Acute Pancreatitis Q & A

[The Health Guy]

Acute pancreatitis Q & A is the place to ask any question you might have regarding acute pancreatitis. Remember I am not a doctor. Most of the forum mebers are likely not doctors. This means unless someone actually has an M.D. behind their name we can’t give blatant medical advice. However …

We can listen, explain what we did and offer sympathetic and more importantly empathetic support.

[Anonymous]

Hi there I’ve recently had pancreatitis very painful I can vouch for that,ive not touched alcohol for three months now could I now have a small beer now n again ?? Alan

[The Health Guy]

Hi Alan – first let me say welcome to the Beating Pancreatitis Forums! Sorry you’ve joined the pancreatitis hall of pain. If you have only experienced ONE, mild, acute attack and you are comlpletely healed you may actually be normal again and never have to worry about what you eat or drink but you’d need to visit with your doc and ask him/her what their take is on your prognosis.

If your attack was more than mild or you have an underlying condition that caused the attack and the condition has not been resolved you may want to resolve that underlying condition to help ensure that future attacks do not occur.

I hope you never have another problem Alan 🙂

[Anonymous]

I was diagnosed with EPI (Exocrine Pancreatic Insufficiency) almost six months ago, primarily through a Pancreatic Elastase lab result of 83, which indicated severe pancreatic insufficiency. A subsequent CAT scan and ultrasound were both normal. Although an Endoscopic Ultrasound showed no Pancreatic Cancer, it also showed no underlying cause for the EPI. I continue to have some recurring pains in my abdomen, but nothing that I would ever characterize as severe pain. I have never had any incidents of throwing up, but the steattorhea caused by the EPI was not nice (to say the least). I was prescribed CREON 24000 4 or 5 months ago, and I initially took one to three capsules with each meal. I am in the Medicare Part D “donut hole”, and my Part D insurance plan co-pay is between $300 and $400 a month, just for the CREON. That’s what really hurts. I also have been recently diagnosed with Fatty Liver Disease, Gastric Esophageal Reflux Disease (GERD), and Barrett’s Esophagus. I was never what you would call a heavy drinker (except on weekends during my college years in the 70’s). I am obese, but not morbidly so, and that appears to be the only underlying cause of the Fatty Liver Disease because my Sleep Apnea is controlled through nightly use of a CPAP machine.

I researched recommended diet modifications for all four diseases and then created my own diet accordingly (since Medicare would not pay for me to see a nutritionist). I added psyllium husk fiber capsules to each meal, along with vitamins and all four of your recommended anti-inflammatory supplements. I now am pretty much on a very low fat modified vegan diet (adding skinless chicken breasts, non-oily fish, and shellfish). I eliminated white sugar, flour, rice, and potatoes; as well as all alcohol with the exception of one glass of red wine twice a week and almost all oil. I am finding it mentally hard to give up egg yolks, so they are not yet gone from my diet. I have been able to reduce the amount of CREON to one capsule with each meal and have not noticed much of a return of the steattorhea.

Here’s my question: Is there any difference in treatments between EPI and CP, from a diet perspective? Will the diet modifications you recommend for treating/curing CP have any effect on EPI? My diet modifications have reduced but not eliminated the cost of CREON. I hate the thought of having to spend that much money every month for the rest of my life (which, based on my familial genes, is expected to be another 35-40 years). I know you’re not a doctor, but do you know of folks out there who have EPI, and do you know what have they been able to do to control it?

Thanks for putting out all this information on the web!

[The Health Guy]

Hi Bill,

I have to confess I have never done any real research on a diet for EPI in those who have not been diagnosed with CP. There are several conditions that cause EPI with CP seeming to be the most prevelant cause. Yet crohn’s disease, celiac disease, pancreatic cancer, cystic fibrosis, shwachman-diamond syndrome and a few others can cause EPI as well.

You yourself, said “My diet modifications have reduced but not eliminated the cost of CREON.” So I’m thinking that, in your case at least, diet may have something to do with EPI. BUT I do NOT know that for sure.

Just for giggles and grins (IF it were me) I’d eliminate your alcohol and oil usage completely and see if that helped more. If it did I’d get rid of the egg yolks. I’m talking test, testing it out to see and I’d give it a while to see if there were some significant results.

All I can say is that EPI usually doesn’t simply show up for no reason. However, I’m going to contradict myself now and say this …

I have read where it does seem to show up in the elderly (what those folks considered an elderly age wasn’t given), the WHY wasn’t blatantly there, explained, for that anomoly either. All that was mentioned for a possible cause in the elderly was atrophy. BUT EPI in the elderly (I’m guessing fairly old 80+) MAYBE a sign of simply growing old and the system shutting down.

I’m sorry I don’t have a concrete answer one way or the other but my curiousity is now peaked so I’ll do more research and IF I find something cool I’ll get back at you. 🙂

• This reply was modified 6 years, 7 months ago by The Health Guy.

[Anonymous]

Hi There,

I am curious to the average size of a pseudocyst? When I had my ultrasound last week it was already almost 4 inches long and 2 inches wide. I have had no pain from it, but starting yesterday have a very uncomfortable feeling in my stomach where the doctor said the cyst is. I’m hoping this means the sac is starting to form so they can drain it, or it is just getting a lot bigger and pushing against things. Do they vary in size a lot?

thanks much,
Karen

[The Health Guy]

Hi Karen – sorry I haven’t been in here in a few days. I don’t know if there is an average size of a pseudocyst. Some are small 2-3 mm while others can be larger 9 cm. Here are some research articles you can read. Yours would be about 10-11 cm? Pretty good sized.

HPB (Oxford). 2006; 8(6): 432–441.
doi: 10.1080/13651820600748012
PMCID: PMC2020756
Pancreatic pseudocysts – when and how to treat?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2020756/

World J Gastroenterol. 2009 Jan 7; 15(1): 38–47.
Published online 2009 Jan 7. doi: 10.3748/wjg.15.38
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653285/

ORIGINAL ARTICLE
Year : 2015 | Volume : 4 | Issue : 3 | Page : 229-234
Endoscopic ultrasound-guided pancreatic pseudocyst cystogastrostomy using a novel self-expandable metal stent with antimigration system: A case series

Eric M Nelsen, Eric A Johnson, Andrew J Walker, Patrick Pfau, Deepak V Gopal
Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA

http://www.eusjournal.com/article.asp?issn=2303-9027;year=2015;volume=4;issue=3;spage=229;epage=234;aulast=Nelsen

• This reply was modified 6 years, 6 months ago by The Health Guy.
• This reply was modified 6 years, 6 months ago by The Health Guy.
• This reply was modified 6 years, 6 months ago by The Health Guy.

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