Newbie here - To Phil

[Guest guest]

Dear Phil,

You asked whether it was known that Crohn's could cause pancreatitis,

and I wanted to tell you that there have been documented cases where

this has happened. Upon research, this is what I've found:

Crohn's disease is a chronic, inflammatory disease that typically

involves the small and/or large intestine. However, some Crohn's

patients experience symptoms not directly related to the bowel. These

can include skin rashes, joint inflammation and arthritis, eye

inflammation, hepatitis (liver inflammation) and bile-duct

inflammation. It is unknown why these organs, which are not in direct

contact with the bowel, are affected.

To answer your question, the pancreas is only very rarely directly

affected by Crohn's disease. However, it is not uncommon for

pancreatitis (inflammation of the pancreas) to arise as a secondary

result of Crohn's. If Crohn's involves the upper small bowel, or

duodenum, the inflammatory process can extend to the opening of the

duct that drains the pancreas. Inflammation at this opening, called

the sphincter of Oddi, can lead to obstruction and pressure on the

pancreas, resulting in pancreatitis. In addition, inflammation of the

sphincter can result in scarring that leaves the duct open to the

intestinal contents found in the duodenum. Reflux of these contents

into the pancreatic duct is also hypothesized to cause pancreatitis.

It is also known that the medications used to treat Crohn's have

caused reactions that lead to pancreatitis. Those medications such as

sulfasalozine, mesalamine, azathioprine and 6MP have caused

pancreatitis when taken by Crohn's patients. There's also

documentation that steriods, such as prednisone, can lead to pancreatitis.

You need to understand that some patients with pancreatitis don't

experience the typical symptoms early in the course of the disease.

There are some who seldom have any pain or discomfort, and others who

have few initial symptoms initially, until the condition progresses.

Pancreatitis, being progressive in nature, doesn't always start with

intense pain, vomiting and nausea, but the symptoms build up in

intensity over a gradual period of time until they become consistently

noticable.

I'm not saying that a lipase reading of 600 is only indicative of

pancreatitis, though. There could have been other reasons for such a

high count, but with Crohn's already established, it is not

unreasonable to presume that the high lipase elevation indicates

pancreatitis.

You should ask your doctor if he would order other testing to verify

this diagnosis. I would assume that your doctor already plans to do

this, but that may be a silly assumption on my part. If it were me, I

would want further documentation or proof that I did, in fact, have

pancreatitis, and would ask for further testing to verify this.

You should also ask your doctor what treatment he recommends to treat

your pancreatitis; whether he plans to put you on pancreatic enzymes

to help with your digestive issues, and what other plans are in the

future?

Please let us know if there's anything we can do to help you. A low

fat, low protein, high carb diet is recommended for pancreatitis

patients, and total abstinence from alcohol is also a very necessary

adjustment. We'll try to answer any questions you should have about

this, or anything else, the best we can.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

www.pancassociation.org/anthology#Heidi.html

Bluffton, SC

SC State & SE Regional Representative

Pancreatitis Association, International

www.health.groups.yahoo.com/group/pancreatitis/

Note: All comments or advice are personal opinion only, and should

not be substituted for professional medical consultation.