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Pancreatic pain - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2584 Questions
User :   Hi, I am writing regarding my son who is 16 yrs old and having abdominal pain for 3 months now. Everything started when he drank glass of cold milk and some juice and it's been going on for 11 weeks now. In the beggining pain went away for a couple days or there would be days that pain will go away for a couple hours, but lately that pain is constant and feels like ongoing spazm around belly button. We have done all test and his blood work shows lipaze abnormal but only 83 and now they think it's pancreatitis. That only showed last week, but what about before and CT scan and ultrasound does not show any inflammation. He has terrible herthburn and pain worsen when he eats something. They put him on low fat diet, but it does not help. He had endoscopy and colonoscopy and everything is fine.
Doctor :   Hi
Doctor :   I am Dr. XXX
User :   Hello
Doctor :   I am reading the query
Doctor :   Please give me a minute
User :   sure
User :   He is also taking prevacid 30mg and levsin but no relief
User :   He id upper GI with barium also fine
User :   He lost a lot of weight 20 lbs for 2 monts
Doctor :   ok
Doctor :   Does he vomit after a meal or food?
User :   no
User :   he has apetitite but food bothers him
Doctor :   Did it start with a fever initially, 11 weeks back?
User :   no
User :   nothing just pain and herthburn
User :   he can not eat big meals he feels full
Doctor :   Any change in the pain with posture?
User :   he can not digest food
Doctor :   like more pain when he lies down
User :   no but it worse when he is sitting
User :   he does feel more comfortable laying down
Doctor :   right
Doctor :   This is a typical pain of pancreas inflammation
Doctor :   and the food aggravates the pain
User :   but CT does now show or utrasound, come blood work did not show before
Doctor :   There are many instances where the radiology does not show
User :   it came up only last week and he had pain nefore
Doctor :   I had seen few times
Doctor :   Serum Lipase elevation is also more towards the pancreas problem
User :   but his lipase are only 80
Doctor :   Yes, the pain is more in children
Doctor :   and they cannot tolerate it
Doctor :   sorry adolescents too
User :   how come blood work did not show
User :   when pain started in begining
Doctor :   The amylase and lipase appear after 48 hours to one week
Doctor :   The doctor would have conducted serial enzymes
User :   but in this case apperead after 3 weeks
Doctor :   It can happen
User :   how I treat
User :   is this serious
Doctor :   The diagnosis of pancreatitis is clinical
User :   how can I help him
Doctor :   and may not include the blood work and radiology
User :   it pancreatitis is constant spazm pain
Doctor :   Rest for the gut is the best thing
Doctor :   Low fat meal
User :   not eating?
User :   how can I do this if he is not hospitilized
Doctor :   When there is an episode of the pain, usually we put them on IV fluids
User :   how long does it last
Doctor :   for initial days
User :   and I though pancreas pain is upper abdominal not around belly button
Doctor :   and slowly get to the solids over a period of 3 to 7 days ( it depends on pain)
Doctor :   If you are reading it on the internet it says so
Doctor :   The actual picture is much different
User :   should I get him back to hospital then since pain is not getting better after his hospital discharge week earlier
Doctor :   I say, yes
User :   how long does it last
Doctor :   Since the pain is not getting better, he should be put on ample analgesics by IV
Doctor :   and fluids
Doctor :   It may take another 3 to 7 days
User :   before pain is gone or getting just better
Doctor :   getting better
Doctor :   The episodes recur
User :   Dr. is this serious?
Doctor :   Pancreatitic pain is really bothersome
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