Could this be chronic pancreatitis?

Posted by tinatoren @tinatoren, Mar 10, 2023

Hi I've been dealing with NERD pain, hiatal hernia, IBS for 20 years and have had yellow stools since 2014 when a scan showed my gallbladder functions at 40 percent. I have gone through cycles of ever increasing flares of burning - eating Prilosec-getting better - more Prilosec etc. But Ive always also had pain just above my bellybutton in a band. Also a dull backache in a belt in my back around waist level and sometimes between shoulder blades.
The pain is sharper in front and more dull in back. I used to think it was my back hurting but then I discovered that when I pressed hard above the belly button the back pain would dissappear until I let go. I could never stand with food in my stomach during flare ups. If I sat or layed down with heatingpad the back pain would go away. The stomach pain used to get better 40 min after eating and then come back 2 hours later. In November 2022 the pain started up and I took 40mg of nexium for 35 days. It did not get better. Now the pain above bellybutton was insanely intense and I would get a horrible nausea and shortness of breath after eating and could not sit up. I've also been dealing with tingling legs and internal vibrations in stomach and seat area with flare ups but in December 2022 the vibrations spread up my spine to my arms, neck, face etc. Lips tremble when swallowing. Then I got myoclonic jerks of neck, back and a little in legs. My entire body tingles when relaxing and I start jerking. Ringing ears dizzy etc. Been bed ridden since January 1st due to stomach pain and neurological symptoms. Feel like my brain is inflamed. I get a horrible preassure in back of head and behind nose when standing more than a few minutes so back to bed. Jerks vibrations get worse the more I move. Can't lay my head to the sides. Besides all this my stomach pain has reached epic levels. A gnawing burning pain just above navel in a belt and sometimes higher but not as high as breastbone. I don't tolerate any food except rice and boiled chicken and boiled vegetables etc. Very small portions. After 10 years I still don't know where that pain above belly button comes from. It's never cramping so not intestines. Not under right rib so not my sluggish gallbladder. Could I have chronic pancreatitis since my stools are yellow?? Mostly horribly chronically constipated but if I eat a lot of fat I get the fatty stools but not often.
Im super scared to go back on ppis or pepcid since I suspect they caused the neorological symptoms. The pain is so bad it's like a torch above belly button.
Endoscopy didn't show anything but Ive had 9 and only once did they see esophagitis although my stomach flares start with pain when laying down and acid comes up. I just feel that the esophagus cannot explain everything.
The burning stomach pain did not improve with all that nexium.
I'm now bedridden and devastated by my head preassure and stomach pain.
Insane internal vibrations in abdomen.
Since I can't tolerate any foods I'm thinking this is way worse than just a bad gallbladder.
Can anyone describe chronic pancreatitis pain or pancreatic insufficiency??

Interested in more discussions like this? Go to the Digestive Health Support Group.

@missingthebeach

Results came back for second elastase test it was normal, fecal fat normal, gallbladder hida normal. I am feeling very lost as to what's causing these issues. I did a full 180 on my diet incorporating healthy grains decreasing fats and sugar. Increased fiber intake. Stools are still lighter in color than usual but aren't yellow as they were for weeks. I started using florestor this week as well. I have had a few normal stools, at least normal to how I remember them being last year before all this began.

I met with gastro this month and their diagnosis is a brain gut disconnect where I am still receiving pain signals though the infection is gone. It's a possibility that I am not dismissing entirely but I still haven't gotten a real answer on iron deposition issues over my liver and pancreas. I also noticed on another scan for a separate issue that they noted a splenule, I am reading there are some complications that can come from these and they can be mistaken for neuroendocrine tumors or vice versa.

Not entirely sure how I feel about this brain gut disconnect as my symptoms under the rib were mild in March where it was a feeling of having something under my rib which then flared into intense pain the beginning of April throbbing, stabbing in front and back of ribs then changed into itching crawling and shooting nerve pains across my rib and up my back. This went on for two weeks and now I am again back to the feeling of having something under my rib, and my back is inflamed and only on the left side mid back and shoulder blade.

I am seeing massage therapists for my back and a physical therapist too but neither have helped yet. There is a small lump in between muscles in my back that may be a knot. I will try to have it checked out by my doctor.

