chronic pancreatitis undiagnosed.

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Pinz

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Hello everybody, I am new to this forum. Although I am from India, but I thought I might find a lot of answers here. I will first share my story and then will ask some questions.

My story: I was a fit person (84kg 5'10" 35years father of twin boys). Then it started in 2018 while I was in USA. I never abused alcohol, was mild smoker. My symptoms were always mild. I would get an attack after eating food suddenly - my symptoms were dull pain in top line of my stomach and a feeling of fullness and nausea, nothing else. Next day I will have loose stool and after checking my food, I used to get better with days. I would again go back to original healthy eating and then suddenly baam - again another mild attack. So this continued for 6 months and everytime I used to get better with days passed. I went to so many doctors and specialist and all said that it was IBD or IBS. Someone prescribed me Ciprofloxacin and the side effects were horrible. It made me feel suicidal and I could not sleep. I came back to India to my family and met a doctor. He gave me flupentixol (medicine for depression) and it worked well. I took so many types of antibiotics. The doctors did endoscopy, colonoscopy, CT scans, MRI scans, stool tests and what not. All came out normal apart from once enlarged spleen and liver. Meanwhile I started loosing weight and lost almost 25 lg in 1 year.
I came off flupentixol slowly and started getting the mild attacks again. I never knew what these attacks were. But now these attacks were causing permanant damages. My digestive capability would detoriate after every attack, they were no more like getting better with time. I suspected that I might have chronic pancreatitis, but my doctors would not agree. After one such attack, I felt like my food was stuck upto my throat for hours. I checked internet and found out about CREON. I was desperate, I tried creon 25000 with food. Baam !! It worked the first time. I became normal again. I started eating normal again. But then again another attack and seemed like that CREON dose is not working. I increased the dose to 40000 and it started working again. Then I thought what was causing these attacks, and realised that my stress signals might be causing them. I started flupentixol again and the attacks stopped. I was on CREON 40000 for over an year without any attack. I re-gained my lost 25 kg in that 1 year. I was doing good. Then all of a sudden I had couple of those mild attacks in 3 days as my body became tolerant to the dose of flupentixol. I increased the dose of flupentixol and my doctor added qutipine to the mix and the attacks stopped. I started loosing weight again with Creon 40000 and I was having steatorrhea. I started increasing my dose of creon again and now I take 5 x 40000 with each meal. My weight loss seemed to stop at this dose.

I haven't checked my BG as I never had any symptoms, so I am not sure about my BG. I went to another doctor and he said that I only have IBS which is not true. Creon is so expensive. I am taking the high dose on my own.

My question is - is my pancreas fully dead? The amount of Creon I am taking, normally people without pancreas take that. Am I right? I am trying to increase the dose of my depression medicine as much as possible to avoid another attack. I fear that after the next attack even this high dose of creon will not work. My current diet includes high carb, low fat high protein. I fear of dying as I need to support my 8 months twin boys. I fear that after the next attack, I will keep losing weight and will die. I have read that at my weight, 5 x 40000 creon is the highest I can take to avoid some complications of colonic fibrosis.

Sorry for the long post. It will be great if you people guide me here. I would love to hear from people without pancreas. I fear that these mild attacks will take away my pancreas one day too.

With love,
Pinaki
 
Welcome to the forum @Pinz

We have several member who live with pancreatitis including @mikeyB, @eggyg and @Hepato-pancreato

Hopefully one of those will see your message, and be able to share their experiences?
 
Hi Pinz, welcome to the forum. The dose of Creon you take to suppress the symptoms of chronic pancreatitis is almost random. On the pancreatitis forum, those with CP and still have their pancreas can take anything between 20,000 and 100,000 units, so it isn’t a direct relationship to degree of disease. I’m going for a CT scan with contrast to see what my pancreas currently looks like on Wednesday. I average out at around 40,000 per meal, a full English breakfast maybe 60-70,000. It all depends on how much fat is in the meal.

Discomfort from the pancreas does not necessarily represent any damage. Acute pancreatitis will for sure, but you haven’t had that. I’ve never had acute pancreatitis- 25% of those who get it don’t live to tell the tale. I’ve never had any pain or discomfort from the pancreas, but mine is heavily calcified.

I can’t imagine why all tests and examinations have been normal. A simple ultrasound examination of the pancreas could give you an answer, that’s how my CP was diagnosed.

You can get more help on https://www.pancreatitis-forum.org.uk/
 
Hi Pinz, welcome to the forum. The dose of Creon you take to suppress the symptoms of chronic pancreatitis is almost random. On the pancreatitis forum, those with CP and still have their pancreas can take anything between 20,000 and 100,000 units, so it isn’t a direct relationship to degree of disease. I’m going for a CT scan with contrast to see what my pancreas currently looks like on Wednesday. I average out at around 40,000 per meal, a full English breakfast maybe 60-70,000. It all depends on how much fat is in the meal.

