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Squeezing pain in waves in upper abdomen - update - pancreas

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Posted 3/20/2013 9:38 AM (GMT 0)
I normally post here regarding my husband, but tonight, I'm posting for myself. Early yesterday morning I woke up feeling a squeezing (or may gripping) pain that came in waves. It wasn't very painful, but it was enough to not let me sleep and keep me up. During the day, this seemed to subside a lot (still felt it occasionally).

This morning I am again awake because of the same squeezing pain in my upper abdomen, right in the center ( above belly button, below sternum). I don't really have any other symptoms like acid reflux or heartburn. I think I maybe dealing with a peptic ulcer.

What do you folks think? Should I go to my PCP or go to a gastroenterologist? I have been taking pepto bismol which seems to alleviate the symptoms. I probably need to be tested for h pylori, but I read that pepto needs to be stopped one month before test, so they probably need to treat me by symptoms alone.

I know I need to get to a doctor, I'm not sure whether to start with PCP or just go to a gastro. What do you folks think? Also, does my husband need to be tested?

As always, thanks for your help.

PV

Post Edited (PV) : 3/29/2013 10:02:25 PM (GMT-6)

Posted 3/20/2013 6:20 PM (GMT 0)
saw my primary care physician. she thinks it's my gallbladder and has scheduled me for an ultrasound on Monday. I asked about pylori and ulcers, but she said they'll test me for that if the ultrasound is clear. In the meantime she gave me a script for protonic which i think is an avid reducer which she said well help with symptoms.
Posted 3/20/2013 8:48 PM (GMT 0)
Hi PV,
It sounds like ruling out gallbladder is a good place to start. Did you eat a high fat meal prior to the pain? I hope you feel better soon!
Posted 3/21/2013 12:08 AM (GMT 0)
I don't recall eating anything fatty; nothing fried, little to no butter or cream, and no red mat. So, I don't think my diet was a trigger. I read more about protonix and it seems like it is typically prescribed for GERD. I don't feel any heartburn or acid reflux, so I'm a little confused about why she gave me a script for that.

Oh well. I guess I'll have my answer Monday after the ultrasound. In the meantime, my husband seems to be catching a cold, and I'm feeling guilty because I've had a few rough nights and affected his rest. I think he's run down because of poor sleep and is catching a cold. :-(. It totally sucks hat I can't be sick without worrying about his health.

PV
Posted 3/21/2013 12:30 AM (GMT 0)
Try not to worry so much about your husband and take care of you for a change. The doc probably gave you the protonix just to see if it would help. I don't get typical heartburn often with my GERD, but I get nausea and excessive burping...that doesn't sound like your symptoms either, but maybe it is an unusual presentation. Gall bladder sounds more likely. I hope you are feeling a little better.

My husband had one gallbladder attack which landed him in the ER a couple of years ago. He had a HIDA scan which revealed that his gallbladder isn't functioning well, but the symptoms disappeared. Our GI encouraged him to wait to see if it happens again before doing surgery, and he has been lucky and it never recurred. It was kind of funny because he had his attack after eating Passover dinner, which has a lot of fat (brisket and matzoh ball soup), and he isn't even Jewish...just supporting me, who didn't even eat much of it due to my Crohn's:) We don't typically eat much red meat or high fat foods, so I guess it just did him in. I hope you get answers and feel better soon!
Posted 3/22/2013 2:22 AM (GMT 0)
PV please update us with your results!

I suffered with a similar debilitating pain almost a year ago. I was hospitalized and told it was constipation (I suffer a lot with C and it was NOT! That!) it was mostly on the left at that time and the hospital dosed me up and sent me away I was fine while the pain pills n morphine were available but when they worse off I suffered still! I sometimes still get bouts of pain, I got it more centrally and can even be on the left or right side now but it's never taken me as badly as it did last year so I don't worry too much about it but am interested if it is your gallbladder as I suspect mine was a gallbladder attack and I know if it ever comes back in the same fore that's the first thing I'm getting them to check!!!

Please let us know how you get on!
Posted 3/30/2013 3:51 AM (GMT 0)
Doctor office called with ultrasound results - gallbladder and other things look ok, but pancreas looks abnormal. The nurse then asked me if i had a history of pancreatitis (which I don't).

I've had occasional squeezing pain since 3/18, and I recall feeling this once earlier (maybe a year ago?). It came and went within a day and I didn't think much of it.

She asked me to come in on Monday for more blood work. My dad had cholesterol deposits called xanthoma near his eyes, which are typically associated with high triglycerides. I've been checked before, and my cholesterol was marginally high, but triglycerides were normal.

Unfortunately, I skipped my physical last year, so I have no baseline for the triglycerides. Other than my dad having xanthomas and diabetes (type 2 insulin dependent, got itin his 50's), I don't reall having any other risk factors for pancreatitis - I don't drink any alcohol, and apparently have no gallstones.

