot of anxiety, what are other possible causes of my abdominal and upper right quadrant pain.

Answered by Dr. Ajit Naniksingh Kukreja (3 hours later)

Brief Answer:
Gastritis itself

Detailed Answer:
Hi

Stress is the main culprit it aggravates the gastritis

Usually the right upper quadrant pain is due to gall bladder disease but when all the reports have turned normal I would treat you as a case of gastritis

So continue with Proton Pump inhibitor and manage your stress levels

Hope this helps
Do not hesitate to write back for further discussion
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ajit Naniksingh Kukreja (32 hours later)

Dr Ajit, I have another scenario that really needs explained. We have discussed possible mild pancreatitis, but no imaging exams reflect inflammation. But, every time I exercised in the last 2 months, I experience a chill feeling and tingling in my feet after. I have exercised all my life and this has never happened. I know pancreatitis can cause dehydration and hence, cause these symptoms. Again, I have abdominal pain, and back pain that is not concentrated in the mid back. I do not have weight loss or oily stool. What is causing these chills, without fever, and tingling in the feet after I exercise?

Answered by Dr. Ajit Naniksingh Kukreja (9 hours later)

Brief Answer:
All data on net is not authentic

Detailed Answer:
Hi

Thanks for writing in again

One point I would like to stress is never rely on any data on web unless from an authentic source

Dehydration has many more important signs than pointing to pancreatitis

None of your reports have come to the diagnosis of the same so I would request you reassure yourself and keep cool

The symptoms are more of stress related

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Ajit Naniksingh Kukreja (2 days later)

Dr Ajit, what can I do to avoid weight loss while on a strict gastritis diet? It appears I can eat very little. I do not want weight loss.

Answered by Dr. Ajit Naniksingh Kukreja (3 hours later)

Brief Answer:
Regular diet is enough

Detailed Answer:
Hi Thanks for writing in again

With passage of time the inflammation will subside and you will be able to take adequate diet

It is common for patients to loose weight on gastritis diet but once the disease is under control they regain weight and energy

Wait and watch

Hope this helps
Do write back if you have any questions
Regards

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Above answer was peer-reviewed by : Dr. Yogesh D