Discomfort from the pancreas does not necessarily represent any damage. Acute pancreatitis will for sure, but you haven’t had that. I’ve never had acute pancreatitis- 25% of those who get it don’t live to tell the tale. I’ve never had any pain or discomfort from the pancreas, but mine is heavily calcified.

I can’t imagine why all tests and examinations have been normal. A simple ultrasound examination of the pancreas could give you an answer, that’s how my CP was diagnosed.

You can get more help on https://www.pancreatitis-forum.org.uk/
Thanks @everydayupsanddowns for inviting others.
Thanks @mikeyB for your response. Regarding symptoms, I have had mild symptoms or mild attacks unlike you (as I mentioned in my original post). There is surely no calcification, but maybe autoimmune pancreatitis. Nothing was found in the imaging tests tho. Also look at the enzyme intake, it's too high for me. That makes me think that my pancreas isn't working at all and looks like it's damaged to a great extent. Without damage, why do I need so much creon?
 
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If your scans show an enlarged liver this is going to have a knock on effect with not only your blood sugars but it will also put pressure on other internal organs.

i would basically knock off the creon and check your blood sugars and if they are too high then seek medical advice.

did you know that you can also get pain along with other symptoms from having an enlarged liver.

i did quite a few posts on here regarding the issue as i have suffered with liver problems for quite a long time and also suffered an enlarge liver. tests have now shown i am in stage f1 of fibrosis.

the diabetes i have was having a knock on effect and sending me in to a nasty cycle, now i am on medications for diabetes the liver issues are beginning to settle down although the fibrosis won't sadly go but can be managed.
 
Without damage, why do I need so much creon?

I think @mikeyB was suggesting that creon intake can be a bit like insulin needs, in that ‘you need what you need’? But are you saying that your clear scans mean you don’t currently have a diagnosis of pancreatitis?
 
I think @mikeyB was suggesting that creon intake can be a bit like insulin needs, in that ‘you need what you need’? But are you saying that your clear scans mean you don’t currently have a diagnosis of pancreatitis?
That is correct...I don't have a diagnosis of pancreatitis. The doctor wrote "non-pancreatic EPI"...god knows what does that mean!
 
If your scans show an enlarged liver this is going to have a knock on effect with not only your blood sugars but it will also put pressure on other internal organs.

i would basically knock off the creon and check your blood sugars and if they are too high then seek medical advice.

did you know that you can also get pain along with other symptoms from having an enlarged liver.

i did quite a few posts on here regarding the issue as i have suffered with liver problems for quite a long time and also suffered an enlarge liver. tests have now shown i am in stage f1 of fibrosis.

the diabetes i have was having a knock on effect and sending me in to a nasty cycle, now i am on medications for diabetes the liver issues are beginning to settle down although the fibrosis won't sadly go but can be managed.

I thought it was the imflammed pancreas that caused the enlarged liver and spleen...I used to get mild pain at the back of where the liver and spleen are, but only if I move or bend back. That pain went away with time, but everytime comes back after the mild attack. I did my BG check at the time of every CT scan and every time my blood sugar came normal.
 
Hi pinz and welcome, may i ask specifically where you get the pain, firstly where abouts in relation to your belly button and secondly do you get pain anywhere else while you have your abdo pain?
 
Hi Pinz, welcome to the forum. The dose of Creon you take to suppress the symptoms of chronic pancreatitis is almost random. On the pancreatitis forum, those with CP and still have their pancreas can take anything between 20,000 and 100,000 units, so it isn’t a direct relationship to degree of disease. I’m going for a CT scan with contrast to see what my pancreas currently looks like on Wednesday. I average out at around 40,000 per meal, a full English breakfast maybe 60-70,000. It all depends on how much fat is in the meal.

Discomfort from the pancreas does not necessarily represent any damage. Acute pancreatitis will for sure, but you haven’t had that. I’ve never had acute pancreatitis- 25% of those who get it don’t live to tell the tale. I’ve never had any pain or discomfort from the pancreas, but mine is heavily calcified.

I can’t imagine why all tests and examinations have been normal. A simple ultrasound examination of the pancreas could give you an answer, that’s how my CP was diagnosed.