I had an MRI done of my spine as well that showed no tumors or anything sinister in March. I will try other gastro teams to see if there is anything they see but I am beginning to lose hope here. Not sure if I will have another flare up - we shall see. It's been a really nice quiet week I am appreciating it very much.

Is there anyone on the board that has chronic pancreatitis that can describe their symptoms? Is the pancreas visibly enlarged in scans, is the pain constant, are there flares? What causes flares? What was the definitive scan or test result that warranted the diagnosis?

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I've had the pain underneath my ribs but I also had surgery on my lung but then it swelled up 8 months later which is now and they're checking my pancreas which I never even thought of. But I've had blood in my stool years ago and I think I messed up. So as for thinking, there's something in your ribs. Yeah I think that maybe the reason I never healed or thought I never healed. Also I had low oxygen before my lung was removed all the way into the '70s which can kill off a lot of your organs. I had multiple organ failure sepsis, pneumonia and covid. So they did me and and then they gave me so many antibiotics. They made me toxic. I smelled smoke for months but the most miserable I've ever been has been in the last couple months and it looks like it's swelling on that side and I can't stop going to the bathroom and again he told me I had blood years ago but I never followed through

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If it is chronic pancreatitis that can be quite tricky to diagnose. If you are acutely ill with a flare up of your pain and get your lipase level tested that can be informative. When it is the chronic stuff then testing for it is not as straightforward because there appears to be no one test that is a marker for chronic pancreatitis with 100 percent acuracy. If your issues are hereditary then there is a genetic test. That is how my diagnosis was made. I had my whole genome testing done with sequencing.com and the Ai sent me a message that I carried the genes for pancreatitis. The Ai listed the tests I should get done and recommended I tell my doctor I had these gene mutations. My neurologist ordered a medical grade pancreatitis panel test from AMBRY and it confirmed I really had the genes. Because since I was a child I was diagnosed with so many misdiagnosis for my symptoms my diagnosis was quite delayed (63 years) so in my case pretty much every system in my body is damaged, which made for a very confusing clinical picture. In the meantime while you are trying to figure this out when the pain is flared up hurting have you tried completely resting the pancreas, just stop eating for a day or 2? I have found that strategy very helpful to keep things from spiraling out of control as long as I am sure to keep my electrolytes including sodium, chloride and glucose at adequate levels. As well I have had success at managing the pain by severely limiting the amount of fat I intake with each meal and snack, Like no fat to up to 5gm per meal is all my body can handle or the pain attacks whether I use the enzymes or not. As far as the neurological symptoms one of the mutations is a contributing factor but the neurological aspect I think is more than just a malfunction with my chloride channel gate not opening normally, I think the years of malabsorption of fats has taken a heavy toll on my brain and nervous system, the lack of absorption of fat soluble vitamins as well causes widespread random symptoms and when pancreas is inflamed I am learning lipase seeps into the blood stream crosses the blood brain barrier and damages the brain. So preventing that pain after meals I think is key to protecting the brain, in addition to correction of the nutritional deficiencies.

REPLY

I have been struggling with abdominal pain for the last 6 months that gets worse when I eat or drink. I have lost 35lbs. I am nauseous all the time and unable to eat without pain, even a bland diet or liquid diet, low fat etc.. I have had CT Scans, Ultrasounds and upper endoscopy, all normal. I have had low lipase levels and borderline vitamin deficiencies. Liver enzymes have also been elevated. I have had a partial gastrectomy due to gastroparesis over 12 years ago and have not had any issues until the last 6 months. Recently had a HIDA scan and it showed slow emptying of bile. They tried to perform an ERCP and were able to get to bile duct but unable to enter it due to anatomy. The angle was such that they could not get the wire set correctly. They did see bile emptying so we know it is not completely blocked. There is also a blind loop that is 5cm long from the partial gastrectomy which a concern was food maybe getting stuck although there did not seem to be any in the loop during the ERCP. Just trying to see what should they look at next? Could if be chronic pancreatitis or something else..

