Minimal Change Chronic Pancreatitis
If you are experiencing pain, nausea, and other discomfort after acute pancreatitis you may have minimal change chronic pancreatitis. Many people have asked me why they have had recurrent attacks of acute pancreatitis or have had one doctor diagnose them with chronic pancreatitis only to have another say they don’t have chronic pancreatitis or any pancreatitis at all.
For those of you who have had this kind of experience with your pancreatitis journey let me assure you that not all doctors know what they are taking about when it comes to acute or chronic pancreatitis. Even those who have some knowledge don’t know everything even if they think they do. In fact …
They have “cookie cutter” diagnostic criteria and for those who even know ANYTHING about the disease and can even recognize it in a clinical setting miss it or rule it out when you don’t fit that “cookie cutter” mold.
Diagnostic criteria and scoring for acute pancreatitis
Diagnostic criteria for chronic pancreatitis
IF someone doesn’t fit the “cookie cutter” mold the disease is most often ruled out. But …
Dr. Sutherland says different in regards to chronic pancreatitis and he has a list of certfications and is kudosed as being one of the top authorities. He is:
- Director of the Diabetes Institute for Immunology and Transplantation
- Head of the Transplant Division in the Department of Surgery
- Holder of the Golf Classic “fore” Diabetes Research Chair
- Professor of Surgery at the University of Minnesota
I found this on Dr. Sutherland’s blog/forum: “There are articles on minimal change CP that I will send you the references. We also have an abstract showing that the traditional view that an EUS has to show 5 of 9 criteria for CP to be diagnosed is not correct, even one criteria has been associated with documented CP under the microscope.” Read the article here
Now keep in mind he makes a boatload of money from pancreas surgery and is regarded as one of the best when it comes to TP/AIT so there is always the possibilty he is pushing for more surgeries but my gut feeling and common sense tells me that he is correct about minimal change chronic pancreatitis.
Clinical Example Of Minimal Change Chronic Pancreatitis
Drs. David C. Whitcomb from the University of Pittsburgh, and Christopher E. Forsmark, from the University of Florida discuss recent advances in the diagnosis and clinical management of pancreatitis. The patient they discuss has MCCP (minimal change chronic pancreastitis).
[youtube qxIk1nUtxVU]
This fairly new recognition of minimal change chronic pancreatitis means you most likely have chronic pancreatitis if you continue to be symptomatic after acute pancreatitis, whether or not your damage presents on radiological testing in blazing colors. IF you have symptoms, especially pain, it isn’t all in your head, your symptoms are real and you need to get a handle on your condition and control it or you may be faced with a life of misery or a radical TP/AIT.
Minimal Change Chronic Pancreatitis (scholar type articles):
1: article one
“F you have symptoms, especially pain, it isn’t all in your head, your symptoms are real and you need to get a handle on your condition and control”
How do you treat early CP? It’s always going to be same outcome when it comes to pain, whether you catch early or not. Unless you want to starve the patient to death.
I’m not sure what your point is Larry. My pain is controlled. In fact unless I do something really stupid I have none. If you are talking in generalities then yes others who are in pain need to get it controlled and then become pain free (goal) if possible.
How do I treat early CP? I treated mine with diet and supplements just like the posts on this blog say. I don’t treat anyone else.
I don’t agree with your last statement about outcome. Myself and a few others who have adopted my lifestyle, regimen, protocol or whatever you want to call it have proven differently. There are some who will never heal properly. Those who have been sliced and diced, for whatever reason, seem to always have difficulty.
Is there a Diet for Chronic Pancreatitis/ available?
Hi Victoria 🙂 – Yes on the diet, no fat, no alcohol. You need to find the posts in regards to diet and also the post on how to do a food diary. The food diary prep and implementation are important. Without that step you are flying on my word and you’ll never really know what is safe for you. Do the food diary and make sure you do the prep first. Think plant based. Modified vegan. Vegans use fats, oils, and foods that contain to much fat (avocado, coconut, nuts, sunflower seeds, etc) in prep and cooking. You shouldn’t if you want to heal. So for the first 6 months it is modified vegan, supplements and doing everything by way of the food diary. Good luck!
Watched the video. Not happy. Yes, the dr achieved a diagnosis but it sounds as though the patient is worse off. There are too many bad news stories attached to the methods used for diagnosis, in particular ERCP. Yet the dr doesn’t care, he is only focused on the challenge of achieving a diagnosis. How is this helpful?
