You wrote:
"Current medical status: was diagnosed
1/30/06. GI has prescried enzymes, do not
seem to help. Experience constant pain in
pancreas area. eat very strict vegetarian
diet with no fat. Do eat fish. Drink no
alcohol. Lipase level 54-56. We nt to
Mexico for alternative treatments. Lipase
level brought down to 16.7, pain went
away. Returned to Boston after 6 days
lipase level 55 pain returned, HELP
Current medical treatment: One enzyme or
another no help"
Chronic pancreatitis is a prolonged
inflammation of the pancreas which is
characterized by permanent damage of the
anatomic structures of the pancreas which
manifests with frequent functional
failures even after elimination of the
causes. In the final stadium of the
disease there is a complete functional
failure of both the endocrine and exocrine
areas of the pancreas.
Causes for occurring chronic
pancreatitis are:
1. Alcohol abuse (90% of cases);
2. Unknown reason (5% of cases), and
3. Congenital pancreatitis,
hyperparathyroidism and cystic fibrosis
(the remaining 5% of all cases).
Small excretory canals of the pancreas
become obstructed and pancreatic enzymes
get activated in the pancreas itself
instead in the small intestinal lumen.
Early activation of the pancreatic enzymes
causes inflammation and damage of the
pancreatic cells. In time, the pancreas
will fail to create its exocrine (which is
responsible for food digestion in the
intestines) and endocrine (blood glucose
regulation) functions.
The dominant symptom present during
chronic pancreatitis is upper abdominal
pain that worsens from time to time. Lack
of the enzyme "lipase" causes fats to be
eliminated through the stool (steatorrhea)
rather than being absorbed into the body.
In time, mellitus can occur due to
decreased secretions of insulin and this
condition presents symptoms of secondary
diabetes . Symptoms of vitamin deficiency
(A, D, E, K and B) can also occur.
There are several diagnostic procedures
used to confirm chronic pancreatitis:
1. Laboratory analyses: Blood analyses
(increased lipase, amylase and
phospholipase A and latter glucose), stool
analyses (fats and elastasa present),
positive PABA-test in the urine, positive
secretin-test.
2. X-ray image of the abdomen shows
calcifications in the pancreatic region;
3. Abdominal ultrasound is the most
valuable method that can show calcules in
the pancreatic canals;
4. Endoscopic Retrograde
Cholangio-Pancraticography (ERCP)-
visualizes the billiary and pancreatic
duct and is obvious before a decision is
made for surgical treatment or not;
5. Endoscopic ultrasound, and
6. Fine needle biopsy under ultrasound
control.
Treatment therapy for chronic pancreatitis
includes:
1. Taking enzymes to compensate for
pancreatic failure and to decrease
irritation and secretion of enzymes by
the pancreas;
2. Taking H2-blockers to decrease stomach
acidity;
3. Endoscopic treatment of the pancreatic
obstruction by putting protease in the
pancreatic canal or breaking the calculus
with lithotripsy or laser;
4. Treating diabetes, and
5. Surgical treatment when pains become
severe and intervention endoscopy failed
to help.
DISCLAIMER:
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