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My husband, age 59, was recently told that his blood sugar

was elevated a bit and...
My husband, age 59, was recently told that his blood sugar was elevated a bit and his doctor put him on Januvia starting June 1, 2013 100mg/one pill per day. Sugar dropped down to almost normal (A1C= 6.5) and all was well. Then about one month ago he started noticing stomach pain and pain in right flank area on back. Said it was mostly achy pain and some sharp pain from time to time with certain movements. Pain is around belly button area about a 4 inch diameter around it. No bowel change, no fever, no headache, never missed a day from work since this started (office desk managerial job)and no problem for first 3 months on drug. Anyway he is now convinced that he has pancreatitis from the Januvia and stopped taking it 10 days ago and says pain is better etc...Doesn't sound like pancreatitis to me from what I have read. That is usually upper abdominal pain that is severe and burning which he does not have. He lifted a 125 pound dumbbell with one hand showing off for the guys at gym and that happens to be when pain around umbilical area started. He did have an umbilical hernia repaired 10 years ago and wondering if the lifting was the more likely cause of the pain in his stomach. Says it feels like a bruise and hurts when wearing his pants. Refuses to go to doctor and now refusing to take Januvia since he thinks the drug caused this problem. Looking for an opinion from a doctor who may be able to say what is more likely going on here. If pancreatitis, I am worried and agree with stopping drug and drinking water and taking motrin etc...if aggravation of hernia then no big deal and want him to continue the Januvia. Any opinion or suggestion appreciated. Thanks.
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Answered in 9 minutes by:
10/25/2013
Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Anthony Bray, MD : Hello!!
Anthony Bray, MD : your stubborn husband does need to get this checked further by his doctor !!!!!
Anthony Bray, MD : I suspect that you may be right that the umbilical hernia may very well be suspect cause of the peri- umbilical pain!!
Anthony Bray, MD : Pancreatitis / liver inflammation/ abdominal pain have been reported with Januvia too so I can't discount the possibility of the medicine being related...
Anthony Bray, MD : pancreatitis would be reflected by simple blood test for pancreatic enzymes --- lipase and amylase---
Anthony Bray, MD : these would be elevated if he had pancreatitis... It would be important for him to know if this were the case...
Anthony Bray, MD : it seems prudent for his doctor to consider switch in medicine for his diabetes --- perhaps to Metformin ( Glucophage) or another alternative....
Anthony Bray, MD : even if the Januvia were not the cause of the abdominal pain as long as your husband d believes that this may be the case then naturally he would not want to take this medicine ( that is normal and I do not criticize him in this --- normal to suspect new medicine )
Anthony Bray, MD : he does need to be in some firm if treatment for his diabetes I would say --- he wants to maintain good control as reflected in his last hemoglobin A1C test ....
Anthony Bray, MD : there are many medicines that may be used for diabetes and he should not fear them all by any means!!!
Anthony Bray, MD : the abdominal and flank pains need to be worked up... I hope that you may be able to convince him to go ahead and see his doctor...
Anthony Bray, MD : liver function tests--- AST/ ALT are the main liver enzymes to check for inflammation if the liver ...
Anthony Bray, MD : right flank pain could be due to separate problem such as kidney stone or kidney infection for example...
Anthony Bray, MD : other liver disease may cause abdominal pain --- most typically right upper quadrant and may radiate to back --- referred pain to area of umbilical region would be possible....
Anthony Bray, MD : epigastric pain more typical for pancreas caused pain with radiation to mid back--- nausea most common if there is pancreatitis too...
Anthony Bray, MD : physical exam of area would be most helpful for his doctor to determine the cause ... Exam followed by further tests would be my recommendation .....
Anthony Bray, MD : it is certainly possible that pain could be due to his hernia ... I agree that the discomfort in the same location as his hernia makes the most sense...
Anthony Bray, MD : From this perspective I can't diagnose him reliably though ... Different causes are possible....
Anthony Bray, MD : I hope that this information is helpful for you!
Anthony Bray, MD : I hope that your husband indeed feels better and takes care of his health!! I hope he maintains good control if his diabetes.
Anthony Bray, MD : let me know if you have further questions or discussion and I will be happy to get back with you!
Anthony Bray, MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be much appreciated! Thank you and best regards!
Anthony Bray, MD : Anthony Bray MD
Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Hello!!
This is Dr. Anthony Bray from Justanswer.com... I spoke with you the other day with regard to your husband's abdominal pain and diabetes treatment. Thank you for your questions and for you positive feedback and bonus! These are much appreciated!
I hope that your husband gets good medical evaluation and care with regard to his issues. If you should have other medical questions in the future and wished to contact me specifically that you are most welcome to do so!! You may reach me via my profile page on the JA site....http://www.justanswer.com/medical/expert-anthonybraymd/
Once on this page the question may be typed I to the box and it would be directed to me...( if at a time that I was not inline then another expert may pick up the question and help you...
Thanks again and best regards!
Anthony Bray MD
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