Hi Alison. IMHO the patient is always worse off when undergoing orthadox care simply because most doctors do not have a clue as to how to treat either acute or chronic pancreatitis. Most often their only answer to (1) AP is NPO (no food) and pallative support (drugs) until it resolves by itself due to no food/rest. In the event of severe acute they still have no clue how to stop it and then certain life saving support care, including surgical procedures may become warranted. But they never attack the problem, inflammation. (2) The videos main message is that some doctors are finally becoming aware that a patient doesn’t need to fit their “cookie cutter” criteria mold to in fact have chonic pancreatitis. That doesn’t mean they have figured out how to treat it, it simply means that some are actually beginning to use their brain in an open fashion to think out side the box.
The main reason I posted this minimal change chronic pancreatitis article was because there are so many folks who most likely have chronic pancreatitis yet they receive a misdiagnosis due to that “cookie cutter” criteria. They don’t fit, so the doc, in his/her infinite wisdom, says they think the patient is either faking or simply nuts and tells them there is nothing wrong BUT to come back if symptoms get worse. Anyway, that is the message of this post and the video message is hope for CP patients without a diagnosis to get a diagnosis. Yet, like I said that diagnosis may be worthless due to the fact that doctors don’t know what to do anyway except give out pain meds, lousey diet info and when opted for surgical procedures like debridement (most often seen in necrotic AP), resection, whipple or TP/AIT.
Hya!
In short: for the last two years several health problems which, in my view, relate with the pancreas. (Floating, stinking stools, steatorrhea, flatulence (smelly), pain upper left abdomen right beneath the lower rib within 20-30 minutes after a meal, fatigue). I even spent some days in the hospital last month because of it.
Pancreatine pills (the ones freely available), your low fat diet and smaller portions more often a day helped enormously.
Yesterday I visited my dr again. he says it can not be the pancreas because lab values and a CT scan showed everything is normal, apart from a small increase in amylase.
He says it is irritable bowel syndrome.
He said it can not be minimal change chronic pancreatitis because that is a rare condition.
There is something amiss with his reasoning there of course, but I’d like to know: do you know whether MCCP is rare or not?
Or is it not uncommon (it’s only rare when no one is looking)?
I have to go back to my GP and I would like to say, or better show, that it is not simply me imagining having a rare disease.
Thanks in advance for your answer.
Hi Sylvia, sorry to hear you are not feeling well. Here’s the deal. I can’t diagnose. I can’t tell you that you might have such and such but IF you ever have uncontrollable abdominal pain that is so severe it basically disables you while present make sure you go to the ER and get re-evaluated. Don’t wait till the pain is gone, go. Have someone drive you or call the EMT’s for a ride. Between now and then you may want to get checked for celiac disease for it can cause almost everything you have mentioned and a lot more. The thing I find interesting is that a low fat diet and digestive enzymes seem to help. That is probably not gonna help celiac disease but I don’t know that. IF you are taking grape seed and vitamin C THOSE will help celiac disease in fact C has been shown to protect the small intestine against gluten.
As far as minimal change chronic pancreatitis being rare I doubt that. What I do not doubt is that most doctors don’t even know how to diagnose it and what MCCP actually implies when you realistically look at what causes CP in most cases, recurrent acute pancreatitis. Alcholic pancreatitis sometimes presents as CP first instead of AP. Autoimmune pancreatitis almost always presents as CP first and is often misdiagnosed as pancreatic cancer.
IF it were me I’d ask to be checked for celiac disease antibodies (don’t stop eating gluten) and also IgG4 (raised in panc can and autoimmune panc). Good luck 🙂
Hi THG!
Thanks very much fir yor reply. Much appreciated.
I was diagnosed with celiac in 2013 and have been on a strict glutenfree diet ever since.
I mentioned I spent some days in hospital last month. It was via the ER. I was taken in because they thought I had pancreatitis – initially, seeing my distress and the things I was complaining about. When lab values did not show a rise in lipase and a mere subtle rise in amylase, and a CT scan that did not show anything amiss, the aformentioned doctor sent me home: “it’s probably your intestines”.
When I returned to him to report how I had been doing (“I am doing much and much better, as soon as I started taking pancreatine and a low fat diet, i.e. 20 grams of fat max a day”) he wavered my suggestion of MCCP off: “That is a very rare disease”, looked at my lab values on his monitor again and repeated his words about me having IBS.
