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tinatoren (@tinatoren)

Could this be chronic pancreatitis?

Digestive Health | Last Active: Dec 17, 2023 | Replies (26)

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@missingthebeach

Hello everyone,

I am in my mid 30's. I would consider myself a moderate drinker with a couple of very bad hangovers a year. I have been prediabetic since my 20's. I eat a high fat low carb diet normally.

I have always been healthy but this year my life changed. I began experiencing loose stools in December with oil in the toilet bowl. In January it got worse with various colors, yellow, brown, black. Undigested bits of food. Increased amounts of oil in the toilet bowl. I have been tested for parasites and food poisoning - all negative. At the end of January I was unable to eat because food made me gag and belch and I began having nightly symptoms. I was going to sleep and within an hour of falling asleep I would wake up in a sweat so bad my shirt was soaked with my stomach grumbling and on fire. My temperature would drop to 95 degrees - and I had to use heating pads to get my temperature back up. I had urges to evacuate all the food eaten during the day several times over night.

I have had
a colonoscopy (one polyp found)
an endoscopy (nothing found)
a CT with contrast (nothing found)
Lipase normal
Elastase normal
Full bloodpanel/workup normal
an MRCP without contrast - resulted in a slight signal dropout in the liver and pancreatic parenchyma suggestive of "mild iron deposition" which can be seen in cases of primary hemosiderosis. No lesions, no ductal dialation.
Tested for iron in blood - normal
SIBO - negative

The nightly symptoms have since gone away after two rounds of antibiotics from a tooth issue. Once the inflammation was gone I was left with stabbing pain in my left rib and just above my belly button. When there is no stabbing pain there is a feeling of having something lodged under my rib. There is always pain, sometimes it's mild aching. Other times it's stabbing, throbbing, I have felt shooting pains across my rib from the front to the back rib. Pins and needles, crawling and itching. My stool has stopped being loose and oily now four months later but it's pale, yellow/tan colored and bulky. Recently I have had bouts of constipation. The only time I do not feel these sensations is when I am exercising and the bloodflow is increased.

I am scheduled for a fecal fat test, an additional elastase test and a hydascan.

No answers as to what the "deposition" is on my liver or pancreas - I am being told I have IBS and to monitor my symptoms in journal.

Is this pancreatitis? My gastro team is declining to do further imaging on the pancreas because of the blood work and elastase being normal.
What else should I be pressing them to do? How can I convince them this isn't as simple as "IBS" and why are they ignoring my MRCP results!?

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Replies to "Hello everyone, I am in my mid 30's. I would consider myself a moderate drinker with..."

Hello @missingthebeach and welcome to Mayo Clinic Connect. Your symptoms improving as a result of your antibiotics seems to point to some type of inflammation/infection that was reduced after having taken the antibiotics.

First, you will notice that I have moved your post into an existing discussion on the same topic which you can find here:
- Could this be chronic pancreatitis?: https://connect.mayoclinic.org/discussion/could-this-be-chronic-pancreatitis/

Members @tinatoren and @susanh824 may be able to come back and share their experiences.

Have you done any research into gut health and microbiome to see if you could potentially achieve some additional improvements?

@missingthebeach,
Wow, my symptoms are also similar to yours. Last year, under Chiropractic care for back issues I had several CT and MRI scans in which the Radiologist noted an "enlarged pancreas". My PCP ordered a pancreatic MRI to be prudent and found a mass-like area of enhancement on the head of the pancreas and enlargement. This started a whirlwind of events including an Endoscopic ultrasound with Biopsy to rule out cancer, a new diagnosis of Chronic Pancreatitis cause still unknown and an episode of acute pancreatitis after the biopsy which put me in the hospital for a few days. My labs are mostly normal except I have a positive ANA. I have the extremely low body temperature in which I simply cannot warm myself back up, constipation in spite of oral fluid increase and a healthy pancreatic diet and the pain under my left breast or just over my pancreas. I went thru a 47 day Steroid Trial and just had my follow up MRI last week. This test was supposed to confirm that I have Autoimmune Type 2 Pancreatitis...however, my GI called today and feels that there was no shrinkage to the mass, which the biopsy said was negative for cancer and the report said that my pancreatic cells have been severely reduced and replaced by the fatty cells which is a decline from the last test. This is not an indicator of body mass, because I am underweight, instead when the pancreatic cells begin to die, because the pancreas is attacking itself, the cells are replaced by "fatty deposits".
In your case, I would absolutely insist on imaging. If you have pancreatitis, you may not have any change to your labs if it's caught in the early stages. Unfortunately, we must be our own advocate because the physicians have their own agenda.
My GI is sending me to a Pancreatic Specialist because clearly something is wrong with my pancreas but we've ruled out cancer for now, autoimmune, alcohol, and obesity. He acknowledges that having Chronic Pancreatitis puts me at risk for cancer at any time and will continue to order imaging every 6 months.
Hope this helps and I wish you the best in your journey.