How can I tell if I have IBS or chronic pancreatitis?

Posted by just @just, Feb 3, 2012

I have had different stomach pain for 30 years now. I have had my gall bladder removed. My doctor recently told me I have IBS. I think I have both IBS and chronic pancreatitis. Am concerned about not being treated completely and damaging my pancreas. Has anyone experienced chronic pancreatitis and if so, what were your symptoms? My upper stomach will hurt like crazy and almost feel hard. It is difficult to sit still when this happens. My heart rate will increase; and a new symptom now is a pain in my middle, right back a little below my shoulder blade. Sometimes the pain is enough to reduce me to tears. The major part of the pain will last 1-8 hours. When the pain subsides, I will have slighter pain in my abdomen that I describe feels like I have been punched over and over and I will be exhausted and these latter 2 symptoms will last about a day. I do have other, different symptoms, which my doctor is treating me for GERD and IBS, which I believe is correct; however, the pain I have described he is lumping into IBS as well and I am concerned it is chronic pancreatitis which has gone on for 30 years. Any advice? Thank you.

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@gman007

I am so very sorry for your pain and pray that you have already received an answer and some type of treatment plan. I will tell you that the pain you describe sounds very much like acute pancreatitis. I repeat this often, but women who have experienced child birth, kidney stones and pancreatitis are first, very unlucky, but, everyone has told me that the pain of pancreatitis is the worst. Mine begins just below my rib cage and radiates into my back and eventually seems to envelope my entire abdomen. The first major acute attack I had began on a Friday and I am surprised I didn't OD on antacids, because it began as if I was experiencing either a heart attack or my esophagus was going to rupture. I don't like to cause panic, but if you have not had an endoscopy where a scope has been used to look at your pancreas, I would request one immediately. I had a tumor that required the removal of about one third of my pancreas and had not been see on my annual CT scan. An endoscopy doc was going to give me what is known as a celiac plexus block and discovered the tumor. Thank God, it was benign, but pancreatic cancer has the highest mortality rate of all cancers, to my knowledge and the primary reason is that doctors who do not see it in high volumes don't recognize it. It also still carries the stigma of being an alcoholics disease and uninformed physicians assume, incorrectly, that even with the correct diagnosis, the individual is still going to slowly kill themselves. I have a congenital defect that causes poor drainage from my pancreas known as pancreas divisum. Find the highest volume center for dealing with pancreatitis, that you can get to, and get there. If you have a relationship with your PCP or any other physician, ask them to please do an endoscopy just for your peace of mind and I would think your combined different DX's should get insurance approval for one. I also have IBS-C and there is no comparison of the pain. Chronic blockage may cause some pain, but it does not rise above discomfort for me and I know how to eventually solve that issue. Please stay in touch and let us know how you are doing and you certainly have my prayers.

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Hi just read your reply about pancreatitis. I have a similar pain as you have. Right side under right breast all the way to my back. Sometimes it's sharp like a knife but I always have a dull pain there. I just had an endoscopy to check an ulcer in duodenum. That was healed but they found I have Barrett's esophagus. I'm on Prilosec but I still have the pain. Apparently I had silent gerd because I don't get heartburn. I feel full all the time and have terrible gas pains. Had gallbladder tested no stones. But doc says I have typical gallblay pain. I feel they are missing something. I also have diverticulosis and benign colon polyps. They come back where I need a colonoscopy now every 6 months. I don't really know what's causing pain on right side but I've had it forever and it is getting worse. Do you think I should ask them to check my pancreas also. Or could the pain I'm having be from all my other problems? I really am at a loss what to do. Hope you are well.

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Because of what I know about pancreatic cancer and the inability of typical scans to gets really good looks at the organ, I would say yes. There is a new scan that is a 68 _____, that I learned about from a member on here and it reveals neuroendocrine tumors much better than a CT scan. It was just approved by the FDA and there are not a huge number of facilities using it yet and insurance may be a problem, but that may be easier than and endoscopy. My advice is to always find a high volume pancreas center - somewhere they do lots of pancreatic procedures. Mayo is a good start, but if that is not reasonable geographically, find out from your GI or another where the closest high volume center is. I am fortunate to have some of the best pancreatic docs in the country in Charleston, SC which is about a 3 hour drive from my home. I visit about 3-4 times a year for different procedures. One thing I did not mention in my previous post is that if you are hospitalized with pancreatitis (usually acute), you are NPO'ed (nothing by mouth) until your pancreatic enzymes return to something approaching normalcy. This is to rest your pancreas and keep it from trying to produce digestive enzymes. If I have a really bad flare, I will try to survive on gatorade (low carb) and yogurt if I have to have some nutrition. At 225 lbs., I am not going to starve anytime soon, but do have to have enough carbs to maintain my blood sugar. I am not a doctor, but just play one on here - joking of course. You have my ear and my prayers and they are most valuable in reverse order.

Take care, Gary

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OMG you just explained me. My troubles have been for at least 30 yrs. If not more. I have had every test under the sun in spades. Over and over again in case they missed something. They removed my gallbladder. It was functioning at only 23% it had grown into my pancreas and liver. It was a mess. I just had an endoscopic ultrasound. So now I know I have chronic pancreatitis and I have IBS and acid reflux/gerd. I am taking lots of medications for my stomach. Omeprazole for reflux, Align a probiotic, fiber, Creon pancreatic enzymes. You have to watch the FAT. It is your enemy, even the good fat you have to be careful with. Watch your gassy veggies. Broccoli, Cauliflower, cabbage, beans.They can be mean to you. Watch your grains, dairy, sugar. Be careful of meats. Stay away from carbonated drinks, watch your caffeine. Drink lots of water. Oh and a biggie, no alcohol your pancreas doesnt like it. Maybe just maybe you can survive.

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First & for most, everyone in this group should get a stomach emptying test done. I was diagnosed with pancreatitis & IBS. Well after having that test done, it revealed that I have gastroperisis (paralyzed). After I went to ensure drinks for sustenance, I soon found my pancreas, gallbladder (diagnosed years ago) & kidneys were getting pressure from my stomach. If this is ur case, the answer is liquid diet. MAIN POINT: GET TESTED FOR GASTROPERISIS PLEASE!

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Hi
I have the same symptoms as you. I’m still waiting to go for an infused CT. My pain is so bad that I have to lie down with the heating pad. I can’t move I’m exhausted I feel like I’m going to die that’s how bad the pain gets. I’ve been told tby my dr that she has exhausted all avenues for me. I just don’t know what to do. If this CT shows nothing. I am on med for GERD I just recently saw a gastro dr and he says I should try the Fodmap diet. I’ve had both scopes and they are both clean.

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Not sure what I have. Suspect autoimmune hepatitis, or problem with pancreatic.

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@janb1937

Not sure what I have. Suspect autoimmune hepatitis, or problem with pancreatic.

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@janb1937, what tests have you had? Is your doctor working with you to find a diagnosis?

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I am wondering the same thing. I have been diagnosed with pancreatitis. I believe acute. I am not a heavy drinker but I have had many years of stress with a diet of much cheeses and meats and Mexican food along with accompanying one-two max drinks. I am now off all alcohol and cleaned up my diet. I have had most my years with IBS. I never had the usual horrible pancreatitis symptoms that includes fever, vomiting, diarrhea. I just had a painful upper stomach and elevated pancreatic tests that lasted one week after being evaluated. Problem is, I am taking enzymes at meals and the gas continues and some usual IBS symptoms but I can't tell now if it is my pancreas causing all this or the IBS. Nothing seems to be normal anymore. I still have to do a endoscopic ultrasound but the docs don't feel it is an emergency so I am waiting months to get in. It is scary and frustrating. I have my gallbladder and it is fine. Anyone else experiencing this nightmare?? It does feel that when I exercise my stomach does better. I've been on the computer non-stop during the pandemic. I wonder if that caused it or I got sick shortly after getting a CV19 booster! I need more answers! Sorry you are suffering too.

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I have had some dull pain generally and sometimes sharper in the upper right quadrant ever since I had my gallbladder removed in 2014. When I went to the last gastroenterologist he told me that he would check for stones in the bile duct with an ultrasound and found none. He advised me that doing an ERCP is generally not a risk free option since the chance of complications is so high.
Since then, I had to have an appendectomy due to some mucinous cyst in the lumen of the appendix that is supposed to be a pre-cancer. Since the surgeon was going to do a laparoscopic procedure I asked him to look in the area where I had pain because I thought perhaps it could be due to a buildup of scar tissue after the cholecystectomy. He told me he would take a look and would try to remove some scar tissue by laser. However, he further explained to me that when ever and where ever the internal organs are touched that creates inflammation so it is a losing battle to get ahead of internal scar tissue generally. Since then I have done a lot of reading about this matter and I think that perhaps even the titanium clips may be causing inflammation as well to the area despite the fact that they are supposed to be inert. Aside from pancreatic cancer, the only other possibility I came up with is S.O.D.( sphincter of Oddi dysfunction). However, to treat that, one has to have a sphincterotomy which could have lots of risks or take some different meds that may or may not work at all. Has anyone explored all of these possibilities despite the risks?

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@ibspan4

I am wondering the same thing. I have been diagnosed with pancreatitis. I believe acute. I am not a heavy drinker but I have had many years of stress with a diet of much cheeses and meats and Mexican food along with accompanying one-two max drinks. I am now off all alcohol and cleaned up my diet. I have had most my years with IBS. I never had the usual horrible pancreatitis symptoms that includes fever, vomiting, diarrhea. I just had a painful upper stomach and elevated pancreatic tests that lasted one week after being evaluated. Problem is, I am taking enzymes at meals and the gas continues and some usual IBS symptoms but I can't tell now if it is my pancreas causing all this or the IBS. Nothing seems to be normal anymore. I still have to do a endoscopic ultrasound but the docs don't feel it is an emergency so I am waiting months to get in. It is scary and frustrating. I have my gallbladder and it is fine. Anyone else experiencing this nightmare?? It does feel that when I exercise my stomach does better. I've been on the computer non-stop during the pandemic. I wonder if that caused it or I got sick shortly after getting a CV19 booster! I need more answers! Sorry you are suffering too.

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Have you been tested for Exocrine Pancreatic Insufficiency?
If so are you taking Zenpep or Creon??? Or are you taking a nonprescription supplement?
Gastritis is very common with EPI even with prescription treatment. It takes time and a registered dietitian is a great source to help you figure out exactly what is best for you!
EPI can be very different for each individual.
For instance, you might be able to digest some foods that I cannot tolerate even with Zenpep. It’s a very unique disorder!
Of course if EPI has been ruled out entirely a registered dietitian is still a big help either way for anyone with IBS and are covered by many insurance plans.
All the best!

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