Prior to our last meeting I had sent him a letter. The letter contained a medicle article about MCCP:
http://www.iosrjournals.org/iosr-jdms/papers/Vol13-issue12/Version-5/N0131257879.pdf
I wanted to avoid the situation of having a doctor that is in the dark when it comes to MCCP and him pointing at my intestines again.
Because when in pain the pain feels like a screwdriver that is deeply stuck in the upper left abdomen, it does not crawl, it does not move to the left, the right or towards the lower part of the abdomen, it is there at the exact same spot all the time. So IBS strikes me as odd.
Anyway, I seriously doubt he read the article.
I did not tell you that ever since 2012 I have had health issues. Every time I felt that screwdriver deeply stuck inside my left abdomen. Sometimes it was accompanied with a light tingling pain in the upper right abdomen. Pain was there 20-30 minutes after a meal. A meal that contained fat. But it took me a long while to discover that link between fat and my complaints.
In 2012 I was taken into hospital, again via ER. They thought of AP then – I had all the classic, typical symptoms. But a CT scan which was taking within 48 hours showed a normal pancreas.
I learned just recently that nothing may show up on a CT scan when taken within 72 hours of hospital admission.
Lab values were not normal, but not a threefold rise. More of a 2-2.5 rise. 🙂 CRP was high: 345.
The CT scan that showed a normal pacreas also showed a oedematic colon (colon ascendens, oedema until the flexura hepatica) but a coloscopy showed everything was fine with the colon.
Because of those findings they dismissed the earlier suspected pancreatitis and embraced the idea of colitis.
Lately I have learned by searching the internet that AP may not be excluded when having a CT scan with normal pancreas and oedema in surrounding parts. I found articles where they only learned after surgery that the pancreas, pancreatitis, was the actual problem.
I am Dutch, living in the Netherlands, and sadly do not know any doctors that are familiar with MCCP.
Anyway, thanks for reading. Thanks for your help. Thanks for putting up this website, THG, and for sharing all your experiences and findings. I do not doubt that without your knowledge I would still be miserable and in pain.
You are most welcome Sylvia I’m sorry I haven’t been more help. It is interesting to find you have been tested for celiac disease and have it. It is also interesting to find that you have been doing enough research to know that CT scans done at inappropriate times (before 72hours of AP onset) usually are worthless in regards to showing pancreas damage. Even doctors don’t know that or they wouldn’t do them until 3 days after onset of AP symptoms. Even a normal pancreas at 72 hours doesn’t mean you didn’t have AP. I would be more interested in the enzyme, WBC and CRP elevations. Did the docs call what they saw on CT (edema) edema or ascites which is fluid collection in the peritoneal cavity, causing abdominal swelling and is seen in pancreatitis? They may for some reason use the names interchangably. Anyway, I hope you soon feel much better BUT if you do have another attack make sure you make it to the ER so there is another chance for a firm diagnosis. 🙂
Interesting, ascites related to pancreatitis!
I looked up the report of the CT abdomen made in 2012. To me it seems, alas, that they do not mix the words. (Although I really do not understand the difference between those two words when it comes to the abdomen).
I tried to translate the findings into english, hopefully it makes some sense to you (I do acknowledge that you can not diagnose or give second opinions, but in my experience a so called educated patient sometimes knows more than the average doctor 🙂 )
“CT abdomen shows image of colitis ascendens reaching as far as flexura hepatica:
Edematous colonic wall thickening practically circular at one place on the colon ascendens. The surrounding pericolic fat tissue is minimally edematous infiltrated as is, very locally, the peritoneum. No ascites to be recognized.”
Btw: Lipase 137 U/L (22-51), amylase 218 U/L (0-107), leukocytes 19.6 10^9/L 4.0-10.0).
I read some articles a while ago where doctors described that what seemed to be a colonic problem turned out to be a secondary infection caused by a clear pancreatitis after one glance on the pancreas while operating the patient because of the colon.
So personally I think it may very well be I had a colitis, but I still think the pancreas was the culprit, but the doctors never acknowledged that.
I already feel much better, THG. Besides the low fat diet and the pancreatine I am taking Emblica officinalis (Amla powder) which comes up frequently as a natural aid against pancreatitis. Studies show promise.
