I have a history of acute pancreatitis. I have been hospitalized twice with extreme pain (8-10) and nausea. The first time, my enzymes were only slightly elevated and they treated my pain and sent me home. The second time, my enzyme levels were high enough that they kept me for 2-3 days until they returned to normal. I also have an intolerance to most opiates which results in migraines, when given iv, and pain that mimics pancreatitis in location and intensity but does not result in elevated enzymes. I have learned over the years that I can avoid the worst of this reaction by taking oral opiates, when necessary, in half doses twice as often as prescribed. Occasionally, even this results in a pain attack. Although I don't need pain meds often, it would be nice to be able to take them when needed. My question is two-fold. First, how can these meds mimic pancreatitis if they don't result in elevated enzymes? Also, is there anything else I could try to prevent this reaction when pain meds are needed?