Concern Re: Biliary Obstruction

[Guest guest]

Walt wrote,

" ... steady elevation in my alkaline phosphates (94-330) in 7

months . .. My pain level has also steadily increased. ...gone ...to

75mcg patch (every 3 days) and ..10/325 Percocet. ... My concern is

that the new plumbing that they gave me when they had to reconstruct

my biliary tract is some how becoming obstructed. I really need your

prayers that this resolves on its own. I don't want to have this

replaced. I don't think I have another surgery in me. I see my Dr.

on the 7th... "

Walt,

I'm sorry to hear that you are having such a difficult time with the

progression of your disease. So many people do not realize or accept

that Chronic Pancreatitis is a progressive, debilitating,

deteriorating disease. I know that you have often spoke about how

fortunate you have felt that your disease has, in fact, progressed

so slowly, and that you have been able to manage it so well without

frequent hospitalizations. I will certainly pray that this too shall

be minimized and that surgery can be avoided.

Are the primary concerns regarding potential biliary obstruction the

increased Alkaline Phosphatase, pain, and recent onset of Diabetes?

As you may know, Alkaline phosphatase is an enzyme, a protein that

helps cells work. You find alkaline phosphatase in high

concentrations in the cells that make bone and in the liver. In the

liver, it is found on the edges of cells that join to form bile

ducts (tiny tubes that drain bile from the liver to the bowels where

it is needed to help digest fat in the diet).

High ALP usually means that the bone or liver has been damaged. If

other liver tests such as Bilirubin, aspartate aminotransferase

(AST), or alanine aminotransferase (ALT) are also high, usually the

ALP is coming from the liver. If calcium and phosphate measurements

are abnormal, usually the ALP is coming from bone.

In some forms of liver disease, such as hepatitis, ALP is usually

much less elevated than AST and ALT. When the bile ducts are blocked

(usually by gallstones, scars from previous gallstones or surgery,

or by cancers), ALP and bilirubin may be increased much more than

AST or ALT. In a few liver diseases, ALP may be the only test that

is high.

In some bone diseases, such as a disorder called Paget's disease

(where bones become enlarged and deformed), or in certain cancers

that spread to bone, ALP may be the only test result that is high.

It is definitely something to be followed, particularly since you

are showing levels exceeding 300, as normal adult range is 20 - 125

IU/L. The optimal adult value is 72.5 IU/L. It is important to

realize, however, that sometimes doctors don't know why ALP is

high,

and they need to order other tests to determine the exact cause. In

such cases, your doctor may order another enzyme, GGT, that is made

by the liver in the same places as is ALP, but which is not made by

bone.

Generally, persons with Chronic Pancreatitis are found to have low

levels due to the high percentage of protein deficiency,

malnutrition, and select vitamin deficiencies.

For specific laboratory values used in diagnosing Biliary

Obstruction go to:

http://www.carbonbased.com/cbcdisAB.htm#BiliaryObstruction,Extrahepat

ic

One final word regarding your desire to avoid additional surgery and

preferably to have the situation resolved, I encourage you to go to

both Dr. Wayne Dyer's website and the PBS website for information

regarding alternative healing resources through connecting to the

source from which we came, God, Higher Power, what ever you want to

call it. Dr. Wayne Dyer presents this on PBS and I encourage you to

search for the time and date for your city.

http://www.drwaynedyer.com/home/

http://www.pbs.org/stationfinder/stationfinder_relocalize.html

Karyn E. , RN

Executive Director, PAI

http://www.pancassociation.org

Pancreatitis Association International