I noticed green tea extract (capsules) was particularly helpful against the overwhelming fatigue.
Glad you are feeling better Sylvia 🙂 Nothing wrong with Indian goose berries. Full of antioxidants that surely help. Be careful of green tea extract. It isn’t as safe as they tout it to be. Drink green tea instead and avoid possible trouble.
Thank you for all this wonderful information!! I KNOW I have chronic pancreatitis but because I don’t fit their “criteria” then I don’t have it! They have ruled everything else out. It feels as if they really don’t want to give a diagnosis of cp and just want to blow my symptoms away….its frustrating t say the least but armed with this info I can be ready for them!!! THANK YOU!!!
You’re welcome Stacy Lee 🙂 Hopefully the info on my blog will help you beat pancreatitis.
Hey Health Guy. Just was told after an endoscopic ultra sound that I have advanced scarring on my pancreas due to high triglycerides. My lipase is normal and amylase was a 25 (bottom of normal). I have never had “pain” in my upper left abdomen just a constant slight discomfort with the exception of once or twice I had an immediate sharp pain but it was gone in seconds. I just started a low fat diet and the enzymes but they don’t seem to have any affect on my “slight discomfort”. Does this sound odd or normal for CP? Also, no bathroom issues for me… But the doc said eventually real pain and digestive issues will come.
Hi Gavin – “I just started a low fat diet and the enzymes but they don’t seem to have any affect on my “slight discomfort”.” You may not see over-night miracles. Give it time. In order to prevent more pancreas damage, even reverse existing damage (IF IT WERE ME and it is, was etc) I’d follow a strict low, low fat diet, NO alcohol, and go to my health store and get Vitamin C, grape seed extract and curcumin and start taking them. I’d definitely want to put my CP into “remission” if possible.
Do you have any references to doctors discussing reversing potential of damaged pancreas? I’m encouraged by your progress and many on your commenters. I’m going to pick up the stuff you mentioned. Thank you.
My doc and nutritionist say 40-50grams of fat a day total is their reccomendation also my doc says the EUS shows extensive scarring but he believes the function of my pancreas is still 80-90 percent. Does this sound odd?
Also, yes I am thankful for no pain or bathroom issues…hope it stays that way.
Hi Gavin – Since you have extensive scarring you may want to tread lightly with the fat content. I have found most doctors and nutritionists don’t know squat when it comes to diet for those who have a damaged pancreas. In my opinion and experience 40 – 50 grams of fat daily is a tad high. Some people tolerate more fat that others but just remember this: It isn’t your doctor or nutritionist that has to deal with the results should you suffer more damage and/or an acute pancreatitis attack. BUT as always you have the choice to do whatever you feel is right for you.
By the way Gavin be glad you do not have the bathroom issues or the intense pain that is a hallmark of pancreatitis. Trust me, been there, done that, it ain’t a pretty picture.
Hi Health Guy,
Hope this email finds you well. Okay I had another endoscopy they found no ulcers etc but I could of told them that. My Gastro Dr has given me a script for motilium – or domperidone. She said it will help with nausea and getting food through my stomach quicker. My GP is the only one thus far who has said it could be pancreatitis. I think I have minimal change pancreatitis because my bloods and ct scans are normal. But all my symptoms line up with pampncreatitis. In your humble opinion have you ever tried this medication? I’m worried to try it in case it makes me feel worse.
Thanking you
Stacey.
Hi Stacey – I answered your question via your other comment. Oh and I suppose it is always possible that you have minimal change CP. My next question (because I don’t remember whether you told me or not) is have you ever been diagnosed with acute pancreatitis?
I have had abdominal pain for three years. Main complaint is epigastric pain after eating (really anything; at first would walked in the night with nausea and pain after a high fat meal but I don’t wake with “episodes” it’s mainly always there) and I do have lower fecal elastase (199 then 360) I have had all clear scans until last week. The MRCP w secretin showed “borderline diminishes precontrast t1 hyper intensity” seen in chronic pancreatitis. Dr says its IBS. I’m pushing back but don’t know what to do in the meantime. I have avoided alcohol 6 months now but eat higher fat due to underweight and small intestinal bacterial overgrowth which means I need to avoid certain carbs. I don’t know if I ditch that diet and deal with SIBO because I can’t do both low carb low fat no animal protein and live.
And do I need enzymes? Do you take them or just your supplements?