You can get more help on https://www.pancreatitis-forum.org.uk/
Hi @mikeyB - hoping you can help me. It appears that I have the same issue. I have a heavily calcified pancreas. Had the issue for over 20 years but only last year was put on Creon after losing alot of weight and becoming quite ill. I've been a diabetic for 20 years. I can't seem to make the Creon work for me. It worked for a short while but then has stopped working in the past 6 months. I was on a PPI and then stopped cause I didnt think it made any difference but my gastroenterologist says that my pancreas is so heavily calcified that I have no bicar secretion which would make it hard for the creon to work. I am back on 20mg PPI for the past few weeks. I am only 45kg and taking 95K creon with main means which are small and have 10g of fat and 45-70K with snacks. I've kept increasing creon hoping that something will work. I've also tried antibiotics for bacterial overgrowth three times now. Just reaching out to see if you take any acid suppressant and what dosage of creon do you take? Many thanks!
 
Hi @mikeyB - hoping you can help me. It appears that I have the same issue. I have a heavily calcified pancreas. Had the issue for over 20 years but only last year was put on Creon after losing alot of weight and becoming quite ill. I've been a diabetic for 20 years. I can't seem to make the Creon work for me. It worked for a short while but then has stopped working in the past 6 months. I was on a PPI and then stopped cause I didnt think it made any difference but my gastroenterologist says that my pancreas is so heavily calcified that I have no bicar secretion which would make it hard for the creon to work. I am back on 20mg PPI for the past few weeks. I am only 45kg and taking 95K creon with main means which are small and have 10g of fat and 45-70K with snacks. I've kept increasing creon hoping that something will work. I've also tried antibiotics for bacterial overgrowth three times now. Just reaching out to see if you take any acid suppressant and what dosage of creon do you take? Many thanks!
Most of the people earlier in the thread no longer post but there are still many who do take Creon so hopefully they will be able to comment.
 
Most of the people earlier in the thread no longer post but there are still many who do take Creon so hopefully they will be able to comment.
Hi @Nikki81 . I am latecomer to your thread but very interested to know what other type 3cs are experiencing with CREON. Firstly I hope that you are well and getting all the help you need. I take 4 2500's with all meals. I have cut out snacking for the time being as I am trying to get my diabetes under control since my Pancrectomy a year ago. You were asking about acid inhibitors- I take one Lansoprazole a day. Creon sorted out my gastric problems and seems to let me maintain my weight but each pound I gain takes weeks and is easily lost. I hope this is of some use to you. May I ask if you have managed to get your diabetes control or are you experiencing unexpected highs some hours after eating? Regards, Chris
 
Hi @Nikki81 . I am latecomer to your thread but very interested to know what other type 3cs are experiencing with CREON. Firstly I hope that you are well and getting all the help you need. I take 4 2500's with all meals. I have cut out snacking for the time being as I am trying to get my diabetes under control since my Pancrectomy a year ago. You were asking about acid inhibitors- I take one Lansoprazole a day. Creon sorted out my gastric problems and seems to let me maintain my weight but each pound I gain takes weeks and is easily lost. I hope this is of some use to you. May I ask if you have managed to get your diabetes control or are you experiencing unexpected highs some hours after eating? Regards, Chris
Hi another latecomer to the thread but my tuppence worth is I have extensive exocrine necrosis following an AP attack in March 22 and then developed Diabetes in August 23.
Put on Creon in Sept 22 after losing weight and starting EPI and take 50k for snacks and 75k for meals.
Been a godsend in terms of eating and diet back to normal and put on weight and got energy back.
Put on insulin and managing fine even though 3c is a more brittle form of DM.
 
