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Hello. I’ve Just Had An EUS Showing Parenchymal Changes Throughout

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Posted on Thu, 23 Jun 2022
Question: Hello. I’ve just had an EUS showing parenchymal changes throughout my whole pancreas with a pancreas that is significantly atrophic now. My blood trypsinogen and trypsin levels are also significantly low now, less than 5, which is consistent with chronic pancreatitis. I have significant pain especially after eating greasy or fatty foods. I’ve had acute pancreatitis attacks over 30 years. My amylase and lipase levels would elevate significantly and dangerously when I first starting getting pancreatitis, but they no longer elevate when I have an acute attack. I have really bad pancreatic insufficiency which makes my stool appear pale, filled with fat, and hard to flush because it floats on top of the water. I have to utilize a plunger to flush it. What is your opinion after reading my story. Do you think U have chronic pancreatitis based on function (pancreatic insufficiency, low trypsin/trypsinogen) levels and based on structure (atrophic pancreas) parenchymal changes throughout the pancreas and a atrophic pancreas?
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Follow up: Dr. Ramesh Kumar (25 minutes later)
I use to be healthy over 30 years ago with a healthy appearing pancreas with no pancreatic issues such as acute pancreatitis. The changes in my pancreatic structure and function happened over time after I had so many acute pancreatitis attacks over the years. What is your opinion?
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Follow up: Dr. Ramesh Kumar (9 minutes later)
I’ve had acute pancreatitis attacks which started over 30 years ago. My pancreas appeared normal and I did not have pancreatic insufficiency until I had all of the acute pancreatitis attacks over the years. What is your opinion? Do you think my pancreatic insufficiency, a very low trypsin and trypsinogen levels-less than 5 could have happened because of all of the acute pancreatitis attacks over the years? My recent EUS showed parenchymal changes throughout the whole pancreas and a significantly atrophic pancreas now. Do you think the structural changes to my pancreas happened because of all of the acute pancreatitis attacks over the years? Are changes is the pancreatic structure and function (pancreatic insufficiency) reversible? Give me your honest opinion?
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Follow up: Dr. Ramesh Kumar (8 minutes later)
Is damage done to the pancreatic structure and function reversible! Will my low trypsinogen/trypsin levels (less than 5) and changes to my pancreatic structure( an atrophic pancreas and parenchymal changes throughout the pancreas) ever return to normal again? Will I be able to one day eat fatty and greasy foods and fried foods again like others? Please give me your honest opinion doctors!
doctor
Answered by Dr. Ramesh Kumar (11 days later)
Brief Answer:
Need more details.

Detailed Answer:
Hello and thank you for choosing Ask a Doctor service for your query,
Have seen your details,
My first observation is that you are worried because of finding in pancreas but as such apart from eating faty food no other symptoms are there.If any other symptoms are there then please let me know.
At first I would like to say that stools rich in fibers float on water while stool which has lots of lipids sink inside pot.So you are unnecessarily worrying about it.
Secondly if you don't have any problem like constant pain etc then forget about findings.
Before giving further answer I would like to know that why EUS was done...What I mean by that is did you have any symptoms for which test has been done or were you hospitalised for acute attack or it was as a routine investigation.
For a professional answer I need the details.
But one thing I would say that yes by adding few enzyme tablets you could eat fried food so don't worry.
Waiting
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramesh Kumar (28 hours later)
I’ve had acute pancreatitis attacks over and over again since 1990. I’ve had pain since I’ve suffered from my acute pancreatitis attacks. My amylase and lipse use to elevate really high after easy greasy or fatty foods, but they no longer elevate. I live with chronic pain since I have suffered from chronic pancreatitis. I really get really bad pain and nausea after eating greasy or fatty foods. My blood trypsinogen and blood trypsin levels were normal before I start getting acute pancreatitis, but since I’ve had so many attacks since 1990, my blood trypsinogen and blood trypsin is now below 5. For example if I went out and ate a meal of fried chicken, mashed potatoes with gravy, buttered cheesy biscuits etc. I would be doubled over in pain. I use to be able to handle greasy and fatty foods before I start getting sick with the pancreatitis over and over again. A colleague of yours on this website told me that chronic pancreatitis is irreversible. He also told me with a trypsinogen level of 7 or lower, that it is advanced chronic pancreatitis. My pancreas has shrunk tremendously. It is atrophic and has hyperechoic strands all through it and lobularity through is as well. One area of calcification was found in the head of my pancreas.
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Follow up: Dr. Ramesh Kumar (20 minutes later)
I have lobularity, hyperechoic strands and hyperechoic foci throughout my pancreas and an area of calcification in the head of my pancreas. I have many diagnoses of acute pancreatitis, chronic recurring acute pancreatitis and chronic pancreatitis. My pancreas wasn’t damaged and was completely normal until I started having acute pancreatitis attacks over and over again. I was pretty healthy until I start getting sick with pancreatitis. I’ve had the chronic pain ever since I’ve suffered from pancreatitis.
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2906 Questions

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Hello. I’ve Just Had An EUS Showing Parenchymal Changes Throughout

I use to be healthy over 30 years ago with a healthy appearing pancreas with no pancreatic issues such as acute pancreatitis. The changes in my pancreatic structure and function happened over time after I had so many acute pancreatitis attacks over the years. What is your opinion?