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@bluedog35

I have been struggling with abdominal pain for the last 6 months that gets worse when I eat or drink. I have lost 35lbs. I am nauseous all the time and unable to eat without pain, even a bland diet or liquid diet, low fat etc.. I have had CT Scans, Ultrasounds and upper endoscopy, all normal. I have had low lipase levels and borderline vitamin deficiencies. Liver enzymes have also been elevated. I have had a partial gastrectomy due to gastroparesis over 12 years ago and have not had any issues until the last 6 months. Recently had a HIDA scan and it showed slow emptying of bile. They tried to perform an ERCP and were able to get to bile duct but unable to enter it due to anatomy. The angle was such that they could not get the wire set correctly. They did see bile emptying so we know it is not completely blocked. There is also a blind loop that is 5cm long from the partial gastrectomy which a concern was food maybe getting stuck although there did not seem to be any in the loop during the ERCP. Just trying to see what should they look at next? Could if be chronic pancreatitis or something else..

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I had nausea and pain all the time they finally diagnosed me with chronic pancreatitis thru eus

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@bluedog35

I have been struggling with abdominal pain for the last 6 months that gets worse when I eat or drink. I have lost 35lbs. I am nauseous all the time and unable to eat without pain, even a bland diet or liquid diet, low fat etc.. I have had CT Scans, Ultrasounds and upper endoscopy, all normal. I have had low lipase levels and borderline vitamin deficiencies. Liver enzymes have also been elevated. I have had a partial gastrectomy due to gastroparesis over 12 years ago and have not had any issues until the last 6 months. Recently had a HIDA scan and it showed slow emptying of bile. They tried to perform an ERCP and were able to get to bile duct but unable to enter it due to anatomy. The angle was such that they could not get the wire set correctly. They did see bile emptying so we know it is not completely blocked. There is also a blind loop that is 5cm long from the partial gastrectomy which a concern was food maybe getting stuck although there did not seem to be any in the loop during the ERCP. Just trying to see what should they look at next? Could if be chronic pancreatitis or something else..

Jump to this post

Yes after months of testing, many repeats, 5 ER visits and 3 hospital stays, chronic pancreatitis was diagnosed via endoscopic ultra sound. The light used during this procedure visualizes the organs. I was so happy I finally got a diagnosis. Good luck to you.

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@bluedog35

I have been struggling with abdominal pain for the last 6 months that gets worse when I eat or drink. I have lost 35lbs. I am nauseous all the time and unable to eat without pain, even a bland diet or liquid diet, low fat etc.. I have had CT Scans, Ultrasounds and upper endoscopy, all normal. I have had low lipase levels and borderline vitamin deficiencies. Liver enzymes have also been elevated. I have had a partial gastrectomy due to gastroparesis over 12 years ago and have not had any issues until the last 6 months. Recently had a HIDA scan and it showed slow emptying of bile. They tried to perform an ERCP and were able to get to bile duct but unable to enter it due to anatomy. The angle was such that they could not get the wire set correctly. They did see bile emptying so we know it is not completely blocked. There is also a blind loop that is 5cm long from the partial gastrectomy which a concern was food maybe getting stuck although there did not seem to be any in the loop during the ERCP. Just trying to see what should they look at next? Could if be chronic pancreatitis or something else..

Jump to this post

Hi @bluedog35 . Welcome to Connect.
You have certainly gone through a lot and feel miserable. You have to be so frustrated not being able to tie all these tests together somehow.

I haven’t had testing that shows much so far, still I know the problem is there, definitely real. My unintended weight loss has been the most helpless feeling because there was absolutely nothing I could do about it. Add knowing pain from eating will come when trying to fix it……I finally got to doctors that are helping me figure out what I can do lifestyle-wise to make this all tolerable as they pin down what is wrong. It can’t happen soon enough!

Has any changes with your original gastrectomy been ruled out? What does your doctor think you should consider next?

