Sharp pain.

[fishrichard]

About two months ago I started getting this sharp, very intense pain in my upper left abdomen, about an inch below my rib cage. The pain was so intense I could not sleep. Friday the same thing happens only to last through the weekend. It started with a dull pain , intensified, and now is dull and seemd to be fading. Any thoughts. Rich

[Dugie8]

did you get married about a month ago?

[fishrichard]

ha, It will be a year in Feb.

[fishrichard]

hey Dugie, what do you do in RSt. We fly in there a good bit.

[Dugie8]

Originally Posted by fishrichard

hey Dugie, what do you do in RSt. We fly in there a good bit.

I call it home. My company home bases, so I can live just about any where I choose and not have to worry about commuting to work.

[JEP]

Originally Posted by fishrichard

About two months ago I started getting this sharp, very intense pain in my upper left abdomen, about an inch below my rib cage. The pain was so intense I could not sleep. Friday the same thing happens only to last through the weekend. It started with a dull pain , intensified, and now is dull and seemd to be fading. Any thoughts. Rich

I'd say to see a doctor. just a thought!

[fishrichard]

I'm going today, just wanted to get an idea of what it could be, or maybe some questions I could ask the guy this afternoon.

[buffalopilot]

sounds like gallbladder pain

[fishrichard]

Good ole Rochester. I love the Hanger Bar and Grill.

[NotCoolEnufToFly]

Originally Posted by buffalopilot

sounds like gallbladder pain

I just had my gallbladder removed in September and I don't think that's what it sounds like. Gallbladder is located on the upper right side of your body and it feels like you are having a freaking heart attack. I was freaking out at the ER when I felt it. I couldn't breath and I was throwing up which is something I never do. However, I'm not a Dr and I don't really KNOW. He'll probably have to have some tests run, I would think.

[My Flight Surgeon]

I agree with seeing the doc. An examination will really help. The gall bladder is on the right side. The only things on the left are the spleen and colon. May be a pulled muscle or gas.

One thing you can do to see if it is a muscle -- lie flat on the floor, lift both legs off the ground at the same time (stright leg raise) and feel the belly -- if it is tender to the touch, it is muscle, if not it is probably something inside.

[fishrichard]

Back from the Doctor visist. He scheduled a CT scan tomorrow. He mentioned my pancreas and kidneys, but wouldn't comment any further ; I'm sure he wants to see the results first. Any thoughts Doc?

[My Flight Surgeon]

You just need to get the tests done. Did he order any lab work?

[fishrichard]

Blood, urine. does that count?

[My Flight Surgeon]

Yes.

See what the results are of all the tests.

[fishrichard]

Swollen lymph nodes and elevated pancreas levels were the results; which the doc said was consitent with pancreatitis. He suggested a low fat diet. Heres the thing, I just turned 29, I'm 5'9 160lbs, run about 15-20miles per week, and eat pretty good allready. Could my diet really be the problem? Is there any other possible causes? Thanks Doc.

[My Flight Surgeon]

Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.
Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food. But if these enzymes become active inside the pancreas, they start "digesting" the pancreas itself.


Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts, accumulations of fluid and tissue debris, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.



Chronic Pancreatitis

If injury to the pancreas continues, chronic pancreatitis may develop. Chronic pancreatitis occurs when digestive enzymes attack and destroy the pancreas and nearby tissues, causing scarring and pain. The usual cause of chronic pancreatitis is many years of alcohol abuse, but the chronic form may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged. The damaged ducts cause the pancreas to become inflamed, tissue to be destroyed, and scar tissue to develop.
While common, alcoholism is not the only cause of chronic pancreatitis. The main causes of chronic pancreatitis are

• alcoholism
• blocked or narrowed pancreatic duct because of trauma or pseudocysts have formed
• heredity
• unknown cause (idiopathic)

Damage from alcohol abuse may not appear for many years, and then a person may have a sudden attack of pancreatitis. In up to 70 percent of adult patients, chronic pancreatitis appears to be caused by alcoholism. This form is more common in men than in women and often develops between the ages of 30 and 40.
Hereditary pancreatitis usually begins in childhood but may not be diagnosed for several years. A person with hereditary pancreatitis usually has the typical symptoms that come and go over time. Episodes last from 2 days to 2 weeks. A determining factor in the diagnosis of hereditary pancreatitis is two or more family members with pancreatitis in more than one generation. Treatment for individual attacks is usually the same as it is for acute pancreatitis. Any pain or nutrition problems are treated just as they are for acute pancreatitis. Surgery can often ease pain and help manage complications.
Other causes of chronic pancreatitis are

