Hi. Thanks for your query. Noted the history about your son and understood the concerns. Enlarged pancreas can be due to pancreatitis of whatsoever nature which needs further evaluation and the blood work may be absolutely normal unless proved otherwise. Since he has pain in upper abdomen and low back I would advise him further plan in the following way: Get an opinion of a Gastroenterologist for clinical evaluation, examination and further investigations: ERCP is mandatory as well as EUS mean endoscopic ultrasonography. MRCP helps further and may show another causes in the bile ducts or gall bladder which needs to be addressed well. Occasional there can be sphincter of Oddi dysfunction, edema or trauma cause by worms in duodenum. All the possibilities needs to be seen hence also needed is tests of stool and blood again and again. Till then give him pancreatic enzyme supplements with every meal and breakfast as he is loosing weight. About the low back ache: needs an opinion of an Orthopedic Surgeon and MRI of the back as needed to get a proper diagnosis and hence the proper management.