Pancreatic involvement

Is there anyone here who suffers from Exocrine Pancreatic Insufficiency brought on by Sjogren's? I have it. It's so hard to digest my food. I have to take enzymes (only plant ones because I'm a vegetarian) and eat small portions and chew WELL -- then I'm ok. But at lunch at work, I eat more than I should and then suffer the water in my Small Intestines and subsequent gas from undigested food. Anyone else suffering from this? It looks like IBS - but this is the cause.

Hi DLT, I'm not sure that this is exactly what it is with me, but I had an inflamed pancreas 20 years ago when they first suspected gall bladder problems, and believe it continues to act up from time to time. I think that one of these systemic autoimmune (Psoriatic Arthritis, and Sjogren's) was at work even then. You know what they say about hind site!

I also have a hiatal hernia, so I never really know which one is acting up (maybe both)! Don't think I have IBS, I KNOW I have irritable back pain!

I take probiotics and Spectrazyme and they really do help! The Spectrazyme is so helpful in being able to digest proteins and cheese! Taking morphine occasionally doesn't help either! When all else fails it's milk of magnesia!

BTW,20 years later they did take the gall bladder out, I was rushed to the ER, in extreme pain, told them it was digestive, but they put a heart monitor on me! ha! Finally listened to me, but I had to YELL!

Hi again SK. That just proves we know our bodies best, huh? I feel like I have to tell my doctors everything or they wouldn't have a clue. My acupuncturist, however, is amazing and knows things before I do. Yes, it does sound like maybe your problems were and are possibly caused by Sjogren's. Thank you so much for sharing your experiences with that. It gets lonely being on other SS sites and I'm the only one with the pancreas problem. Misery loves company, as they say. Actually, I just like to hear what works for people. I will look up that Spectrazyme - thank you!

GEE, I NEVER HEARD OF THIS, BUT MAKES A LOT OF SENSE TO ME NOW, AS I HAVE RECENTLY STARTED HAVING THESE DIFFICULTIES DIGESTING FOOD AS WEL. AND PAINS INSIDE, I SWEAR I DON'T KNOW WHAT IS GOING ON IN THERE. WILL DEFINITELY HAVE TO RESEARCH THIS ONE.

That's how it started with me so maybe they can check your pancreatic enzyme levels. I think you just have to not take any enzymes 2-3 days before they test. This started big time for me last October. I would eat some food I normally ate before, but a short while later -- pain. My weight started dropping. I had loose stools and so much gas. The things that cause the most pain/difficulty are fats, proteins, and carbohydrates (which is about everything except fruit). I take veggie enzymes now which help a lot but I still have to chew very very well and keep my portions small. Have you noticed any weight loss at this time?



gmabuster said:

GEE, I NEVER HEARD OF THIS, BUT MAKES A LOT OF SENSE TO ME NOW, AS I HAVE RECENTLY STARTED HAVING THESE DIFFICULTIES DIGESTING FOOD AS WEL. AND PAINS INSIDE, I SWEAR I DON'T KNOW WHAT IS GOING ON IN THERE. WILL DEFINITELY HAVE TO RESEARCH THIS ONE.

I know that we have less and less digestive enzymes as we age, and the standard med and OTC remedies actually delete what we need the most, the enzymes and acids to break the food down.

Besides probiotics, some even use prebiotics, but personally, I never use these.

As for the Gall Bladder, with mine, it was normal size, not a single stone in sight, so they would never get to the most expensive of the tests,

Medical Health Tests Articles Medical Tests

Procedure, Results, Side Effects and Cost of Hida Scan For Gallbladder

Submitted by Nic on October 18, 2012
24

A Hepatobiliary Iminodiacetic Acid (HIDA) scan refers to an imaging procedure, through which a medical expert tracks the production and flow of bile from your liver, into your small intestines. This procedure creates images of your gall bladder, liver, small intestines and the bile ducts. Some of the alternate names for the HIDA scan are Cholescintigraphy and Hepatobiliary Scintigraphy. The HIDA scaninvolves the use of a tracer or radioactive chemical and therefore, it is a type of imaging study known as nuclear medicine scan. Your doctor may order a HIDA gallbladder scan, to check for -

  • Obstructions in the bile ducts, caused by gallstones or a tumor
  • Diseases of the gallbladder
  • Cholecystitis or inflammation in the gallbladder
  • Bile leakage from the gallbladder or bile ducts

At times, your doctor may also ask you to go through a HIDA scan for gallbladder, just to measure gallbladder ejection fraction or the rate at which your gallbladder releases bile.