• congenital conditions such as pancreas divisum
• cystic fibrosis
• high levels of calcium in the blood (hypercalcemia)
• high levels of blood fats (hyperlipidemia or hypertriglyceridemia)
• some drugs
• certain autoimmune conditions

Symptoms

Most people with chronic pancreatitis have abdominal pain, although some people have no pain at all. The pain may get worse when eating or drinking, spread to the back, or become constant and disabling. In certain cases, abdominal pain goes away as the condition advances, probably because the pancreas is no longer making digestive enzymes. Other symptoms include nausea, vomiting, weight loss, and fatty stools.
People with chronic disease often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to break down food, so nutrients are not absorbed normally. Poor digestion leads to excretion of fat, protein, and sugar into the stool. If the insulin-producing cells of the pancreas (islet cells) have been damaged, diabetes may also develop at this stage.
Diagnosis

Diagnosis may be difficult, but new techniques can help. Pancreatic function tests help a doctor decide whether the pancreas is still making enough digestive enzymes. Using ultrasonic imaging, endoscopic retrograde cholangiopancreatography (ERCP), and CAT scans, a doctor can see problems indicating chronic pancreatitis. Such problems include calcification of the pancreas, in which tissue hardens from deposits of insoluble calcium salts. In more advanced stages of the disease, when diabetes and malabsorption occur, a doctor can use a number of blood, urine, and stool tests to help diagnose chronic pancreatitis and to monitor its progression.
For more information about ERCP, please see the ERCP fact sheet from the NIDDK.
Treatment

Relieving pain is the first step in treating chronic pancreatitis. The next step is to plan a diet that is high in carbohydrates and low in fat.
A doctor may prescribe pancreatic enzymes to take with meals if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the body digest food and regain some weight. Sometimes insulin or other drugs are needed to control blood glucose.
In some cases, surgery is needed to relieve pain. The surgery may involve draining an enlarged pancreatic duct or removing part of the pancreas.
For fewer and milder attacks, people with pancreatitis must stop drinking alcohol, stick to their prescribed diet, and take the proper medications.



Hopefully this is not what you have.

[fishrichard]

Thanks Doc. I've been great since the last attack. I've been eating lots of fish and vegtables, hopefully diet change is all it takes. Side note, is there any disadvantages in eating too much tuna?

[My Flight Surgeon]

Tuna are large fish. The larger the fish, the more likely it is to be contaminated with mercury. http://www.fda.gov/fdac/reprints/mercury.html As you can see, you should not eat the meat of large fish more than once a week.

[cessnajockey454]

A doctor said I had Pancreatitis about 10 years ago following what I thought was a two week cold while trying to recover from a St. Patrick's day drinking binge that involved lots of green beer.

I was skinny, working out hard and eating almost no fat at the time.

Four or five days into the high fever, I went to a doctor who prescribed something which gave me an allergic reaction which sent me to the emergency room where they diagnosed me with the measles - I didn't actually have the measles and Benadryl cleared the allergic reaction up.

But I still had fever and was taking Tylenol every 4 hours or so to reduce it. After a little over two weeks of popping Tylenol down my throat with no change in the fever, I went to another doctor who actually ran tests.

The doctor sent me straight back to the hospital for what turned out to be a five day stay since my pancreas had apparently shut down and wasn't functioning.

They put me on an IV, fed me no food and took my bed covers away to reduce the fever with the threat of an ice filled bathtub if the fever didn't go down.

Thankfully, my pancreas started working again and after a few months I was back to normal.

The doctor said it was my drinking that caused all this. But a nurse suggested that it might have been caused by me overdoing the Tylenol.

Just to be on the safe side, I quit both - booze and Tylenol. And so far, I've been OK pancreas wise.

[My Flight Surgeon]

It was the alcohol. The nurse was wrong. Tylenol interferes with liver function, not the pancrease. You should limit Tylenol to a total of 4000 mg a day otherwise it can induce irresversible liver failure.