Hi Kristin – lower fecal elastase can show with bowel disease, infection etc. You may have some form of IBS just as your doc suspects but there may be more to it. The secret is to find out what type of IBS. The colon is found in the region you are experiencing pain. IBS can cause nausea. It could be IBS but like I said there may be more too. I’d keep seeking answers, a concrete diagnosis. And then work from there.
I forgot to mention my MRCP showed diminished precontrast of t1, consistent with chronic pancreatitis. IBS can’t explain that away.
Kristin – good point!
Kristin: if you have N infection in your bowel plus it sounds like you also have a bacterial overgrowth and IBS has your doctor put you on Xifaxan? It’s an antibiotic just for the stomach which treats IBS, bacterial overgrowth’s, and any infection in the stomach. It’s a fairly new antibiotic. I took it for 28 days in a row 3 x’s a day. Although I still am not out of woods by any means it certainly did help. The minimum you should take it for is 14 days. Thanks Neal
https://www.xifaxan.com/?gclid=COHeyK-n3M0CFVFlfgodArwIbw
Yes I did rifaxin and it improved my stool and elastase a bit but I still have the pain and the change in my pancreas mentioned above so iknow it’s not just SIBO and IBS. Good idea though
Thank you so much for all the information. I have seen numerous doctors and four gastro-enterologists and had a CT scan, two MRIs, two ultrasounds and they all say I have a normal pancreas. I have pain, diahorrea and was losing a lot of weight and thanks to your site I see that I have minimum change pancreatitis. Does this mean that it is easier to heal the pancreas and get rid of the pain following your diet plus the supplements?
Hi Jen – I don’t recall diagnosing anyone?! I’m not qualified to diagnose. But you are welcome for the info. Have you had acute pancreatitis? More than once? If you’ve been diagnosed with acute pancreatitis diet and supplements may definitely help healing.
Dear Health Guy
I am very grateful for the information and it;s so reassuring and good to know that you have survived 35 years with pancreatitis. I am just wondering how you deal with going on holiday? Sticking to the diet must be quite difficult unless you are self catering.
Jen – holidays are quite challenging. I learned to be very picky about what I ate. It’s not easy.
Hi Health Guy. I also had another question. Now that you are healthy are you back to normal energy levels?
Jen – to be honest I had a lot more energy until I had to go gluten free (found out I was a celaic). I’ve been GF for about 6-7 years now and it sucks. There are way to many foods I can’t eat now. I had a LOT more energy before going GF.
@the health guy
Could it be you have a slight iodine deficiency?
Hi Sylvia – it is possible. Thanks – I actually hadn’t thought about that. 🙂
Really sorry to hear that. I thought just sticking to a pancreatitis diet was difficult enough.
Thanks, it’s ok. Just another challenge lol 🙂
Hi Health Guy – two of the symptoms that I have are hot flashes and sweating. I just wondered whether you had suffered from these and if you did, did they improve with the diet. I am currently doing a lot of juicing and feeling a lot better with regards to the pain but I still have hot flashes and sweating.
Hi Jen – nope no hot flashes here. Glad you are feeling better 🙂
These could be down to the menopause then, and probably made worse by my stressing about it!!
Jen – If you’re at that age it certainly could be a menopause issue.
Hi Health Guy – apologies but I have another question. You mention on the website that the pancreas can regenerate itself if you stop the inflammation. Does that mean that the function in terms of the enzymes improves as well?
I have read some research that leads me to believe that certain pancreas tissue could possibly regenerate. I have found nothing that says it will. Yet I have had some people tell me that their scans change from bad to good or damaged (scarring etc) to clean after diet and supplement induced healing. Whether enzyme production improves is not known.
Sorry – just one more question. I have read on some websites that chronic pancreatitis sufferers take Omeprazole but you do not mention this. Do you feel that it is not necessary to take Omeprazole with the enzymes. It seems that whatever you are doing is working, so I would be interested to know.
Jen, some folks with pancreatitis have GERD issues as well which may be directly due to the pancreatitis or may be caused by something else entirely but if it helps it’s all good. I’ve never really checked into WHY docs prescribe that class of medication.
Hello Health guy,
Please see below my case history so from present condition to past. I am also taking supplements as suggested by you below for almost a year now and was better but suddenly got pancreatic back to back two attacks in 2 weeks. Kind request to go through my history and suggest how I can modify my diet, medicines, supplements. Also what you feel about type of my CP ( doctors came to conclusion that its idiopathic). I really have long life to live and urge you to read my case and give your opinion.