Procedure

The HIDA gallbladder scan is conducted by a radiologist and can be completed within 2 hours or so. During the procedure:

  • You will be asked to lie down on a bed
  • The radiologist will inject a radioactive chemical intravenously
  • A camera will be placed over your abdominal area. This is a special camera, as it senses radioactivity and captures pictures of all the areas that the tracer travels to.
  • The test chemical injected into your body will be removed from the blood and secreted into the bile
  • From the liver, the chemical should flow with the bile, into the bile ducts, gallbladder and the intestines.
  • The radiologist will get a look at your gallbladder, bile-filled liver as well as your bile ducts.

Results

Though a radiologist may be able to give you an idea about the results of the scan right away, in most cases the results will be sent directly to your consulting physician, who will explain them to you. The HIDA gallbladder scan results usually indicate -

  • Normal activity: In case the tracer moves freely with the bile, from the liver, to the small intestines, it usually means that there is no problem.
  • Inflammation: If the tracer cannot be seen in the gallbladder, it could be an indication or cholecystitis or an inflammation in the gall bladder
  • Leakage: If the scan picks up images of the tracer outside the biliary system, it means that there is a leak.

Speak to your doctor to know about your results and their indications.

Side effects

The amount of radioactivity that your body is exposed to during the procedure is too small to cause any serious problems. This tracer becomes inactive after a couple of hours and is usually eliminated in the stools. However, there are a few side effects associated with the HIDA gallbladder scan, such as -

  • Development of a rash
  • Bruising at the site of the injection
  • Allergic reactions to the medication use for enhancement of the procedure.

Nuclear medicine tests are not performed on pregnant women, because of their adverse effect on the fetus. Therefore, if you are pregnant and have been advised to undergo a HIDA scan, it is important for you to speak with your doctor.

Cost of HIDA scan

The cost of the HIDA scan may vary, depending upon your radiologist's fees and the medical facility charges. However you can expect to pay anywhere between US$ 1,500 and US$ 2,000, which should include the cost of the scan, tracer and the radiologists fee.

References

  • Saroja Adusumilli, Evan S Siegelman, MR imaging of the gallbladder, Magnetic Resonance Imaging Clinics of North America, Volume 10, Issue 1, February 2002, Pages 165-184, ISSN 1064-9689, 10.1016/S1064-9689(03)00055-2.
  • The SNM procedure guideline for hepatobiliary scintigraphy 4.0. Reston, Va.: Society of Nuclear Medicine.
  • Practice guideline for the performance of adult and pediatric hepatobiliary scintigraphy. Reston, Va.: American College of Radiology.
  • Segerman D, et al. Radionuclide imaging: General principles. In: Adams A, et al. Grainger & Allison's Diagnostic Radiology. 5th ed. Philadelphia, Pa.: Elsevier
  • Mettler FA. Essentials of Radiology. 2nd ed. Philadelphia, Pa.: Elsevier Saunders



SK said:

I know that we have less and less digestive enzymes as we age, and the standard med and OTC remedies actually delete what we need the most, the enzymes and acids to break the food down.

Besides probiotics, some even use prebiotics, but personally, I never use these.

