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Chronic pancreatits or Crohns disease?

Posted by Linda G. Facebook

In 1997 I had pancreatic divisum. My ampulla duct never formed at birth and it did not cause a problem until my mid thirties.  I had chronic and acute pancreatitis on different occasions prior to the surgery to open the duct.  It supposedly corrected the problem, however,  I was left with some scarring and calcification on the tail of the pancreas.  I did fairly well for a while, but began to have "flares as I call them. They seemed to occur twice a year. Spring and Fall. When this occurs, I suffer with the pain under my upper left rib cage and sometimes I am hospitalized for pain management and fluids.  The flares always passed but I would have a constant rumbling in that area (acted like it was in the bowel). My  amylase and lipase levels are always normal. So, they tell me it is not the pancreas There is no swelling in the pancreas and I also have had Endoscopy Ultrasounds. (Too numerous to count) A couple of doctors have stated that the pancreas is burned out, but I do not have diabetes.  So, my gastro doctor tells me that if  the pancreas were burned out, I would not be producing insulin.  I suffered through the flares for years spring and fall until this last episode which occurred in the late spring of this  last year.  This time, it began with the worst nausea I have ever experienced.  I never had this kind of nausea with pancreatitis.  The  pain is there but not acute.  It seems to be the severe nausea that is the worse.  My gastro doctor told me I had small ulcerations on the bowel wall after he did a test with the capsule that takes photos of the small intestine. He said I also had positive markers for crohns. Yet, he seems uncertain because of the area of the pain.  I am assuming it is not typical of crohns to be so high??   I have no blood or seldom have runny stools but do battle constipation.  It is important for me to keep my bowel moving.  I have been sick since June and it is not getting better this time.  One gastro doctor says it is chronic pancreatitis and I would not necessarily have any elevation to my amylase or Lipase.  Yet, my gastro doctor who I have been with for years believes it is crohns disease.  I did have positive markers for crones but the doctors continue to disagree. I have asked to have pancreatic studies done again and I feel they need to scope my small bowel to make the determination as to whether it is crohns. The problem is, they will not scope the small bowel unless you are having blood, which I am not. So, here I lay....nauseated...and the discomfort under the rib cage and taking meds for crohns which does not see, to be helping at this time. I do have other areas of the abdomen that are sore and similar to the upper left rib discomfort.    I guess my question to you is , "Will calcification on the pancreas cause this?"   I am at my wits end.  What should I do? I need to have the correct diagnosis.  How do I get the doctors to do that. I believe the pancreatic studies which showed them the problem in 1997 with the pancreas should be repeated.  Is it possible that scar tissue has caused the duct to narrow?  Would they see this through the endoscopic ultrasound?  Am I wrong to request the small bowel be scoped to determine Crohns?  I am getting by right now by using suppositories for the nausea.   I might add, it feels raw under the rib cage and bending over aggravates the nausea.  It feels so sore.   I also have belching...    Thanks so much...Linda
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