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@bluedog35

I have been struggling with abdominal pain for the last 6 months that gets worse when I eat or drink. I have lost 35lbs. I am nauseous all the time and unable to eat without pain, even a bland diet or liquid diet, low fat etc.. I have had CT Scans, Ultrasounds and upper endoscopy, all normal. I have had low lipase levels and borderline vitamin deficiencies. Liver enzymes have also been elevated. I have had a partial gastrectomy due to gastroparesis over 12 years ago and have not had any issues until the last 6 months. Recently had a HIDA scan and it showed slow emptying of bile. They tried to perform an ERCP and were able to get to bile duct but unable to enter it due to anatomy. The angle was such that they could not get the wire set correctly. They did see bile emptying so we know it is not completely blocked. There is also a blind loop that is 5cm long from the partial gastrectomy which a concern was food maybe getting stuck although there did not seem to be any in the loop during the ERCP. Just trying to see what should they look at next? Could if be chronic pancreatitis or something else..

Jump to this post

There is an issue with the gastrectomy which could possibly be causing the issue. They left what is called a blind loop which is basically an appendage that goes no where. It is longer than they would have expected so the thought is that food maybe getting stuck in there and causing pain till it comes out. They were trying to rule everything else out first because this would be a major surgery. I am not sure what is next, I a, waiting to hear back from the doctor. It is very frustrating because I know there is an issue and they have been unable to pinpoint it. This has been going on since October. Not being able to eat without pain has been extremely hard. I am hoping the doctors have a plan soon.

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@bluedog35

There is an issue with the gastrectomy which could possibly be causing the issue. They left what is called a blind loop which is basically an appendage that goes no where. It is longer than they would have expected so the thought is that food maybe getting stuck in there and causing pain till it comes out. They were trying to rule everything else out first because this would be a major surgery. I am not sure what is next, I a, waiting to hear back from the doctor. It is very frustrating because I know there is an issue and they have been unable to pinpoint it. This has been going on since October. Not being able to eat without pain has been extremely hard. I am hoping the doctors have a plan soon.

Jump to this post

It's so frustrating but you hang in there and be you own advocate. Just keep questioning and keep on your medical team. That's what helped me get a diagnosis. It might take a while but I'm hopeful your team will determine a diagnosis.

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@missingthebeach

Results came back for second elastase test it was normal, fecal fat normal, gallbladder hida normal. I am feeling very lost as to what's causing these issues. I did a full 180 on my diet incorporating healthy grains decreasing fats and sugar. Increased fiber intake. Stools are still lighter in color than usual but aren't yellow as they were for weeks. I started using florestor this week as well. I have had a few normal stools, at least normal to how I remember them being last year before all this began.

I met with gastro this month and their diagnosis is a brain gut disconnect where I am still receiving pain signals though the infection is gone. It's a possibility that I am not dismissing entirely but I still haven't gotten a real answer on iron deposition issues over my liver and pancreas. I also noticed on another scan for a separate issue that they noted a splenule, I am reading there are some complications that can come from these and they can be mistaken for neuroendocrine tumors or vice versa.

Not entirely sure how I feel about this brain gut disconnect as my symptoms under the rib were mild in March where it was a feeling of having something under my rib which then flared into intense pain the beginning of April throbbing, stabbing in front and back of ribs then changed into itching crawling and shooting nerve pains across my rib and up my back. This went on for two weeks and now I am again back to the feeling of having something under my rib, and my back is inflamed and only on the left side mid back and shoulder blade.

I am seeing massage therapists for my back and a physical therapist too but neither have helped yet. There is a small lump in between muscles in my back that may be a knot. I will try to have it checked out by my doctor.

I had an MRI done of my spine as well that showed no tumors or anything sinister in March. I will try other gastro teams to see if there is anything they see but I am beginning to lose hope here. Not sure if I will have another flare up - we shall see. It's been a really nice quiet week I am appreciating it very much.

Is there anyone on the board that has chronic pancreatitis that can describe their symptoms? Is the pancreas visibly enlarged in scans, is the pain constant, are there flares? What causes flares? What was the definitive scan or test result that warranted the diagnosis?

