What causes back pain inspite of having mild gastritis and lesions in the pancreas?
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I have been in contact with several of your doctors in the last two months. I have taken all the imaging exams, MRI, MRCP, ct scan, upper GI, abdominal ultrasound, HIDA scan, endoscopy, and back xrays. I have been diagnosed with mild gastritis and the MRI found two 1cm side branch lesions in the pancreas. Other than those two findings, everything is normal. I have been on nexium and sulcrafate, along with digestive supplements. My abdominal pain started in November of last year, but now I only have minimal discomfort in the abdominal area. Now, and for the last several weeks, I have back pain that is mostly middle and upper, and at times the lower. It appears to be constant, I am now seeing a chiropractor and also,I am getting accupuncture. What is going on here? XXXXXXX
Posted Sat, 15 Mar 2014 in Abdominal Pain
Answered by Dr. Ashish Verma 2 hours later
Brief Answer: looks like pancreatitis Detailed Answer: Hi, Thanks for writing to HCM. This is Dr. Ashish Verma, a general surgeon, answering to your query. The back pain looks more like a pancreatitis... as you have two 1 cm lesions in the duct...mostly a cyst maybe....due to some obstruction or stricture. Gastritis, I guess is mainly due to analgesic intake following your hip replacement. Since the back pain is unlikely from neuromuscular cause, I am not sure if chiropractor and acupuncture would help. It's due to inflammation in your pancreas...and it needs specific therapy for its resolution. You should visit a gastroenterologist for evaluation before considering any form of treatment. Can you upload the report that mentions those pancreatic lesions...so that i can go through it and help you furthermore? Regards Dr. Ashish Verma
Follow-up: What causes back pain inspite of having mild gastritis and lesions in the pancreas? 42 minutes later
Dr XXXXXXX I will be glad to send you the MRI that explains the lesions in the pancreas. But, I can tell you the cysts are not in the duct and are considered side branch IPMN. They have no focal mass and no abnormalities after contrast. I have seen a pancreatic specialist and she wants to monitor in 6 months. Would the MRI or a ct scan show an inflammed pancreas. All imaging test showed the pancreas as normal and no ducts were dilated.
Answered by Dr. Ashish Verma 2 hours later
Brief Answer: mri shows inflammation Detailed Answer: Hi, The lesions though not in the main branch...but in the side branch...will obstruct the drainage of that side branch...which over a period of time will have enough pancreatic secreations pent up, to cause pain... Your mri was done mostly two months back...and pain started a few weeks ago...so i will suggest that you get a few blood tests like serum amylase and serum lipase...and if possible a repeat mri...or you can consult your doctor again if you want, before that. That IPMN of yours is of two types....benign and cancerous...if yours is causing pain in less than two months...it can be malignant... So get a repeat mri...if it shows that cyst of the same size, with no inflammation in pancreas...at least malignancy can be ruled out and then we can think of other things... Regards Dr. Ashish Verma
Follow-up: What causes back pain inspite of having mild gastritis and lesions in the pancreas? 27 minutes later
Dr Verma! the MRI was done 3 weeks ago, and actually I had both abdominal and back pain at that time. None of the doctors, my GP, the gastreologist, the pancreatic specialist and the several doctors on this site mentioned pancreatis. I asked the pancreatic surgeon at the time I met with her if I could have a follow up after 3 months and she said it was not necessary. Also can you tell me where on the test shows the pancreas inflamed? And? Would you do another test after 3 weeks?
Answered by Dr. Ashish Verma 1 hour later
Brief Answer: its your spine then Detailed Answer: Hi, If the mri was done 3 weeks ago and it didnt showed inflammation... then its not pancreatitis. Then the pain can be either due to incorrect posture, or age related degenerative disc (spine). So, i would suggest that you should consult an orthopedic for it....as you have already done rest of the tests which are normal...so everything else is ruled out. Regards Dr. Ashish Verma
Follow-up: What causes back pain inspite of having mild gastritis and lesions in the pancreas? 4 hours later
Dr XXXXXXX I do intend to follow up with one of the doctors regarding our discussion. Although they have been aware of the back pain, my main complaint was abdominal, which appears to have gotten better. My MRI says the pancreas demonstrates normal parenchymal signal without focal mass and the pancreatic duct is not dilated. My back xray findings shows moderate degenerative disc disease. The impression is multilevel degenerative disc disease. Please advise and if you still want to see my MRI, let me know.
Answered by Dr. Ashish Verma 20 minutes later
Brief Answer: moderate' degenerative disc disease cause backache Detailed Answer: Hi, When your xray back shows 'moderate' degenerative disc disease, then what else you were looking for....that is the reason for your back pain. Dont worry about the pancreas then...just follow up with the specialist as advised by her. There is not much that can be done for it...its age related...but still you can consult with an orthopedic to help slow down the degeneration. And also a physiotherapist for exercises and postural changes to ease the pain. Regards Dr. Ashish Verma
Follow-up: What causes back pain inspite of having mild gastritis and lesions in the pancreas? 7 hours later
Dr XXXXXXX per your suggestion, I did make an appointment to see my orthopedic doctor.
Answered by Dr. Ashish Verma 4 hours later
Brief Answer: thats good! Detailed Answer: Hi, I am glad that my advice has been of help to you. Your orthopedic may also start you on painkillers apart from medicines to slow the disc degeneration. You will have to continue the nexium for a week over and above you are on painkillers... as they cause gastritis. Hope that i have answered to all your queries. If you don't have further queries, you may close this discussion and rate the response. Get well soon. Dr. Ashish Verma