Concern Re: Changing Symptoms

[Guest guest]

Sophie,

You wrote, " ..my main concern now is this severe burning ... is different to

before, it's now a dull pain / pulling sensation that I get, whereas before

it was definitely pain. It also does not radiate to my upper back like it did

before. What tests should i ask my GI to run? "

First of all, welcome. We are glad you are here. I am sorry to hear that you

have been dealing with these symptoms for so long. There are a couple of

recommendations the PAI has for persons seeking a confirmed diagnosis, one way

or the other. First, check and see what type of doctor you are seeing. If it

is a GI doctor, make sure the doctor is a pancreatologist. Most

pancreatologist do not work in free standing clinics, they are usually

associated with a

hospital ERCP department. Sometimes, these are combined with the endoscopy

departments, sometimes, they are not.

Once you have an appointment with a pancreatologist, they will do invasive /

noninvasive testing to determine an appropriate diagnosis. The PAI stresses

that an accurate and timely diagnosis is a key element to having an optimum

outcome. Usually a CT scan or ultrasound will be done before an ERCP. The PAI

recommends that prior to having an ERCP, every effort should be made to have

an MRCP, since the invasiveness of the ERCP usually results in acute

pancreatitis. It is often that a patient goes into an ERCP purely as a

diagnostic

tool. The patient may not have pancreatitis at all, however, the subsequent

attack caused by the procedure will result in irreversible damage, and the

patient

then does have pancreatitis. The ERCP is a very necessary therapeutic

procedure. However, if it should not be done purely for diagnostic purposes, if

at

all possible.

Of course, it would behoove me to mention that if you have not a a complete

blood work up for pancreatitis, that should eb done. It is not a common

practice for GIs or surgeons to check enzyme levels prior to gallbladder

surgery.

Mine were never checked, and my pancreatologist insists that had they been

checked it would have shown pancreatitis.

Karyn E. , RN

Executive Director, PAI

Indianapolis, Indiana