Jump to this post

Hi, I'm new here and from New Zealand.
I have Chronic Pancreatitis and have had it, about 15 years now, I was diagnosed in Australia, and I have had many, many Acute Pancreatitis episodes, which I don't wish on anyone, they are hell
My bloods, amalyse/lipase were at the highest ever at 3,200,after been medically induced by an ERCP, so no more of those in Australia.
A year or so ago, I got AP again, vomiting copious amounts of skinny,green bile,so sick,and couldn't stop vomiting and the pain in my stomach, crippling.
So in those episodes in Australia I would go to hospital, placed on a drip, and given a PCA for pain relief, and rest of the pancreas, that is all they can do.
Then I came home to New Zealand and because I needed pain meds, only one lot, as went off a lot, I was told, I was an addict, so not true, I have real pathology but they don't believe me here.
My cells in my pancreas are burnt out, so if I have an acute episode my amalyze lipase don't elevate, I get the shakes, a temp,and sick.
Last acute episode I was sent home, I can't have any pain relief, as a nasty Dr made sure he stopped that, abusing his power

4 years ago, I saw a gastro specialist with my then husband, he said come back in a few years, so I can diagnose you with Pancreatic Cancer.. I was horrified but what he meant was Chronic Pancreatitis can lead to Pancreatic Cancer, I never saw the Dr again as no follow up, never has been.
I get pain flares more frequently these days, I have nothing for pain as they won't let me, yes inhumane.
The pain comes and goes, I used to take Creon, it's a digestive enzyme for CP, but I found it not helpful as the episodes come and go.
I can't and don't eat much, and yellow floaty stools, that smell yucky.
Oh yes, last CT years ago, my pancreas is dying, it's called Atrophy so no follow up, I don't even have a local Dr, I see a nurse, that's it.
I travel an hour there, and back, as short in Drs in my country.
She keeps saying let's do bloods, every time.. I requested a CA 19-9 which is a Tumor Marker for the pancreas.
It's is elevated, to only 49,but has risen, no action by the nurse, or anyone
Last week I saw the Nurse as my stomach upper and my back same area, was in agony, I said to her, Look the amalyze or lipase don't show, my cells are burnt out, and she pushed down on pancreas and set the pain worse.
I asked for the CA 19-9 test, she didn't do it, she wasn't listening, I went back, then she did it.
So my Gamm GGT, AST(liver and pancreas enzymes)are rising and very high too.
My platelets low, my WBC and neutrophils, and lymphocytes all low, and dropping.
Yet here I am, no follow through
Im on my own, and I know I will probably get Pancreatic Cancer.
I have lost 20 kilos in last year, no action and lastly I'm so, so so tired
Next is a bone marrow biopsy that I had to pay big money, to go private, the tiredness is crippling, I don't know why, but that's a run down.
Healthcare in this country is 3rd war almost, and I have been labelled as something I'm not.
I'm 61 soon, I'm sick, and getting sicker, but the attitude of health care, is called, oh sorry, you fell through the cracks, and that's it, nothing I can do, if in pain, I have to suck it up, I used to take pain relief as I needed it, I stopped taking it 4 times to lower my tolerance on this 4th time, this nasty Dr said, he's going to make sure, even if I have cancer, that I never get pain relief ever again, because I made a complaint about him, serious too, so he didn't like it, so everyone listens to Drs don't they, even when they lie, which he has, so no matter what, even if it's advanced to cancer, probably has, no action, no relief, no dignity, no life, that's me though, my story.
Chronic Pancreatitis is serious, I have double duct sign, no action, pneumonia, no action.
A splenic Artery Aneurysm, no action.
Cirrhosis of my liver, no Dr watching that,
It's really bad, as I was a nurse in Australia now I'm sick in New Zealand and can't get any help, they don't care, through the cracks, I went, and stay.
I hold on to faith, God, because HE is the only one walking beside me, through this nightmare.
Feel free to ask questions if I left anything out about Chronic Pancreatitis.
I also have a gallstone, surgeon refused to remove it, it got stuck once in my bike duct, that was a living hell, they won't remove it.
So I will leave it there
All the best
Anne-Marie

