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  • Lipase-whats wrong?

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    Old 03-03-2009, 09:35 AM   #1
    k2626
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    Lipase-whats wrong?

    I am a 34 yr old female. History of GERD for 2 yrs, and other odd sx the past 7 months (muscle twitching all over, nerve pains, extreme joint cracking-no dx)

    3 wks ago I started to get an upper left pain that would feel like a quick squeeze, location about an inch under my breast, sometimes I would get burning in middle of chest too. Went to dr and my lipase was slightly elevated. He said it could be pancreatitis or "something" else (cancer) causing this rise. My dad died of pancreatic cancer this summer, PC is hereditary so I panicked. Had an ultra sound of my pancreas on Sat, it was fine but lipase still the same. Had a CT w dye yesterday, it was fine but lipase still elevated.

    What could be going on here? My gallbladder was fine as well minus a tiny polyp.

    Could birthcontrol cause a continous slight raise?

     
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    Old 03-03-2009, 12:23 PM   #2
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    Re: Lipase-whats wrong?

    k2626,

    I hate to say it, but it might be your pancreas. Not in terms of cancer, but in terms of your pancreas being inflammed or agitated for some other reason. I have had mildly elevated amylase & lipase readings since November - with a host of other GI symptoms - and I have yet to be diagnosed. Don't panic! Since you mention the left sided pain - it could be something called SOD. You can look it up on the posting boards - much has been written about it here. It is basically a spams of a sphincter that regulates pancreatic enzymes & bile into the duodemum. It's malfunction can lead to elevation of either pancreatic enzymes or liver enzymes depending on the point of "obstruction". It is hard to diagnose, but that could be one possibility. Many develop it after gallbladder removal, but others have their gallbladers & still have it. I, too, have been through many negative tests, but suspect I have this condition. Do you have any other GI symptoms?

    Also, was your amylase also elevated? Increases of both amylase & lipase likely point to the pancreas. If the elevation was just one - source may be something else.

    Again, don't panic - the likelihood of cancer in someone as young as you is very low.

     
    Old 03-03-2009, 12:32 PM   #3
    k2626
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    Re: Lipase-whats wrong?

    I did not have my amalyse tested. My lipase continues to just be slightly elevated. I would think the ab ultrasound and the CT scan would have found a mass if there was one re PC.

    I have not heard of SOD.

    I have had pains where the pancreas lies which led me to the testing to begin with. All of my other labs seem to be fine, livers, metabolic etc. Had a ca 19 last month and it had not risen over the past 5 months when I had one done back then.

    Of course the dr at the ER yesterday did not seem to know what he was talking about, he told me the pancreas lies behind the belly button, I told him I thought it was was up behind the stomach. He said no! Well, I have faith the rad techs actually imaged the pancreas!

    Anyway, I would hope these two tools rule out a mass. I will get an EUS too just to be 110% sure.

    Have had other odd symptoms for 7 plus months-muscle twithcing all over, exreme joint cracking, nerve pains-no sx. Wonder if its related. Lupus not showing in labs yet? Dont know...

     
    Old 03-03-2009, 01:57 PM   #4
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    Re: Lipase-whats wrong?

    k2626,

    It does not surprise me that the Er doc did not know where the pancreas is located. Very few regular doctors are familiar with the organ, its function & possible malfunctions. I am very sorry to have read about your father. Having gone through such a traumatic event with a close family member (hyper) sensitizes us to thinking the worst when it comes to our own health. I have gone through this experience myself, although in my case it was a close relative with ovarian cancer.

    k2626, it sounds like you are very knowledgable about the pancreas given your experience with your father. The fact that you have already had a ca-19 tells me this. A negative CT is a good sign - and should put your mind at rest that you are not dealing with cancer. Still, it is important to get to the bottom of your symptoms. I think getting an EUS is an excellent idea - make sure they look for the 9-11 signs of chronic pancreatitis. EUS is better at getting up close visual of the pancreas. Also get you amylase checked out, too. If both your amylase & lipase are elevated - it is a good chance you are dealing with your pancreas. I, too, have very mild elevations & workign hard at getting answers.

    The only thing that has me thinking is your mention of joint pain, etc. Since you mention the possibility of lupus - you are already thinking along the lines of an autoimmune disorder. There is such a thing as autoimmune pancreatitis - there is a blood test for it - it has a 30% false negative rate, but it might give some answers. In the sutoimmune realm there is also something call Sjogren's Syndrome - which has a pancreatic component, too.

    You do not mention any other GI symptoms other than the pain? Do you have any?

    Also do you have your gallbladder?

    Keep testing, you are on the right path. -M

     
    Old 03-03-2009, 02:03 PM   #5
    k2626
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    Re: Lipase-whats wrong?

    Thanks so much. I have been crying uncontrollably over this that it has taken over my life literally. I am so terrified I have cancer. I just have to hope the ultrasound and CT would have caught something, though I will get the EUS too.

    I have a history of GERD. Two yrs ago I started getting stabbing pains over my heart, thought it was my heart, dr put me on achiphex and it went away. However, it took me over a yr to get it under control with being on the meds.

    Other than pain I dont really have any other symptoms that stand out in terms of digestion.

     
    Old 03-03-2009, 02:12 PM   #6
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    Re: Lipase-whats wrong?

    Get the EUS for peace of mind - I had one in December & it was not that bad. They knock you out completely... Have your amylase & lipase tested together. Lipase is more specific & sensitive to the pancreas, so that is why some docs only test that, but as I said, amylase & lipase together - point more to pancreas. The fact that you have no other GI symptoms like malabsorption or diarrhea is also a good thing.

    If that EUS is negative & you still have elevations look to an MRCP-S (a secretin MRCP) that checks the funtionality of the pancreas. I am waiting for that test now. It is non-invasive.

    You did not mention whether you still have your gallbladder - Do you?

     
    Old 03-03-2009, 02:28 PM   #7
    k2626
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    Re: Lipase-whats wrong?

    I do still have my gallbladder....

    This is just so scary. I just keep thinking its PC I would not be so terrified if I had not just lost my dad to this. I need to relax in the tests I had. I also had an ultrasound of my pancreas this past summer (I was having lower left pain that I have had for yrs and also asked them to look hard at my pancreas)

    My drs have told me the US is a good tool too especially since I am so thin, 105 at 5'5. So two clear US and a CT I should be good to go. But one more test it will be just to be triple sure!

    Its does not help that my ca 19 was slightly high this summer at 43 (new standard is 37) but then rechecked in Feb it is back at 37. I woud think it would have gone up if it were PC though I am no dr. I am having this rechecked too.

    My dr mentioned maybe my birthcontrol is causing this to be slightly elevated. Another dr said some people have elevated enzymes naturally. Have no clue, I hear so many things from different drs. Maybe other stomach issues like colitis etc?

    What do you think is causing your rise? What other symptoms do you have?

     
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