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What Causes Burning Sensation After Eating Fatty Meal?

Posted on Thu, 16 Oct 2014

Question: I have burning sharp pain 1 hr after eating a fatty meal . Medical Hx had cholecystectomy 2005 for biliary dyskinesia with chronic cholecystitis. SOD type 3 with ercp manometry cbd sphincterotomy 2012 and ercp with balloon dilatation and sphincterotomy to 8mm 2 wks ago. Pain is almost nil now if i sustain a bland simple diet but after a hamburger initial pain has returned but milder after second procedure. Im not a drinker or user of drugs. Im a 55 y/o male. My major concern is that the diagnosis was missed im fearful i have chronic pancreatitis.had one bout of acute pancreatitis after first procedure when they placed a pancreatic stent for "protection" but that resolved in 3 days. Thx- XXXXXXX

Answered by Dr. Dr. Klerida Shehu (6 hours later)

Brief Answer:
Your body is showing:can't tolerate fat

Detailed Answer:
Hi XXXXXXX

I understand your concerns.

Having burning sharp pain 1 hr after eating a fatty meal is indicative for possible:
- inflammation/infection of intrahepatic biliary pathways
- pancreatitis

As you have chronic pancreatitis, that could explain your symptoms. It is extremely important to follow a strict diet. Each time that you will break this rule, you will have problems.

Antiinflammatory drugs are advised to use. Further investigation of pancreas, kidney, liver function is also advised.

Hope it helped!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr. Klerida Shehu (2 hours later)

I've never been diagnosed with chronic pancreatitis that was my question. I had acute pancreatitis once after first ercp that resolved in 3 days and was pain free for 2 yrs. conclusion by pancreaticobiliary specialist was scarring over CBD and this proved correct after 2nd ercp with balloon dilat. And sphincterotomy . My question is could I have chronic pancreatitis in addition to biliary problem and if so how is this diagnosed?Also after this second procedure which was 2 wks ago there were no elevations of amylase lipase or lfts

Answered by Dr. Dr. Klerida Shehu (2 hours later)

Brief Answer:
Following tests advised..

Detailed Answer:
Hi back,

From what you are describing, you do not have signs of chronic pancreatitis. Digestive enzymes are recommended to measure to exclude it:

- secretin stimulation test: secretin is an enzyme that stimulates the pancreas to release a fluid that neutralizes stomach acid, thus aiding to digestion. This test is carried out through naso-pharyngeal intubation.

- fecal elastase test: elastase is an enzyme that helps in digestion of proteins.

You can run these tests first.

Hope it helped!
Dr.Klerida

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

Follow up: Dr. Dr. Klerida Shehu (19 hours later)

Any other lab tests or imaging that would test for chronic pancreatitis. But very good to know that it doesn't sound like chronic pancreatitis

Answered by Dr. Dr. Klerida Shehu (3 hours later)

Brief Answer:
Already mentioned earlier...

Detailed Answer:
Hi back,

Thank you for following up.

As you have conducted ERCP, ct-scan, abdominal ultrasound, and pancreas function tests, I advise to measure the levels of digestive enzymes as mentioned earlier: secretin stimulation test and fecal elastase test.

As long as the other tests were perfectly normal, these are other conclusive tests.

If they are perfectly normal too, then, try to put your mind at ease and follow healthy changes in your diet and lifestyle regimen.

All the best!
Dr.Klerida

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

Follow up: Dr. Dr. Klerida Shehu (14 hours later)

Thank you for the advice I will use it. One last ? My gp used the term visceral hypersensitivity and said I should try elavil. It almost seems the severity of symptoms were to great for this. Could this be an additive factor in my symptomsCreon was started pain is actually worse. Also had ct scan with and without iv contrast and large water intake just prior to scan. With exception of bph no other abnormal findings. Thx

Answered by Dr. Dr. Klerida Shehu (8 hours later)

Brief Answer:
BPH might be a cause to your pain...

Detailed Answer:
Hi back,

Visceral hypersensitivity is a term prescribing that you are the type of person who is more sensitive than others. Elavil will help reduce that hypersensitivity.
Yes, visceral hypersensitivity is a factor that makes your symptoms get worst occasionally.

Creon is the pancreatic enzyme commonly used to improve digestion problems. That will not aggravate your symptoms. On contrary, it will help you.

BPH (benign prostate hypertrophy/hyperplasia) can be a cause to the pain you feel. Enlarged prostate is compressing the organs nearby. As you are more sensitive than other patients, you will feel this pressure like a sharp pain deriving from your liver/pancreas. You might have urinary tract infection or other genital problems that can be mistaken with pain deriving from your liver/pancreas.

You should follow a healthy diet and lifestyle regimen for your bph too. It is true that fatty foods will aggravate your bph symptoms as fatty foods, chillies, alcohol, etc, will affect prostate negatively. That's why you are advised not to consume them.

Hope it helped!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Klerida Shehu (13 hours later)

Thank u very much will keep you posted

Answered by Dr. Dr. Klerida Shehu (32 minutes later)

Brief Answer:
Do not forget to close this discussion...

Detailed Answer:
You're most welcomed!

Do not forget to close this discussion. You can reopen it anytime you'll have other queries!

Dr.Klerida

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Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju