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

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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@mgm223 -
I had my gallbladder removed years ago. After a few years I started having quite severe right upper abdominal pain, usually after meals. I had an MRCP that showed “sludge” in the common bile duct. I then had the ERCP where the sphincter opening was enlarged.
Not long after the severe pain returned- another MRCP and follow up ERCP. This time the sphincter had an incision to make the opening permanently open.
Since then I only rarely feel pain if I eat too much fat, but that pain passes.

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Did you have any problems with your pancreas either time? The gastroenterologist I have seems reluctant to do an ERCP because of the possibility of pancreatitis and possibly death. So it looks like this sphincterotomy in your case was the final fix. I am happy for you!!!. This may be the final fix for me as well. Thanks for the info!!!

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@collenp
Welcome to Mayo Clinic Connect!
You have been through too many painful abdominal conditions!
Did you have pancreatic illness when you got the Moderna shot? Did pancreatic symptoms worsen after the shot?
I had pancreatitis diagnosed once- so painful and so sick.
Also had the pyelonephritis of kidney many years ago- also very sick.
I hope the rest of this year is better for you.
Let’s see if other members can share side effects of statins.
Here is a link to Mayo Clinic’s discussion on statin side effects:
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013

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Hi. I'm sorry that you are having so much pain. I think the most difficult part is not knowing exactly what is causing your symptoms. Once you get an answer to that, it is much easier to cope with the physical pain.

I have had chronic pancreatitis for at least 20 years. It started as a sharp pain in my right shoulder along with upper abdominal pain & bloating. I would resist going to a doctor or ER for so long that by the time I did go, my lab results were normal.This went on for about 10 years.

Finally I had an attack of pain & nausea too intense to postpone getting medical help pronto. My lab results were 3 or 4 times the norm. (Amylasen lipase, liver enzymes)
At that point I had my gallbladder removed by laproscopy. They found only 1 stone, but loads of thick sludge (they said the consistency of bubble gum)in the gall bladder.

Six pain-free months followed, and then out of the blue one morning an unbelievable abdominal pain radiating to my back & nausea struck. My husband dragged me to the ER where my lab results were off the charts. An ERCP was done, where they found I had pancreas divisum. (I have only a small portion of a pancreatic duct, which normally runs the length of the pancreas to enable drainage of the digestive enzymes produced by the pancreas. Drainage was blocked so, in effect, my pancreas was digesting itself. OUCH!!)

Have your doctors done any lab work soon after the onset of your pain? Have you had a pipida scan (ultrasound to detect gall stones)? Those tests might ease your mind about having pancreatitis. If your doctor is unable to give you answers to your questions, it may be time for a second opinion. Please let me know how things go for you. If I can help in any way, please let me know. Don't give up.

Be well,
Nookers

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Thank you for responding to my post and showing your concern. Yes my pancreatitis did worsen after the Moderna Bivalent covid shot. It was my 4th covid vaccination. I also began a 20 mg dosage a day of Atorvastatin the day before the covid vaccine.
I went to my PCP on 12/29/22 because my pancreatitis was flaring up again. I have had pancreatitis flare ups for 18 years. All began with a botched ERCP with stenting and suffered perforation of the duodenum. Gall bladder removed soon after. I have never felt the same since. Now come to find out most statins aggravate the pancreas, liver and kidneys and having covid, findings are being posted that hospitalized covid patients are also suffering with pancreatic complications and the bivalent vaccines cause pancreatitis. I can't get a break. I have stopped taking the statins. I am now a vegetarian and go for acupuncture for abdominal pain control.
Take care,
Thank you again for your post response.

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@collenp
Interesting to hear that you get acupuncture for abdominal pain. I have been thinking of looking into it.
How often do you get treated?

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I have been going for acupuncture for pancreatitis and biliary colic pain for about 15 years.
When I have flareups I go every 2 weeks for about 2 months. The pain settles down. Since December 2022, after taking statins for 3 weeks and the bivalent covid shot, my pancreatic pain was excruciating. I have had 2 acupuncture treatments and scheduled for my 3rd appt. Next week.
I have never taken pain meds ever for pancreatitis and biliary colic.
Give it a try. Be open to it and be very relaxed during your treatment.
It has worked for me.
Take care
👍

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