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Suffering from pancreatitis. Having frequent abdominal pain, mild fever, and back pain. Diagnosed with psuedocyst. Curable?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Dear sir,

I have been suffering from pancreatitis from sep,2012.i am having frequent abdominal pain,mild fever,body pains,back last few day back i was diagnosed with resolving pancreatitis with a psuedocyst measuring 2.9cm on anterior tail part of pancreas and slight swelling of pancreas in mostly in tail part.In such a condition,when i am likely to be normal and healthy? Is there complete cure for this pancreatitis ? Today morning i have got loose motions (only two and stopped) i have experienced this same condition last month too pnly for one day.My query is such loose motion condition is common in pancreatitis. what is my condition now ,is it curable?i am controlling my diet completly as suggessted by dietician. Please do clear my doubts.I am not knowing why this problem arised to me i am young enough ,i have never taken alcohol.please do can you tell me the reason behind this?
Posted Sat, 3 Aug 2013 in Digestion and Bowels
Answered by Dr. Ketan Vagholkar 3 hours later
Thanks for writing in.
From the history and reports which you have sent it appears to be a pseudocyst of the pancreas involving the tail. The size of the cyst is too small to merit any surgical intervention. Another issue is that it is non communicating as diagnosed on MRCP.
The chances of a permanent cure is a bit less. Certainly a good level of pain relief can surely be achieved. The treatment which you are taking at present is alright and does not require any more alteration.
Pancreatic insufficiency giving rise to loose motions can only be controlled by enzyme supplements. Intermittent pain killers may be added to the list of medications.
The condition in your case may have either a autoimmune or familial etiology. THis is in view of the early age of onset. Unfortunately nothing much beyond supportive care can be given at this stage of the disease.

I hope this answers all your doubts.
Above answer was peer-reviewed by
Follow-up: Suffering from pancreatitis. Having frequent abdominal pain, mild fever, and back pain. Diagnosed with psuedocyst. Curable? 28 hours later
Dear sir,
Thanks a lot for your clarification.I do have more doubts please do answer these too.
1.I am attaching my recent colour doppler scan ,with report as resolving pancreatitis(you can have a look at it ).My query is if it is resolving pancreatitis means is there any chance for complete cure or is there any chance of pancreas functioning normally or any chance of relief from pain and other symptoms of this.If so can u tell me expected time i may recover?

2.In the answer you mentioned as CYST NON COMMUNICATING does this have any favour for my recover ? actually what does NON-COMMUNICATING exactly mean?

3.Sir, I am loosing my quality of life due to this long standing problem.As a yound girl with many hopes on career i have completed my pg in M.PHARMACY but could not go for any job.I am loosing the flexibility even to go out atleast for one hour alone.I am forced to be in home due to my diet restrictions.Please can you suggest me any way to overcome this problem and shine in my career by managing pancreatitis.Day by day i am getting depressed alone in the house.Please do suggest to overcome this problem ?

4.Sir,Is there any relation with our physical activity with pancreatitis.My query is can i do bike driving,car driving?From child hood onwards i am a CLASSICAL DANCER ,i stopped it after this problem attacked adding to my depression as it is my life passion.Can i continue doing dance ,will it have any side effects on pancreas problem?

5. Can you please tell me the diet to be followed in my condition? I would follow strictly.

6. In the answer you said "Unfortunately nothing much beyond supportive care can be given at this stage of the disease." Please can you give a clear idea on stage of disease i am now.I am stressing you because being an STUDENT i can even understand inner chemical process.But i lack knowledge which doctors have.So please do consider and explain me clearly sir.

Eagerly waiting for your answer,
yours XXXXXXX s

Answered by Dr. Ketan Vagholkar 11 hours later
Dear Ms XXXXX,
I can understand the stress and agony which you must be undergoing.
I will answers all your doubts sequentially.
1. Resolving pancreatitis as per the report signifies the road towards healing. It means that the inflammatory process is becoming less. The pancreas is assuming its normal state. As there is no evidence of stone formation in the pancreas the chances of relapses would be very less. that signifies great hope.
2. On communicating cysts have a propensity to resolve fully. If they are small cyst as seen in your case they can heal and resolve completely without any sort of surgical intervention. Non communication means that it does not have any communication with the pancreatic duct. As a result there is no refilling of the cyst with enzyme containing fluid. Therefore the chances of complete healing.
3. With regards to the disease, 3 issues usually trouble the patient. All these can be tackled easily by good medications and supportive care.
a) Diabetes which in your case is absent so you need not worry.
b) pain which will last till the inflammation resolves completely. As in you case there are no stones so the intensity of pain will be much less requiring just analgesics. There is no need for any advanced pain relieving methods to be tried.
c) maldigestion is to some extent problematic. But this can be tackled well by meticulous enzyme supplements and dietary modifications which suit your system.
4. During an episode of pain hectic physical activity should be avoided. But I feel that once the lesion resolves completely you can start your hobby of classical dancing but in a graded format ensuring at any time that you are not precipitating a painful attack. Avoid overzealous sessions of dance as far as possible.
5. Regarding diet the recommendations would be a moderate protein, moderate carbohydrate low fat diet. You will need to consult a medical dietician to set it right . A lot of trial and error methodology will be required to set the dietary plan.
6. Supportive care means dietary manipulation and medications. You should not have any problem with your career goals. You will just require care and caution till the inflammatory reaction resolves fully.
I hope this answers all your doubts.
Above answer was peer-reviewed by
Follow-up: Suffering from pancreatitis. Having frequent abdominal pain, mild fever, and back pain. Diagnosed with psuedocyst. Curable? 2 days later

I am really thank full to you for your keen clarification of my doubts.I cannot express my gratitude in words for you.After so many days i found a sign of relief and a hope of recovery.I had met so many doctors but none clarified my doubts due to lack of time.In the way please can you answer my further questions too.

