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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for pancreatitis

have had pancreatitis off and on for over two years now...had gallbladder removed 3 years ago...sphinter of oddi disfunction, biliary diskenesia, i cannot eat without throwing up everytime, i have chronic diahrea, i was just admitted to the hospital with severe pain in my abdomen which was constant right side of my belly button and radiated to my right side and was burning. No fever. No white blood cell elevation..ct scan showed no bowel obstruction or inflammation and blood work showed no pancreatic elevation. They said nothing was wrong with me and sent me home...SOMETHING is wrong. I asked for a CT of my appendix and they did CT without contrast looking for kidney stones. No stones. Never redid CT for appendix. What should i do and what might this be?
Tue, 27 Nov 2018
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Internal Medicine Specialist 's  Response
Hi,

Chronic diarrhea (steatorrhoea), recurrent pain abdomen are consistent with chronic pancreatitis. The serum amylase and lipase levels (blood work) are usually not strikingly elevated in chronic pancreatitis.

Pancreatic enzyme replacement has been the cornerstone of therapy. Enzyme therapy usually brings diarrhea under control. Conventional non enteric-coated enzyme preparations containing high concentrations of serine proteases may relieve mild abdominal pain or discomfort.

Pregabalin can improve pain in chronic pancreatitis and lower pain medication requirement. Addition of pro-kinetic drugs will help in reducing vomiting. There is no entity like chronic appendicitis.

Regards,
Dr. Tushar Kanti Biswas
Internal Medicine Specialist.
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