REPLY
@kiwigirl63

Hi, I'm new here and from New Zealand.
I have Chronic Pancreatitis and have had it, about 15 years now, I was diagnosed in Australia, and I have had many, many Acute Pancreatitis episodes, which I don't wish on anyone, they are hell
My bloods, amalyse/lipase were at the highest ever at 3,200,after been medically induced by an ERCP, so no more of those in Australia.
A year or so ago, I got AP again, vomiting copious amounts of skinny,green bile,so sick,and couldn't stop vomiting and the pain in my stomach, crippling.
So in those episodes in Australia I would go to hospital, placed on a drip, and given a PCA for pain relief, and rest of the pancreas, that is all they can do.
Then I came home to New Zealand and because I needed pain meds, only one lot, as went off a lot, I was told, I was an addict, so not true, I have real pathology but they don't believe me here.
My cells in my pancreas are burnt out, so if I have an acute episode my amalyze lipase don't elevate, I get the shakes, a temp,and sick.
Last acute episode I was sent home, I can't have any pain relief, as a nasty Dr made sure he stopped that, abusing his power

4 years ago, I saw a gastro specialist with my then husband, he said come back in a few years, so I can diagnose you with Pancreatic Cancer.. I was horrified but what he meant was Chronic Pancreatitis can lead to Pancreatic Cancer, I never saw the Dr again as no follow up, never has been.
I get pain flares more frequently these days, I have nothing for pain as they won't let me, yes inhumane.
The pain comes and goes, I used to take Creon, it's a digestive enzyme for CP, but I found it not helpful as the episodes come and go.
I can't and don't eat much, and yellow floaty stools, that smell yucky.
Oh yes, last CT years ago, my pancreas is dying, it's called Atrophy so no follow up, I don't even have a local Dr, I see a nurse, that's it.
I travel an hour there, and back, as short in Drs in my country.
She keeps saying let's do bloods, every time.. I requested a CA 19-9 which is a Tumor Marker for the pancreas.
It's is elevated, to only 49,but has risen, no action by the nurse, or anyone
Last week I saw the Nurse as my stomach upper and my back same area, was in agony, I said to her, Look the amalyze or lipase don't show, my cells are burnt out, and she pushed down on pancreas and set the pain worse.
I asked for the CA 19-9 test, she didn't do it, she wasn't listening, I went back, then she did it.
So my Gamm GGT, AST(liver and pancreas enzymes)are rising and very high too.
My platelets low, my WBC and neutrophils, and lymphocytes all low, and dropping.
Yet here I am, no follow through
Im on my own, and I know I will probably get Pancreatic Cancer.
I have lost 20 kilos in last year, no action and lastly I'm so, so so tired
Next is a bone marrow biopsy that I had to pay big money, to go private, the tiredness is crippling, I don't know why, but that's a run down.
Healthcare in this country is 3rd war almost, and I have been labelled as something I'm not.
I'm 61 soon, I'm sick, and getting sicker, but the attitude of health care, is called, oh sorry, you fell through the cracks, and that's it, nothing I can do, if in pain, I have to suck it up, I used to take pain relief as I needed it, I stopped taking it 4 times to lower my tolerance on this 4th time, this nasty Dr said, he's going to make sure, even if I have cancer, that I never get pain relief ever again, because I made a complaint about him, serious too, so he didn't like it, so everyone listens to Drs don't they, even when they lie, which he has, so no matter what, even if it's advanced to cancer, probably has, no action, no relief, no dignity, no life, that's me though, my story.
Chronic Pancreatitis is serious, I have double duct sign, no action, pneumonia, no action.
A splenic Artery Aneurysm, no action.
Cirrhosis of my liver, no Dr watching that,
It's really bad, as I was a nurse in Australia now I'm sick in New Zealand and can't get any help, they don't care, through the cracks, I went, and stay.
I hold on to faith, God, because HE is the only one walking beside me, through this nightmare.
Feel free to ask questions if I left anything out about Chronic Pancreatitis.
I also have a gallstone, surgeon refused to remove it, it got stuck once in my bike duct, that was a living hell, they won't remove it.
So I will leave it there
All the best
Anne-Marie

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Hi, @kiwigirl63, and welcome to Mayo Clinic Connect. It sounds like you've been through a lot of pain and significant disappointments. I'm very sorry to hear about that.

Hoping you can connect with others here in this discussion about chronic pancreatitis such as @palermo1 @cc8 @penelope52 @choosejoy and others who can empathize with your pain and provide some support as you seek answers.

When did you have your last flare? Was there something that brought you some measure of relief when that happened?

REPLY
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