Present complaints:
Occasional pains in the epigastrium and left hypochondriac regions. Similar pains on the back.
Foul Eructation and flatulence. Rich food difficult to digest. Unsatisfactory stools.
Medication:
1. Panlipase 20000-25000 TDS (pancreatic enzymes)
2. Sompraz OD ( esmaprazol sometimes when I feel acidity)
Supplements:
1. Grape seed extract 500 mg ( manufacturer royale wellness)
2. Turmeric 400 mg (manufacturer new chapter)
3. Vit C 500 mg ( manufacturer royale wellness)
Past history:
On 16/08/2016
Patient was little better but pain recurred towards afternoon. Patient is NBM.
On 15/08/2016
Patient went to hospital and was given perfalgan IV and pain gradually subsided. But there was some residual pain.
S Amaylase- 512 U/L High
S calcium- 10.2 mg/dl High
S Lipase- 1236 U/L High
CRP- 47.75 mg/dl High
On 10/08/2016
Patient complained of pain in epigastrium travelling to the back. Continued the medication as above. Patient was nbm and recovered but slight pain still persists. Patient had some sweets and popcorn and tofu . next day complaints recurred. Since there was pain, patient took ibuprofen 600 and pain rapidly increased.
October 2015
Pain in epigastrium after rich ,non veg food. Immediately patient went NBM and slowly on liquids and he recovered.
August 2013
Offensive flatulence, eructations, abdominal pain which stays for max 5 mins and disappears and repeats itself. This pain comes occasionally once in 2/3 days.
There is sighing which comes involuntarily. Continuous thinking of disease and fear that it may lead to cancer.
Stool difficult form 2 days.
Medication:
1. Nexium 1 tablet
2. Creon 2 tablets BD
3. Fybogel once at night.
USG: pancreas show slightly increased echogenecity.
On 27/12/2010 he was admitted with the following complaints:
• Abdominal pain since 2 days in the epigastrium and left iliac fossa
• Loose stools 2-3 episodes.
• Foul eructations with abdominal discomfort which was more on taking food and associated with nausea.
O/E tenderness in the epigastric region and vague tenderness all over the abdomen.
Investigations:
S amylase: 1060 U/L
S Lipase: 542 U/L
USG- Abdomen: bulky pancreas with smooth contours and diffuse homogenous echotexture.
17/01/2011:
USG abdomen showed no significant findings but for insurance purpose and keeping the history in mind the radiologist gave report saying Pancreas shows altered echogenecity and impression of early pancreatitis.
Treatment: Creon BD
This treatment patient took for a couple of months and then stopped by self. The 2011 showed few attacks’ of pain on and off which were mild in nature.
In August 2012:
Patient complained of same abdominal discomfort with eructations and flatulence. O/E there was tenderness over the epigastrium.
USG- no significant findings.
On 16/01/2013:
Patient complained of severe pain in the epigastrium with a full feeling in the abdomen, abdomen was bloated. Immediately he was taken to the hospital and put on iv drugs like nexium, perfalgan.
S Amylase : 2704 U/L
USG: was not clear as abdomen was full of gas and hence a CT was adviced.
CT findings: Atrophic pancreas with irregular outline and inhomogeneous density of gland.
Treatment given: avoiding Oils, fats, excessive sugar, non veg.
Medication:
• Nexium 2 BD
• Creon 2 TDS.
Hey Melvin – I’m sorry to hear you are not well. “Rich food difficult to digest.” I am not sure what you mean by rich foods but to me rich food usually means high fat. I’d cut out the rich foods. If you haven’t done it already (sounds like you have not) I’d do the food diary prep and begin a food diary using the directions.
I must admit I am totally amazed that Ibuprofen increased your pain and that perfalgan (acetaminophen) which usually doesn’t help did. I have never found anything to make me suspect Ibuprofen as a inducer or aggrivator of pancreatitis. The closest is this article that states Ibuprofen may have been a potential suspect yet there was no re-challenge to confirm. On the other hand there is information that truly points a positive finger at acetaminophen as a cause of AP. In both cases overdose was the problem. We know that in the Ibuprofen case the guy took a 51 mg/kg dose. Let’s convert that to pounds. I weigh about 150 lbs/68 kgs (if my math is right). 51 x 68 = 3,468 mgs of Ibuprofen in a single dose! That is a TON of Ibuprofen. Anyway … The fact still remains that Ibuprofen did not work well for you and acetaminophen IV did. So whatever works!
