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Answered in 3 minutes by:
3/13/2018
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,823
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Customer reply replied 5 months ago
Hi ,
I have some pancreas questions. I have never smoked or used drugs. I drink maybe one alcoholic drink once a year. So basically I don't drink. I am 6ft tall and 210 pounds. I eat very healthy. Very seldom do I have very fatty foods. My job is alot of sitting so I do not get alot of exercise otherwise i consider myself pretty healthy. 3 weeks ago I had 2 days of very pale colored stools and then it got better. I went to my doc and he did a lipase and amylase blood draw. My lipase was slightly elevated at 87 and amylase was normal. He told me to come back in 2 weeks for a retest. Last week a had a bad fall and landed on my upper left abdomen. I went to the ER and they did a CT scan with contrast of my chest, abdomen, and pelvic area and drew labs. My lipase was normal at 43 and my scan was normal as well. Now 3 days ago I had to go back to my doc to check my pancreas and liver enzymes again. My liver was completely normal and my amylase was normal but my lipase was 234. I could not believe it so asked for a retest. 3 hours later after dinner I had a retest and my lipase was 327. The doc called me and scheduled a MRI for Thursday. The following day I went back in for another blood draw and fasted for a cholesterol test. The cholesterol came back great and my lipase was back down to normal at 39. I'm so confused with these results and am very scared anxious about pancreas cancer. I have had my gallbladder was removed years ago. My stools have been normal. The only thing I have is a little pain under the bottom of my left rib that circles around to my back. I've had this annoying pain that comes and goes for years. Chiropractic work seems to always help. I also have a bad habit of pushing very hard on that area when it hurts. It's never a serious pain but an annoyance that seems to get better with movement and different position. I'm very scared and anxious. I have severe anxiety and take meds for it for years. If the Ct scan is clear then what is the mri for? Also why the bouncing around of lipase levels? Do you think it's from the trauma of the fall or me always pushing on that area. The only thing I read about on the internet is pancreas cancer and I'm deathly afraid. Please advise. Also there is no family history of pancreas cancer

There are some comments that are pertinent before addressing your specific questions.

The most common cause of increased levels of lipase is form pancreatic disease. Inflammation of the pancreas is the most common, which in turn is most often caused by substances that are irritants to the pancreas (primarily alcohol at levels higher that you drink) or from gallstones (which you shouldn't be forming any longer after removal of the gallbladder). However, the 2 days of pale stools also raise a question about liver and biliary function. It is also possible to get pancreatitis from elevated levels of lipids, which is why a fasting cholesterol level was checked. Tumors of the pancreas also can cause an elevated lipase, although it is less common than inflammation of the pancreas.

Although the pancreas should be the first organ considered in someone with an elevated lipase, there are some other conditions that can also cause an elevated lipase, particularly other conditions affecting the GI tract, such as peptic ulcers, inflammatory bowel disease, or celiac disease. If the evaluation of the pancreas cannot identify the cause, then a broader GI evaluation would be appropriate.

Abdominal trauma can cause an elevation in amylase or lipase, although it is usually apparent that someone has had abdominal trauma. However, in most studies looking at causes of elevated lipase levels, abdominal trauma is not often identified as a cause, probably because the studies were not done on people that recently suffered abdominal trauma.

To address your specific questions:

If the Ct scan is clear then what is the mri for? While a CT scan is very good, an MRI is better. An MRI is more sensitive at detecting small tumors.

why the bouncing around of lipase levels? The varying lipase levels indicate that the underlying condition is varying in the amount of irritation of the pancreas or other portion of the GI tract. However, the varying lipase levels is not specific for any of the underlying causes noted above.

Do you think it's from the trauma of the fall or me always pushing on that area? The abdominal trauma could cause an elevation of lipase, as noted above, but it would not explain the first slightly elevated lipase level. The pushing on the abdomen that you are personally doing would not contribute to the elevated lipase.

Is there any further information that would be helpful?

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Customer reply replied 5 months ago
Being the Ct scan with contrast was normal and my last lipase test was 39 do you feel that the MRI will still pick up tumors? Do you feel this is a classic and perfect match for pancreas cancer? I have a hiatal hernia and sometimes have acid reflux but very seldom. Other wise I have no other symptoms. Do you seriously think this could be cancer? Help

I think that it is very unlikely that there will be a tumor there, but if there is a tumor, the MRI would be the best test to pick up a tumor. No, I do not think that this is a classic and perfect match for pancreas cancer. You are younger than a classic presentation (with almost all cases occurring in people over age 45 and the average age at diagnosis of 71), and you certainly do not have significant risk factors to explain a presentation in a younger person.

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Is there any further information that would be helpful?

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,823
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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