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Suggest Treatment For Chronic Pancreatitis, Episodes Of Chest Pain And Back Pain

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Posted on Mon, 30 Mar 2015
Question: I have been diagnosed with chronic pancreatitis. There is a stone in my pancreatic duct most likely from gallstones in my gallbladder that was removed 2 years ago. I started having similar pain in my back after the surgery and when I went to the doctor I was prescribed prilosec. No tests were done. Last year I started having more pain in my back and a persistent bloated feeling after large meals, especially during holiday periods. The bloating would go away when I severely cut food intake. Last summer I started having the bloating and pain much more regularly and also nausea.after eating. I did some research and determined it could be related to the pancreas. I went to the doctor, had blood tests and they came back with a high lypase count, around 160. I was put in the hospital on intravenous fluids for two days and finally had an mri that confirmed the chronic pancreatitis. The GI who briefly saw me assumed it was alcohol related and prescribed a very strange holistic vitamin regimen which I did not follow as on looking up some of them and the units prescribed they seemed excessive and in fact could have been harmful. I concentrated on avoiding large meals and got my lypase down to around 30. I then went to a follow up appt with my regular doctor who had not seen me at all in the hospital. She did not prescribe anything, indicated surgery wasn't necessary, and wanted me to come back after the holidays for another follow up. This was in October. Also I noticed the pain in my side was activated more with exercise like sit ups, but my doctor says it wasn't related.My concern now is that I have recently been having bouts of severe chest pain after consuming sugar, but also a recurring low grade chest pain on a regular basis if I eat anything. I try to not eat for 2 or 3 days and things settle down, but the minute I eat anything I can feel it starting up again. Back pain, sometimes sharp pain in the right side, like I'd been kicked in the ribs, and of most concern, the sharp chest pain. I take an ibuprofen 800 and a couple of aspirin and in about an hour the chest pain subsides. The back or rib pain can last an entire night and up to two days. A heating pad seems to help all three. What is causing this chest pain? It is the most worrisome. If I'm having an episode the chest pain can start or be made worse by running, or some exertion. I have tried to identify triggers by eliminating certain food, sugar, and alcohol but the attacks seem random. In fact alcohol doesn't seem to trigger it much at all, but sugar and protein will. I'm also not sure how long it takes to have a reaction so it's hard to identify the exact cause. The only thing that happens almost immediately is the reaction to sugar. There has never been a diabetes issue. On breathing in there is also small pain as if it were in the lungs as the attacks subside.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Investigations with second opinion.

Detailed Answer:
Hi.
Thanks for your query and an elucidate history; read over and over again to correlate the things you have nicely put in.

To recapitulate important points for me not to miss anything:
Female / 61 - Chronic Pancreatitis - Cholecystectomy 2 years back - similar pain in back - Prilosec - no tests done - last year - more pain in the back and persistent bloating after large meals - Bloating goes away on cutting food intake - Nausea - did research - back to the Doctor - high lipase 160 - hospitalized - MRI confirms Chronic Pancreatitis - GI thought of alcohol and wrote vitamins which you did not follow - avoided large meals and lipase to 30 - regular Doctor - no prescription - and days surgery not wasn't necessary - * Oct - pain in sides on sit ups - Doctor says not related - recently bouts of chest pain on consuming sugar - rec chest pain on eating anything - most concerned about pain in right side like kicked in the ribs and sharp chest pain - * Ibuprofen 800, Aspirin helps within an hour - pain can last for more -heating pad helps -What is causing **chest pain ? come on running or exertion - Sugar and protein act as trigger - no diabetes - small pains on breathing.
............................................................................................................

After compiling I would advise you the following:
-Second opinion of another Gastroenterologist.
-Upper GI Endoscopy and EUS (Endoscopic Ultrasonography) if the facility is available.
-CT scan of the chest and the abdomen
-Cut off the trigger factors as a part of treatment.
-Routine examination of the blood for sugar, liver functions / Urine / Stool to see the level of indigestion.
-Second opinion.

Additional treatment in discussion with your regular Doctor or Gastroenterologist:
-Pancreatic enzyme supplements
-Priosec, Antacid and other medicines as per the reports of investigations.

I would like to know the exact location of the chest pain.
The starting or enhancing of the chest pain immediately after sugar, running and exertion can indicate towards lower esophageal or stomach problems like inflammation / ulceration and so on.

I hope this answer helps you to get a proper guideline for the proper diagnosis and treatment. Please feel free to ask for further relevant queries if you need to or if you feel that there is a gap-of-communication to clear anything.

Wishing you an early diagnosis and proper management .

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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Suggest Treatment For Chronic Pancreatitis, Episodes Of Chest Pain And Back Pain

Brief Answer: Investigations with second opinion. Detailed Answer: Hi. Thanks for your query and an elucidate history; read over and over again to correlate the things you have nicely put in. To recapitulate important points for me not to miss anything: Female / 61 - Chronic Pancreatitis - Cholecystectomy 2 years back - similar pain in back - Prilosec - no tests done - last year - more pain in the back and persistent bloating after large meals - Bloating goes away on cutting food intake - Nausea - did research - back to the Doctor - high lipase 160 - hospitalized - MRI confirms Chronic Pancreatitis - GI thought of alcohol and wrote vitamins which you did not follow - avoided large meals and lipase to 30 - regular Doctor - no prescription - and days surgery not wasn't necessary - * Oct - pain in sides on sit ups - Doctor says not related - recently bouts of chest pain on consuming sugar - rec chest pain on eating anything - most concerned about pain in right side like kicked in the ribs and sharp chest pain - * Ibuprofen 800, Aspirin helps within an hour - pain can last for more -heating pad helps -What is causing **chest pain ? come on running or exertion - Sugar and protein act as trigger - no diabetes - small pains on breathing. ............................................................................................................ After compiling I would advise you the following: -Second opinion of another Gastroenterologist. -Upper GI Endoscopy and EUS (Endoscopic Ultrasonography) if the facility is available. -CT scan of the chest and the abdomen -Cut off the trigger factors as a part of treatment. -Routine examination of the blood for sugar, liver functions / Urine / Stool to see the level of indigestion. -Second opinion. Additional treatment in discussion with your regular Doctor or Gastroenterologist: -Pancreatic enzyme supplements -Priosec, Antacid and other medicines as per the reports of investigations. I would like to know the exact location of the chest pain. The starting or enhancing of the chest pain immediately after sugar, running and exertion can indicate towards lower esophageal or stomach problems like inflammation / ulceration and so on. I hope this answer helps you to get a proper guideline for the proper diagnosis and treatment. Please feel free to ask for further relevant queries if you need to or if you feel that there is a gap-of-communication to clear anything. Wishing you an early diagnosis and proper management .