I’ve seen this now twice: “Pain in epigastrium after rich,non veg food.”
IF it were me I’d completely overhaul my diet and I’d start with a food diary prep, etc. I’d make sure I was taking 500 mgs of grape seed at least twice per day. 400 mgs of curcumin 2 – 3 times per day. 500 mgs of vit c at least 4 times per day. After 30 days I’d evaluate my progress. If I still had pain I’d increase the grape seed extract to 3 x daily. DIET IS CRUCIAL! The supplements wil likely help but if the diet sucks (high fat with or without alcohol consumption) they won’t be able to completely defend against “rich,non veg food.” If you drink alcohol you need to quit.
Your current prescription drug list is your doctors area.
That’s about all I have Melvin. I hope you are feeling much better soon. 🙂
Thanks you so much Sir, your confidence reflecting in advice is much higher than any top notch gastro 🙂 and I very much appreciate that. If I am not wrong you are a person who has explored each and every aspect of this illness and by sharing this on global platform you are doing amazing job. I am feeling better with your advised protocol and will follow your guidelines. I also learnt that Indian gooseberries and normal clean water enema helps.
You’re welcome Melvin – I hope you are feeling better soon! Indian gooseberries are full of phytonutrients (polyphenols) and those little devils fight inflammation, the inflammation in the pancreas. Hey about the enema thing …
An enema definitely helps. I first learned that when in an acute attack (1979 – 1980?) when I was in desperate need of relief the idea, of doing an enema, popped into my head (I think God popped it into my head cuz I mean really how would I have known?). Anyway I did an enema and shortly after I had almost total relief. It obviously rid my system of all the offending food. I remembered that! That is WHY I have people “prep” with a 3 day fast, then an enema before doing a food diary.
Doing certain things right just seems to work. And not just for me! People who actually do what I did to eventually heal and still do to stay well are finding they feel better and heal too! THAT is the cool part of this whole deal. By the way …
IF you haven’t signed up for the forums you should do that. Then remember to activate your acct via the email (you’ll be sent an activation link) you used to register.
Thanks HG, Since you are been diagnosed with CP for couple of decades now I have question for you. Have you developed diabetes? I hope and pray not so. I am asking this question since my doctor said that I will develop diabetes by next year just looking at MRI two years back. How to gain weight? since protease is also required to breakdown protein which is one of the enzyme produced by pancreas. request your kind advice.
Hi Melvin – To answer your question: “Have you developed diabetes?” NO, not yet and I hope I don’t! THAT would really tork my jaw. If you don’t get the CP under control or into “remission” yes you could very well end up diabetic just as your doc predicts so my goal would be to get the inflammation resolved and the CP under complete control because …
IF you do everything right and get your CP controlled or into remission diabetes may not happen. No promises.
Hi HG,
Just still trying to figure out my pain and nausea. I have an appointment with a new doctor on Monday and am going to go over the whole barrage of tests etc. I have a really important question for you though. Have you or anyone complained of feeling really achy all over your body as a symptom of pancreatitis? I feel so tired all the time and I feel like I just start to feel a bit better then I go to the market to buy groceries then I’m totally exhausted, sore all over and feel like Ive been run over. I’m basically unable to do normal things like my housework, run my kids to school, work, all the things I used to do. I’ve not read any posts here where anyone has said something similar. I really appreciate your patience and support. I hope I’m not wasting your time.
Stacey.
Hi Stacey – you are not wasting my time – so stop that! But I am not going to be much help with this question because I haven’t experienced the achy feeling, just totally wiped at times (when I was sick). Have you been checked for fibromyalgia or lupus?
It could be B12 shortage. Let the doctor check your blood level. Do NOT take any B12 as a supplement before being tested, else spoil the blood results for months, sometimes even years.
Sylvia – to late lol 🙂 I was low on B12 a couple times (before I did supps). Doc actually said I needed some extra. When I remember to take them I have more energy. B12 is in my favorite multi formula (AllOne) but since I found out I am one of the few celiacs that illicit a response from not just wheat, barley and rye but also corn, oats and rice I had to give up my favorite supplement which had the right B12 in it. Oh well, life is hard, then ya die lol
What if your EUS shows scarring but you have none of the symptoms and never had a “flare or attack”? Is that still minimal change pancreatitis? Or something else?