Hi another latecomer to the thread but my tuppence worth is I have extensive exocrine necrosis following an AP attack in March 22 and then developed Diabetes in August 23.
Put on Creon in Sept 22 after losing weight and starting EPI and take 50k for snacks and 75k for meals.
Been a godsend in terms of eating and diet back to normal and put on weight and got energy back.
Put on insulin and managing fine even though 3c is a more brittle form of DM.
Hi @Nikki81 . I am latecomer to your thread but very interested to know what other type 3cs are experiencing with CREON. Firstly I hope that you are well and getting all the help you need. I take 4 2500's with all meals. I have cut out snacking for the time being as I am trying to get my diabetes under control since my Pancrectomy a year ago. You were asking about acid inhibitors- I take one Lansoprazole a day. Creon sorted out my gastric problems and seems to let me maintain my weight but each pound I gain takes weeks and is easily lost. I hope this is of some use to you. May I ask if you have managed to get your diabetes control or are you experiencing unexpected highs some hours after eating? Regards, Chris
@Leadinglights
Hi @Nikki81 . I am latecomer to your thread but very interested to know what other type 3cs are experiencing with CREON. Firstly I hope that you are well and getting all the help you need. I take 4 2500's with all meals. I have cut out snacking for the time being as I am trying to get my diabetes under control since my Pancrectomy a year ago. You were asking about acid inhibitors- I take one Lansoprazole a day. Creon sorted out my gastric problems and seems to let me maintain my weight but each pound I gain takes weeks and is easily lost. I hope this is of some use to you. May I ask if you have managed to get your diabetes control or are you experiencing unexpected highs some hours after eating? Regards, Chris
@sololite thanks for your reply. I have stabilized in the past couple of months after losing weight. I’ve gained a couple of kilos. I am back on acid suppressant - I take one 20mg Esomeprazole a day. I have tried another PPI (rabprazole) and H2 blocker but they didn’t work for me. I lost weight while taking them. I also increased my creon a bit more and started taking the creon closer the when I consume the fattier part of my meal. So I take most creon upfront and try to consume the fatty components of my meal around that. I’ve also noticed that I do better with smaller meals so I eat 7 times a day with about half of my calories from liquid supplements. Also noticed I do better with spacing out meals and low fodmap. I don’t digest sugars very well so I limit sugars to 6g per meal. It’s been painstakingly long to work out some of these issues - I’ve had no help from anyone on this cause it seems my situation is not common where the Creon is not working like it should. I still have some malabsorption which the specialist things may be caused by mild IBS or SIBO. If you can’t digest fodmaps it appears that the food is broken down by Creon but doesn’t stick around long enough for the body to absorb the nutrients which leads to malabsorption. My weight gain is still very slow and I can’t seems to up the calories cause I think the fodmaps affect me. So I get very little sleep cause I have to wait a while between meals to make it work. I also cannot seem to digest any fruit or veg - it cause bloating and malabsorption. So I don’t eat any fruit or veg. I don’t have any issues with my blood sugars - I’ve been diabetic for 22 years and have more issues with lows than highs likely due to malabsorption. I hope some of the information is useful to those who might be struggling to figure out what to do - the last year has been challenging for me trying to work out why things are not working for me like it does for others on Creon.
 
@Leadinglights

@sololite thanks for your reply. I have stabilized in the past couple of months after losing weight. I’ve gained a couple of kilos. I am back on acid suppressant - I take one 20mg Esomeprazole a day. I have tried another PPI (rabprazole) and H2 blocker but they didn’t work for me. I lost weight while taking them. I also increased my creon a bit more and started taking the creon closer the when I consume the fattier part of my meal. So I take most creon upfront and try to consume the fatty components of my meal around that. I’ve also noticed that I do better with smaller meals so I eat 7 times a day with about half of my calories from liquid supplements. Also noticed I do better with spacing out meals and low fodmap. I don’t digest sugars very well so I limit sugars to 6g per meal. It’s been painstakingly long to work out some of these issues - I’ve had no help from anyone on this cause it seems my situation is not common where the Creon is not working like it should. I still have some malabsorption which the specialist things may be caused by mild IBS or SIBO. If you can’t digest fodmaps it appears that the food is broken down by Creon but doesn’t stick around long enough for the body to absorb the nutrients which leads to malabsorption. My weight gain is still very slow and I can’t seems to up the calories cause I think the fodmaps affect me. So I get very little sleep cause I have to wait a while between meals to make it work. I also cannot seem to digest any fruit or veg - it cause bloating and malabsorption. So I don’t eat any fruit or veg. I don’t have any issues with my blood sugars - I’ve been diabetic for 22 years and have more issues with lows than highs likely due to malabsorption. I hope some of the information is useful to those who might be struggling to figure out what to do - the last year has been challenging for me trying to work out why things are not working for me like it does for others on Creon.
Sorry to hear you have such a time of things but glad that you have managed to put some weight back on. It puts my own woes into perspective. Best wishes, Chris
 
Hello everybody, I am new to this forum. Although I am from India, but I thought I might find a lot of answers here. I will first share my story and then will ask some questions.