1. Presently i am under the super vision of Dr.NAGESWARA XXXXXXX AND G.V XXXXXXX of ASIAN INSTITUTE OF GASTROENTEROLOGY.I am continuing their medication and following their treatment.My query is ,as per your opinion is this hospital good and also regarding the doctors ,can i continue treatment with them,what do you suggest?

2. I do have small symptoms, those are causing negative psychological effect on me.Please can you clarify whether they related to pancreatitis or not ? They are:
a. I was sometimes having the swollen abdomen.Mostly during pain episodes.The swelling is not so significant too but if observed can be known to me.
b.I was also having the swollen foot sometimes but not too often..that too not significant.Will there be any relation for this swollen legs to my problem.
c.I have been experiencing a needle like pain at my back towards left ,at the same position where do i get pain in the abdomen in the front (far left of upper abdomen beneath the heart).This pain will persist and can be felt always.But these days being felt sometimes only.will this pain lasts till my recovery.
d.Sometimes i am having loose motions ,some times free motion,sometimes hard stools not free at all.When i take liquids only i wont get stools ,but last time when i took liquids also i got loose motions.
e.From the day of problem to till date i was not being able to sleep on floor,always i need to have cot support and also on the cot also i was not being able to sleep towards my left side(lying position). I am facing uneasiness and pain in these positions of sleep.
f. I was facing the pain in the muscles of that area,mostly during fast movements,vigorous laughing, while moving in a vehicle.I feel a type of uneasiness in the muscles of the pain attacked area almost always.Why this occurs?
g. I am getting back pain all the time .Till today ,i cant sit without back support atleast for half an hour.I never used to face this problem in my past life.this back pain is more during pain episodes.
h. Being a girl,i am having my periods in time.But from last four-five months i am having less flow once and the other time more flow,but the periods are coming in time.Will this have any intervention with my present problem.

I know these are simple symptoms,but having so much negative psychological effect and causing more fear,that is why i need clear explanation sir.

3. To this medication i.e. allopathy can i add on the treatment of ALTERNATIVE MEDICINES (like HOMEOPATHY OR AYURVEDIC OR YOGA).Can these alternative medicines give permanent cure.I am thinking to go for HOMEOPATHY and YOGA along with the allopathic medicines,now.Is it advisable to use now,may i know your suggestion please.?

4. Will this problem of pancreas have any effect in B.COMPLEX deficiency.Why i am asking because i was suffering from hand and leg pains in the night time,which are not seen if i take B-COMPLEX tablets daily.This problem is something which i am facing from last 4-5 years.I should take B.COMPLEX OR ALL CEREALS POWDER to avoid pains in the night.

5. Can you tell atleast a rough expected time of my recovery, sir?,so that i can prepare mentally...

6. Being a young girl,24 years and not married, I may get married in future after sometime.Will this problem of pancreas cause any problem regarding my marriage and married life? Can i get married? Will i have any problem in giving a birth to children in future?

7.Even i get a small pain like symptom(not severe pain) i am not taking any fruits or vegetables due to fear of getting pain.i am maintaining only liquid diet.Is this ok or i can take normal diet at that time too?

8.As you said from the report my infection is reducing.Sir are there any other ways i.e. blood tests or other tests,to find out the healing process of my the infection? I would perform those test.

9.Sir to my knowledge, pain in the pancreatitis is due to activation of enzymes in the pancreas itself.Sir my query is,will this cause any damage to the pancreas tissue permanently or temporarily? I was fearing during my pain episodes that my pancreas tissue is being damaged ,please do give clarification whether to fear or not to fear like that,or actually what happens during pain episodes?

Eagerly waiting for your answers ,

Regards, XXXXXXX s
Answered by Dr. Ketan Vagholkar 4 hours later
I will answer all your questions.
1. The treatment given by your currents doctors is proper. You can continue with the treatment.
2. a.The abdomen is not actually swollen. It is a guarded abdomen which gives a feeling of swollen. You need not worry about it. As soon as the pain settles the abdomen will assume a fairly normal configuration.
b. Edema of feet may be due to low protein content due to intestinal malabsorption. So get protein levels especially albumin levels checked periodically.
c. The pain experienced to the sides and back is referred pain. It is not due to any new pathology.
d. The alteration in the consistency of stools is due inadequate enzyme content. Proper diet along with enzyme supplements is the only treatment.
e. Pain in the left quadrants is due to affection of the tail of the pancreas by the disease.
f. avoid rigorous jerky movements as already advised till the disease settles down.
g. Yes support to the back will be essential till the disease is active. Once in remission you will not require any back support.
h. it is good that you are having your menses. as long as they are maintained you need not worry.
3. Strictly no to alternative medicines as their actions are unknown with no scientific documentation.
4. Deficiency of both fat as well as water soluble vitamins can occur due to malabsorption. Periodic oral and IM supplementation is a must.
5. The disease may take any time ranging from 6 weeks to 6 months for remission.
6. There is no harm in getting married and having children once the disease is in remission.
7. Adhere to a diet which gives you all the nutrients without causing pain or aggravation of symptoms .Do not alter or experiment with the diet.
8. C reactive protein, CBC, calcium levels are indicators for evaluating resolution.
9. It depends upon the severity and extent of the pancreas involved. If only the tail is involved as in your case with mild severity the chances of significant damage is less. Complete or near complete resolution can be expected.
I hope these answers allay your doubts and fears.
Above answer was peer-reviewed by
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