Hi Gavin – since scarring is indicative of CP I’d say it is something definitely worth keeping an eye upon. In other words I would make sure I did everything I could to prevent any more scarring. I’d also want to find out WHY my pancreas was scarred in the first place. There has to be a reason.
I’m having pain in my overall abdomen. I can push in multiple places and it’s tender including just above my waist line. I’m also having some pain in my upper back and lower hip areas. None of this pain is gut wrenching. My upper back pain I tend to fill when I’m sitting back on couch.
I drink heavy when I drink and everything I’ve Googled of course leads me to pancreatitis. I have a gi appt on the 28th. So the only true symptom I have is discomfort when I push into my abdomen. I’ll also get some random sharp pains at times throughout my whole abdomen. Did you experience any of these things?
Forgot to mention had an ultrasound and all read normal.
Hi Chad – Heavy drinking is a risk factor for pancreatitis. IF you have a certain genetic variant you could have alcoholic pancreatitis even though you don’t drink constantly. Alcoholic pancreatitis many times presents in the form of chronic pancreatitis (symptoms etc). Because of this mild chronic pancreatitis doesn’t necessarily have horrible symptoms. Your GI doc appt may shed more light on your situation.
Hi HG,
I’ve been quiet, but I’m still here. As you know I’ve been struggling to get a diagnosis and still am. Well I got my times mixed up for my specialist appointment yesterday so I missed it. Can’t believe it. Anyway I rescheduled my appointment & earliest I can get in is 3 weeks away.
Can I ask you yet another question about chronic pancreatitis please… when the symptoms are present is it normal to feel like you have the flu? ive been feeling pretty good last few weeks so I’ve allowed myself a palm size amount of chicken steamed the last 2 nights, mainly because I really struggle to keep my protein and weight up. Plus I’ve had probably 3 teaspoons of this gut repair stuff from the health shop. It has no fat in it but it’s made from beef gelatin. It’s supposed to repair the gut lining. (Bearing in mind I’m not diagnosed with CP and I know this goes against your advice so I’m not suggesting anyone tries this) Now I’m feeling fluey and yuck.
My symptoms have been more gastritis last few days ie burning nawing pain in tummy with no back pain so I thought well maybe it is gastritis and not pancreatitis. But now I find myself going downhill again. I know if I revert back to fruit, veges and nil fat etc for a few days with rest, I’ll bounce back, but it’s just got me thinking. I was initially diagnosed with chronic gastritis because of the inflammation in my tummy when they did the endoscopy.
As always your thoughts are very much appreciated. Does any of the above make any sense to you?
Stacey.
Hi Stacey – Good to know you are still alive and kicking 🙂
Question: “when the symptoms are present is it normal to feel like you have the flu?”
Answer: It is entirely possible to have flu-like symptoms (stomach flu) with any number of biliary diseases/conditions (gallbladder, pancreas, sphincter of oddi, liver etc), stomach conditions (gastritis), intestinal conditions (IBD) and various cancers. So it’s hard to pin-point flu-like symptoms. By the way none of those examples were meant to scare you. They are only examples and I used them to show how difficult it is sometimes for doctors to pin-point symptom causes for symptoms that occur in so many different conditions. IF I remember correctly one of your scans showed sludge? I’m guessing you have a gallbladder issue and maybe it’s a tad inflamed. That’s just a guess. I’m not a doc. 🙂
Hi HG,
So I went to a hospital appointment last week which my family dr had organised because he is concerned about my ongoing illness and huge weight loss. The surgeon is suggesting I have my gall bladder out he says the reason is my illness sounds like gall bladder because I feel Ill when I eat fat and that there is evidence of sludge and small stones. He says it might not fix my problem but it will take the gall bladder out of the equation. He wants me to see my gastro specialist which is on the 15th Jan to see what she thinks. So I have a few weeks to think about my next move. I’m on PPI medication 2 tabs a day when I try to reduce dosage to 1 tab a day I get a burning itchy feeling in my ribs. My specialist thinks this could be bile building up and causing a back flow. I think I might ask for another ultrasound of my gall bladder to try and get an idea of what’s happening with that.
As always I know your not a dr but your always good to bounce ideas off.
Stacey ?