My story: I was a fit person (84kg 5'10" 35years father of twin boys). Then it started in 2018 while I was in USA. I never abused alcohol, was mild smoker. My symptoms were always mild. I would get an attack after eating food suddenly - my symptoms were dull pain in top line of my stomach and a feeling of fullness and nausea, nothing else. Next day I will have loose stool and after checking my food, I used to get better with days. I would again go back to original healthy eating and then suddenly baam - again another mild attack. So this continued for 6 months and everytime I used to get better with days passed. I went to so many doctors and specialist and all said that it was IBD or IBS. Someone prescribed me Ciprofloxacin and the side effects were horrible. It made me feel suicidal and I could not sleep. I came back to India to my family and met a doctor. He gave me flupentixol (medicine for depression) and it worked well. I took so many types of antibiotics. The doctors did endoscopy, colonoscopy, CT scans, MRI scans, stool tests and what not. All came out normal apart from once enlarged spleen and liver. Meanwhile I started loosing weight and lost almost 25 lg in 1 year.
I came off flupentixol slowly and started getting the mild attacks again. I never knew what these attacks were. But now these attacks were causing permanant damages. My digestive capability would detoriate after every attack, they were no more like getting better with time. I suspected that I might have chronic pancreatitis, but my doctors would not agree. After one such attack, I felt like my food was stuck upto my throat for hours. I checked internet and found out about CREON. I was desperate, I tried creon 25000 with food. Baam !! It worked the first time. I became normal again. I started eating normal again. But then again another attack and seemed like that CREON dose is not working. I increased the dose to 40000 and it started working again. Then I thought what was causing these attacks, and realised that my stress signals might be causing them. I started flupentixol again and the attacks stopped. I was on CREON 40000 for over an year without any attack. I re-gained my lost 25 kg in that 1 year. I was doing good. Then all of a sudden I had couple of those mild attacks in 3 days as my body became tolerant to the dose of flupentixol. I increased the dose of flupentixol and my doctor added qutipine to the mix and the attacks stopped. I started loosing weight again with Creon 40000 and I was having steatorrhea. I started increasing my dose of creon again and now I take 5 x 40000 with each meal. My weight loss seemed to stop at this dose.

I haven't checked my BG as I never had any symptoms, so I am not sure about my BG. I went to another doctor and he said that I only have IBS which is not true. Creon is so expensive. I am taking the high dose on my own.

My question is - is my pancreas fully dead? The amount of Creon I am taking, normally people without pancreas take that. Am I right? I am trying to increase the dose of my depression medicine as much as possible to avoid another attack. I fear that after the next attack even this high dose of creon will not work. My current diet includes high carb, low fat high protein. I fear of dying as I need to support my 8 months twin boys. I fear that after the next attack, I will keep losing weight and will die. I have read that at my weight, 5 x 40000 creon is the highest I can take to avoid some complications of colonic fibrosis.

Sorry for the long post. It will be great if you people guide me here. I would love to hear from people without pancreas. I fear that these mild attacks will take away my pancreas one day too.

With love,
Pinaki
Pinaki,

Your story sounds very similar to where I was in 2002. 2 young girls, started in Florida, every scan and scope imaginable. Prescribed Creon and omaprazole and eventually a gall stone was found through ultra sound. As this did not really explain the irregular symptoms when they took the gall bladder out they had a look at the pancreas and originally identified scarring potentially due to the gall stone. Following biopsy results i was advised i had neuroendocrine tumours. These are now classified as cancer BUT are slow growing and NOT the more aggressive Pancreatic Cancer. Have you had tests run for neuroendocrine? It is rare and often misdiagnosed as IBD and IBS. For 10 years my blood glucose was normal and the Creon & omeprazole managed the toilet issues (most of the time). By 2012 the regular scans identified that it was time to remove the pancreas. Since then life has been OK thanks to the insulin and Creon (I now take 18*25000 as a starting point per meal). Post Total Pancreatectomy and Pre redundancy / early retirement, I was still able to travel throughout Europe, to Florida, and to Pune for work. My girls have completed school, university, and are now enjoying successful careers. Life can be fine without a Pancreas.
 
Sorry for the long post. It will be great if you people guide me here. I would love to hear from people without pancreas. I fear that these mild attacks will take away my pancreas one day too.

With love,
Pinaki
Hello Pinaki @Pinz, I also have no pancreas after surrendering it to pancreatic cancer 4 years ago.

I can offer you no insight to your pancreatic difficulties nor suggest anything useful to help you move forward with those aspects - but I can also reassure you that despite the importance of that little organ we know as the pancreas there can be a successful life after it has gone!

Yes managing the consequent insulin dependency has had its challenges - but to be honest once I got CGM and so able to see how my BG was doing and after finding this forum where so many seemingly incomprehensible "events" got explanations that main issue of diabetes has become a fairly manageable problem. My surgery was pretty major and that bit of the process had one unexpected consequence - internal scar tissue hardening and then snagging my colon requiring emergency surgery to correct that; so should you need surgery in the future I would simply say be alert to internal scar tissue problems which can be prevented with fore-knowledge! But otherwise I live a busy and active life, constrained more by age issues than (non) pancreatic matters.

So I would say no need to fear for your future without a pancreas. You've already been through so many challenges that losing your pancreas should be well within your skillset !! Good luck with getting resolution to your "non-Pancreatic EPI".
 
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