I a going to stay on a low fat and low carb diet to see if it all goes away. I know that pancreatitis canbevery painful, but so far,it has been pretty mild. I know people here have dealt with pancreatitis - does low fat and low carb sound ok for pancreatitis?

I started reading more online,but it scared me with pancreatic cancer,so I stopped. I also made an appt with my husband's gastroenterologist in case this needed more investigation. Let me know if you have any advice for me. Wish me luck!

PV

Post Edited (PV) : 3/29/2013 10:05:58 PM (GMT-6)

Posted 3/30/2013 1:07 PM (GMT 0)
Unfortunately, I don't have any advice to offer, but I am hoping for the best and wishing you well. Please keep us informed of what you find out. Sending courage and hugs your way:)
Posted 3/30/2013 5:02 PM (GMT 0)
Thanks gumby. I'm trying not to stress over it. I did go get my lipids checked, and my triglycerides are normal - so, that isn't a cause.

I'm just confused that I have so few symptoms. I thought people with pancreatitis are very ill and need hospitalization, not like me. I'm fine - just had a few days of squeezing pain, usually more severe in the mornings.

I guess I won't get any answers for a while yet. I suck at being patient and not obsessing over problems. But it seems I will have to learn this patience.

Off to try to do something that will engage my mind so I don't keep thinking about this.

PV
Posted 3/30/2013 6:31 PM (GMT 0)
I spent most of last year with on-and-off pancreatitis because of the Imuran - I've never had a sip of alcohol for religious reasons, and my gallbladder was fine. I even had a feeding tube for a while. The pain is pretty intense, especially around eating. Low fat is definitely the way to go. The reason hospitalization is necessary is because the ONLY way to treat pancreatitis is to stop eating and let the pancreas rest, and for how long just depends on your body. That's why I ended up with the feeding tube for three weeks. Even a week of hospitalization with IV fluids only, my levels still weren't staying down. A simple blood test will tell you if that's what you have or not - they'll check your lipase and amylase levels.

Good luck!
Posted 4/1/2013 6:57 PM (GMT 0)
Went to the doc today for blood work. I believe they are testing my lipase and amylase. I have zero stomach issues right now - completely normal, no pain at all.

I got a copy of the ultrasound report to take to my gastroenterologist. The report says "abnormal appearance of the pancreas is noted. Is there a history of pancreatitis?" No specifics on what is abnormal.

I moved up my gastroenterologist appt from next week to tomorrow at 2 pm. Hopefully he'll be able to schedule me for more diagnostic tests, and by the end of the week, I should have a more complete picture of what the heck is going on with me.

Over the weekend, I couldn't help it, I read a little more about pancreatitis. I must say it sounds absolutely horrendous. There are some reports of people having pancreatitis without symptoms, but it sounds like it is pretty rare. Also, chronic pancreatitis sounds like a really bad thing to have as well. I'm hoping I just have an oddly shaped pancreas or something like that.

Also, I read that in a lot of cases of pancreatitis, people experience warning biliary colic that they ignore. Maybe that's what I experienced. Even though I'm feeling fine now, I'm going to continue and explore it just in case, though it is stressing me out. :-)

Thanks for your support.

PV
Posted 4/2/2013 2:57 PM (GMT 0)
Got my pancreas lab results back. The levels of amylase and lipase are normal (62 and 22). However, the test was conducted 14 days after onset of symptoms. From what I read amylase comes back to normal in 5-7 days, and lipase in 8-14 days, so I don't know if I can trust these results. In any case, it doesn't sound like I had an acute attack - it maybe chronic pancreatitis maybe (which is scary as hell).

I'm going to ask the gastroenterologist to perform an endoscopic ultrasound to take a look at my pancreas to see what he can see.

In the meantime, I'm sticking to a low fat, high fiber diet, and I am planning to stating to take some antioxidants to keep my pancreas healthy.

PV
Posted 4/2/2013 3:49 PM (GMT 0)
Yes, they can definitely lower in that amount of time. I would suggest next time you go to the ER and they can run the tests and get results immediately. An endoscopic ultrasound is a good idea; you may need to go see a specialist to do it, though. When I had mine, there was only one doctor in the entire north half of the state who was qualified to do it. Also, just FYI, chronic pancreatitis isn't as scary as it sounds. You just stick with a low-fat diet and take enzymes when you eat, and you can pretty much control it from there.
Posted 4/2/2013 11:12 PM (GMT 0)
Saw the GI today. He says he's very positive I don't have pancreatitis. He says he's very skeptical of the ultrasound report because all it says is "abnormal appearance of pancreas is noted", with no details. Also, he says that someone with pancreatitis will be much much sicker than I am - I have no pain, and occasionally feel a spasm right below the rib cage.

