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Forum Name: Gastroenterology Topics

Question: Pancreatitis recovery


 Drpepper - Wed Aug 11, 2010 3:55 pm

As I am new to this condition I seek advice from those who have had a similar experience. here is my story,

The last part of June I started to experience pain in the upper stomach area after eating. First couple times it went away after a few hours. The third time it last for a couple days. I went to the doctor and the blood work showed it was probably gallbladder. I had more tests including an ultrasound of the gallbladder and they said it was full of stones and had to come out. I had the surgery on July 12, came home same day. The surgeon did a dye test during it and said I had a stone in the bile duct. He sent me to a digestive doctor and he said I would need an ERCP. I had that done on the 20th. when I woke up I was having stomach pain.I went home but in 3 hours time I was in the er because the pain just got worse. They did a ct scan and said I had pancreatitis and that it ESA caused by the ERCP. I stayed in the hospital for the next 9 days. I had multiple IV,s and had severe diarrea due to the antibiotics. I had nothing to eat or drink for 7 days. The pain eased after about 6 days and I came home on the 10th day.

I have been home now for 10 days. I forgot to mention that I have been a type 2 diabetic for 15 years. I still don't feel good although I do feel some better than I did the day I came home. I am eating a very low fat diet and have lost 20 pounds since this started. My blood sugar has been in the 200 to 300 range ever since entering the hospital. I am now on insulin and it is gradually coming down. I do have some stomach pain still but it doesn't seem to last very long at a time. I also feel sore in the stomach area.

My questions are How long does it ake to get over this? should I be feeling better than I am being home 10 days? Is the stomach pain normal for a while? I am just frustrated that I don't feel better than I do. The doctor says my blood work levels are almost normal again but I just don't feel it. Any advice or comments welcome.

Thanks
 Dr.M.Aroon kamath - Wed Aug 11, 2010 11:08 pm

User avatar Hi,
An elevation in the serum amylase levels is commonly observed after ERCP, occurring in up to 75% of patients. In contrast, acute clinical pancreatitis (loosely defined as a clinical syndrome of abdominal pain and hyperamylasemia requiring hospitalization) is much less common.

Acute pancreatitis is the most common serious complication of ERCP.
Several factors may independently or in combination induce post-ERCP pancreatitis.Risk factors for post-ERCP pancreatitis are additive.

The factors may be
- operator-dependent factors,
- patient-related factors, and
- procedure-related factors.


In general, most reports have found that the risk of pancreatitis is increased after therapeutic ERCPs compared to diagnostic ERCPs.

The incidence of post-ERCP pancreatitis has been estimated in several large clinical trials to range between 1.6 to 15.1%, with a majority of them demonstrating rates of 4-5%.

There is no universally accepted definition for post-ERCP pancreatitis yet. Several definitions have been proposed.
It is logical to assume that the many different criteria used for defining post-ERCP pancreatitis play a significant role in the reported wide variation of incidence reported for this complication.

Obviously, in your case, the diagnosis of post-ERCP pancreatitis must have been according to one of the several definitions.You have not mentioned your serum amylase or lipase levels recorded during the episode.

As for your question regarding the time frame for complete recovery from symptoms, it is rather difficult to answer, as several factors are involved such as,
- whether the procedure was purely diagnostic or therapeutic as well,
- the severity of the pancreatitis (clinical and CT based),
- presence or absence of pseudo cysts of pancreas,
- comorbidities,
- past history of acute pancreatitis,
- if the primary cause(ex; stone in common bile duct) had been successfully dealt with, etc.

As it is only just over 10 days since discharge, minimal symptoms are not unusual and should settle down soon. If you continue to experience pain or should it worsen, please report back to your doctor to get reassessed.
Good luck!

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