Re: I'm a newbie - to

[Guest guest]

Dear ,

Don't distrust this doctor that ordered the fecal fat test. This test

actually is one of the diagnostic tests to determine chronic

pancreatitis with malabsorption. Your symptoms sound identical to what

mine were in the very beginning. Weight loss. It started a few years

prior to my " official " diagnosis. I slowly began losing weight,

dropped a size, then two, over an extended period of time. Since my

father and his family members were all slender, I thought that what I

was going through was just hereditary. I, too, am a smoker.

The occasional upset stomach after eating wasn't consistent enough for

me to see a connection. I'd had similar problems earlier in my adult

life that were never resolved even after months of tests, so I figured

it was just more of the same and that I had a sensitive stomach. My

final wake up call was an acute pancreatitis attack where they did an

ultrasound and CT-scan and found two sizable pseudocysts in my

pancreas.

The tests that your doctor is proposing to do are good diagnositic

tests for determining chronic pancreatitis, and should shed some light

on what your particular pancreatic problems are. A CT-scan first,

before the MRCP, would show pseudocysts and/or calcifications....if

either is present. What the CT-scan doesn't show well is whether

there is any biliary obstruction or blockage, and that's where the

MRCP is used, because this test will show those things.

What this doctor is doing is trying to find out where the problems

are, and for this, you are very fortunate, because many of our

suffering patients go through doctors and examinations for years

before they ever find anyone who believes them and who will do all

these tests to diagnose.

In regard to your pancreatic enzymes, it may be that another

brand/type would be better for you. Did this doctor counsel you on

the importance of a low fat diet? In the US, most doctors recommend a

diet with no more than 30 grams of fat daily, with about 6-8 fat grams

per meal or snack. Several smaller mini-meals throughout the day are

thought to be better than three large ones. Usually red meat is

strictly avoided due to it's high fat content. The use of alcohol also

is strictly prohibited, not even those beverages that claim to be

non-alcoholic, and some people even have sensitivity to cough syrups

and sleeping aids that contain alcohol. If you had a pastrami

sandwich for lunch, it appears that the low fat diet wasn't discussed

or that you've elected to ignore that advise. This will have a

positive influence on the effectiveness of your pancreatic enzymes.

Another thing to consider is the type of enzyme that you're taking.

If you are taking Viokase, or any other enzyme that is in tablet form,

other than an enteric coated capsule, you need to take an antiacid

prior to taking the enzyme. The enzymes that are not enteric coated

break down too quickly by stomach acid if an antiacid isn't used, and

end up being destroyed before they reach the intestines, which is

where they need to be to aid in the digestive process. Many doctors

are not aware of this prerequisite, and fail to prescribe an antiacid

to be taken prior to the enzyme. What kind of enzymes are you

taking?

In conclusion, your doctor does sound as though he's approaching your

problems with the correct course of treatment and tests. The fecal

fat test was one of the accepted diagnostic tests for CP with

malabsorption, and the other tests that he ordered are also

appropriate. If he isn't a gastroenterologist, you may wish to have

this doctor refer you to a gastroenterologist at a later date, but for

now, he is approaching your diagnosis in the correct sequence, and you

should be thankful that you have found someone who believes in you,

and is willing to do all they can to confirm a diagnosis and find the

cause.

If you have any more questions, just fire away!

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.