He thinks I have acid reflux, and he gave me a script for levsin for me to try if I experience it again. Also, I am getting a CT with contrast done tomorrow to image my pancreas. He said that if the ultrasound could see problems with my pancreas, the CT will definitely be able to see them as well.

He told me that the ultrasound is not a good imaging tool for the ultrasound because the pancreas lies behind other organs and also because bowel gas makes it difficult to visualize in an ultrasound. He thinks the ultrasound observation is a red herring and that my symptoms are more indicative of acid reflux problems (I do have some reflux issues, but nothing I sought help for).

I'll let you know what the CT results are. I am keeping my fingers crossed and hoping for the best - that my CT is normal. When I get these spasm, I have very mild pain - it is not in any way disabling, it is just annoying and keeps me from sleeping. I do have a little bit of burping and belching, but no heartburn, and I haven't sought help for it thus far.

Keep your fingers crossed for me!

PV
Posted 4/3/2013 1:35 AM (GMT 0)
Hi PV,
It sounds like you are getting a bunch of reassuring news. I hope your CT scan looks good too. It sounds like your GI is being very thorough. I have GERD along with my Crohn's. I can't recall any squeezing pain, but I definitely burp a lot and. I think Levsin is an antispasmodic, but not an acid blocker. It may help for the cramps, but you may need to add something like Prilosec (a PPI) as well if it keeps up. I hope your CT goes well and you get good news.
Posted 4/3/2013 2:55 AM (GMT 0)
Ok. I'll go to the store and pick up some Pepcid. I felt better after talking to him and I am hoping my test will turn out fine. I have been very stressed out after reading all about pancreatitis. I read more about reflux and esophageal spasm, and I think it may fit my symptoms - I think the squeezing I feel right in the area after the sternum is what when severe may cause the chest pains.

I am keeping my fingers and toes crossed for tomorrow's CT. I absolutely need to keep my job down in order to pay our bills and keep our health insurance in cass my husband got seriously sick. If we were both sick ... I was starting to get very anxious.

Thanks for being here for me to talk to even though this isn't a crohns related issue!

Hugs,
PV
Posted 4/3/2013 4:19 PM (GMT 0)
I tell my husband he isn't allowed to be sick at the same time I'm sick....of course, that always works! ;)

Pancreatitis is a scary thing when you think you have it; I really hope it's just reflux. It sounds like it fits your symptoms a bit more, especially with your blood levels being normal. I have both (reflux and recurring acute pancreatitis) and with the Crohn's and pregnancy mixed in, sometimes it's really hard to tell what is causing what pain where! :)

Please keep us posted!!!! Good luck!!
Posted 4/3/2013 9:07 PM (GMT 0)
Got the CT done today. When I saw my GI (who is a very nice man and a great doc), he was hinting that he doesn't trust the ultrasound report because of the radiologist. He said he was a colorful guy, but a little unreliable.

Today, at the radiology center, the person who administered the contrast, basically told me the same thing. She said she's seen so many bad reports from that radiologist, and that she herself had a breast cancer scare because of his report.

So, I'm hoping I'm another one of his botched findings. I should have my CT results late today or early tomorrow.

Keeping my fingers crossed.

PV
Posted 4/4/2013 7:49 PM (GMT 0)
CT of pancreas was clear - no ductal dilation or parenchymal lesion. There was an incidental finding of a liver hemangioma, which they think should not be causing any problems.

However, just to be safe, the GI has scheduled me for an MRCP for next Wed morning. I asked him if there was anything concerning about the report, but he just said he is just being doubly sure.

So, more waiting. But at least it is so far looking like the ultrasound was just wrong.

pv
Posted 4/4/2013 8:13 PM (GMT 0)
That's good news - positive vibes your way that the MRCP is negative.
Posted 4/5/2013 12:40 AM (GMT 0)
Great news! I think you will be fine!
Posted 4/10/2013 7:38 PM (GMT 0)
Got my MRI done today, and got the results. All fine, except for a 1 cm hemangioma (benign collection of blood cells) on the left lobe of the liver. So, I think I can cross of anything on my pancreas as being problematic. If I could find that ultrasound tech who put down "abnormal appearance of pancreas" with zero details on why it was abnormal, I'd go shake him. :-)

I am very relieved to say the least. I've had no symptoms in a while now, and things seem back to normal. I'll follow up with my GI, and see what he wants to do now.

Thanks for all your support. I think I'm going to go buy some shoes for retail therapy.

Yay!
PV
Posted 4/10/2013 9:25 PM (GMT 0)
I'm so glad all is well. It's really hard when you get to worrying. Sometimes our brains just won't stop though! Go have fun and celebrate!!
Posted 4/10/2013 9:31 PM (GMT 0)
Last summer I too had high lipase levels, which sometimes indicates a problem in the pancreas but high lipase levels also can be caused by an bowel obstruction which I had at the time. 
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