Acute pancreatitis?

[ghworker2010]

 

I we went to a restaurant and I ate a fatty pork dish called ‘’ หมูกรอบทอด’’ (moo grob tod).   Then later at home last night I was lying on the lounge and experienced severe pain in my upper body. It felt like it was in my chest but also wrapped around to my back. I also felt sick / nausea and had mild diahorea last night and twice this morning. This is the second time that its happened. It also occurred 2 months ago where I woke up with the same severe pain and also a numb right leg.

 

I emailed a friend about it this morning and he suggested the symptoms might indicate that I have acute pancreatitis.

 

Ive looked it up on the internet and I think that he could be correct. I feel quite de-hydrated right now to be honest and still unwell- but no more pain.

 

We live in an area (the sticks) where the local hospital is not that great and nor are the doctors. Theres one good gastro dr. Is this the kind of dr that I should see? Or should I be getting on a bus to Bkk or KKaen?

 

I want to get a blood test to diagnose acute pancreatitis. What other blood tests should I get done.

 

Thanks

 

[Sheryl]

The test for pancreatitis is serum amylase but it  is extremely unlikely this is pancreatitis.  You would be much sicker if it were and the pain would still be present.

 

Gallbladder/gallstones come to mind and can be diagnosed by ultrasound. (CT as well, but ultrasound is far cheaper and should be enough unless surgery is being contemplated). It is typical of gallbladder pain to occur after ingestion of fatty foods.

 

I had the exact same experience once - doubled over by the pain for several hours. All I did was avoid eating much in the way of fried foods thereafter. Up to you, but if it were me I would just go easy on the fried dishes and if it still  recurs, then see a GI specialist and get an abdominal ultrasound.

[ghworker2010]

thanks for yr opinion on this. cheers

[ghworker2010]

On 10/13/2016 at 5:49 PM, Sheryl said:

The test for pancreatitis is serum amylase but it  is extremely unlikely this is pancreatitis.  You would be much sicker if it were and the pain would still be present.

 

Gallbladder/gallstones come to mind and can be diagnosed by ultrasound. (CT as well, but ultrasound is far cheaper and should be enough unless surgery is being contemplated). It is typical of gallbladder pain to occur after ingestion of fatty foods.

 

I had the exact same experience once - doubled over by the pain for several hours. All I did was avoid eating much in the way of fried foods thereafter. Up to you, but if it were me I would just go easy on the fried dishes and if it still  recurs, then see a GI specialist and get an abdominal ultrasound.

I went and got blood tests after having experienced the pain in my upper body that seemed to be in my back as well. As soon as I sat up it goes away after 20min. Then on the weekend I had this itchy patch on the palm of my hand. 

 

They did blood tests at the hospital and the 'Amylase' came back normal at 61. would this mean that my pancreas is normal? They did some liver tests also and they came back normal. 

 

I googled the itchy palm thing and the following info was displayed below. Ive also had a loss of appetite. 

 

Do you think I need to get an ultrasound on my gallbladder? As I said its twice now in a 4 day period that Ive had the upper body pain

thanks

 

Early Warning Signs of Pancreatic Cancer

• Diabetes, especially if it comes on suddenly. ...
• Yellowing of the eyes or skin. ...
• Itchy skin, palms, and soles of feet. ...
• Lack of appetite. ...
• Changes in taste. ...
• Abdominal pain. ...
• An enlarged gall bladder. ...
• Pale, floating, smelly stools.

 

 

[Hedghog]

Suprised the hospital didn't suggest an ultrasound,for gall stones.

Although you mention upper body pain,not the severe abdominal pain,more associated with pancreatitis,or gall stones.

I would say request one to check if you do have stones.

Can't hurt not overly expensive.

The itchy skin,is general body itch,sort of prickly itch all over,more than one localised area on the palm.

No doubt Cheryl will have a more professional view than I can offer.

 

[Sheryl]

Was the second episode also after eating fatty food?

 

Improvement upon sitting up is common with pain due to  gastritis with reflux, as is the radiation of the pain to the back.

 

Pain triggered by eating fatty foods, common with gallbladder disease.

 

Nothing you have said is suggestive of pancreatic cancer (or anything else with the pancreas) and the rash on the palm is unlikely to be related to the abdominal pain.

 

If the pain persists, see a GI specialist. Ultrasound can indicate if the gallbladder is distended or has stones. A trial of drugs that inhibit gastric acid secretion may help determine if the pain is from gastritis - though I personally wouldn't start  on meds for a pain that has thus far occurred just twice.

 

Suggest you lay off all this googling of serious diseases you are highly unlikely to have, it will only further increase your anxiety, especially since the symptoms of most dread diseases are very nonspecific.

 

 

 

[ghworker2010]

Back to this thread. The upper pain has happened now around 6 times always after consuming fatty food.

 

I had an ultrasound at the local hospital in the sticks but didn't know I was supposed to fast before it. Anyways to dr said 'from what he could see' he couldn't see any gall stones. He took a look at the pancreas and said it looked normal. He also had a look at the liver and kidney both sides. He said the liver and kidney both had cysts on the left side only. 

 

The gastro dr said its probably just heart burn / acid in the stomach.  He suggested that I should have a gastro scope (I think). He said he would have to put a tube down my throat into my stomach. I declined as I know I would not be able to do this unless under general anesthesia. 

 

Its unpleasant being waking up at 2am with severe upper body pain that only goes away when I sit up for half an hour and take the heart burn medicine. 

 

Am I best to just monitor this and see how it goes. If I had done the ultrasound on an empty stomach at Bummers in bkk I think I would feel better about the prognosis. I will see how it goes for another 12 months I suppose. Do you agree?

 

 

[NancyL]

ghworker2010, it seems you've nailed the cause of your condition precisely.  Eating a high-fat meal in the evening.  The obvious solution is to avoid eating this type of food.  Also, the condition could be exacerbated if you consume alcohol or coffee in the evening.  And if you're overweight.  I've found I'm much more prone to heartburn when I let my weight creep up.  If I lose 10 kilos the need for heartburn medicine disappears. 

[Sheryl]

 

Fat slows digestion -- the food stays longer in the stomach - so the chance of reflux is greater especially if eaten  at night.

 

That antacids help, together with the negative ultrasound, would tend to suggest GERD. Antiacids  would not give relief if it were gallbladder, also this would happen during the day as well as at night if it were gallbladder. While GERD can occur during the day it is most common when lying down.

 

You should AVOID eating fatty foods at night, if you must have them make it earlier in the day. In addition, avoid eating anything for 2 hours before you lie down and consider elevating the head of your bed using cinderblocks or pillows.

 

See here for more on self-management of GERD:

 

http://www.mayoclinic.org/diseases-conditions/gerd/basics/lifestyle-home-remedies/con-20025201

 

Be warned that taking PPIs (omeprazole and the like), while it may reduce symptoms (1) does nothing to stop the reflux (it just makes it less uncomfortable when it occurs) and (2) these drugs can be VERY hard to stop as there is a nasty acid rebound when you do.

 

Weight loss does indeed work wonders. It is not necessary tio get down to an ideal weight, for many people there is a "tipping point" at which the problems start - for me, for example, I'm fine at up to about 10 pounds overweight. Any more than that and problems become noticeable.