As for the Gall Bladder, with mine, it was normal size, not a single stone in sight, so they would never get to the most expensive of the tests,



Medical Health Tests Articles Medical Tests

Procedure, Results, Side Effects and Cost of Hida Scan For Gallbladder

Submitted by Nic on October 18, 2012

A Hepatobiliary Iminodiacetic Acid (HIDA) scan refers to an imaging procedure, through which a medical expert tracks the production and flow of bile from your liver, into your small intestines. This procedure creates images of your gall bladder, liver, small intestines and the bile ducts. Some of the alternate names for the HIDA scan are Cholescintigraphy and Hepatobiliary Scintigraphy. The HIDA scaninvolves the use of a tracer or radioactive chemical and therefore, it is a type of imaging study known as nuclear medicine scan. Your doctor may order a HIDA gallbladder scan, to check for -

  • Obstructions in the bile ducts, caused by gallstones or a tumor
  • Diseases of the gallbladder
  • Cholecystitis or inflammation in the gallbladder
  • Bile leakage from the gallbladder or bile ducts

At times, your doctor may also ask you to go through a HIDA scan for gallbladder, just to measure gallbladder ejection fraction or the rate at which your gallbladder releases bile.

Procedure

The HIDA gallbladder scan is conducted by a radiologist and can be completed within 2 hours or so. During the procedure:

  • You will be asked to lie down on a bed
  • The radiologist will inject a radioactive chemical intravenously
  • A camera will be placed over your abdominal area. This is a special camera, as it senses radioactivity and captures pictures of all the areas that the tracer travels to.
  • The test chemical injected into your body will be removed from the blood and secreted into the bile
  • From the liver, the chemical should flow with the bile, into the bile ducts, gallbladder and the intestines.
  • The radiologist will get a look at your gallbladder, bile-filled liver as well as your bile ducts.

Results

Though a radiologist may be able to give you an idea about the results of the scan right away, in most cases the results will be sent directly to your consulting physician, who will explain them to you. The HIDA gallbladder scan results usually indicate -

  • Normal activity: In case the tracer moves freely with the bile, from the liver, to the small intestines, it usually means that there is no problem.
  • Inflammation: If the tracer cannot be seen in the gallbladder, it could be an indication or cholecystitis or an inflammation in the gall bladder
  • Leakage: If the scan picks up images of the tracer outside the biliary system, it means that there is a leak.

Speak to your doctor to know about your results and their indications.

Side effects

The amount of radioactivity that your body is exposed to during the procedure is too small to cause any serious problems. This tracer becomes inactive after a couple of hours and is usually eliminated in the stools. However, there are a few side effects associated with the HIDA gallbladder scan, such as -

  • Development of a rash
  • Bruising at the site of the injection
  • Allergic reactions to the medication use for enhancement of the procedure.

Nuclear medicine tests are not performed on pregnant women, because of their adverse effect on the fetus. Therefore, if you are pregnant and have been advised to undergo a HIDA scan, it is important for you to speak with your doctor.

Cost of HIDA scan

The cost of the HIDA scan may vary, depending upon your radiologist's fees and the medical facility charges. However you can expect to pay anywhere between US$ 1,500 and US$ 2,000, which should include the cost of the scan, tracer and the radiologists fee.

References

  • Saroja Adusumilli, Evan S Siegelman, MR imaging of the gallbladder, Magnetic Resonance Imaging Clinics of North America, Volume 10, Issue 1, February 2002, Pages 165-184, ISSN 1064-9689, 10.1016/S1064-9689(03)00055-2.
  • The SNM procedure guideline for hepatobiliary scintigraphy 4.0. Reston, Va.: Society of Nuclear Medicine.
  • Practice guideline for the performance of adult and pediatric hepatobiliary scintigraphy. Reston, Va.: American College of Radiology.
  • Segerman D, et al. Radionuclide imaging: General principles. In: Adams A, et al. Grainger & Allison's Diagnostic Radiology. 5th ed. Philadelphia, Pa.: Elsevier
  • Mettler FA. Essentials of Radiology. 2nd ed. Philadelphia, Pa.: Elsevier Saunders

DLT, if you read the opening info from Cedars Sinai, you will see that it does state that the GB and Pancreas can be affected by Sjogren's, however if you click the link, there is no further info. I guess you have to become a member to get further info. I get enough emails from the more than dozen BF groups I belong to, so no more emails for me! ha! It's a job just to go through them each day!

SK, I know what you mean about being on so many lists! Thanks for the info.

Check this out, especially the last paragraph!

http://www.webmd.com/digestive-disorders/features/what-are-probiotics

Who knew?

Thanks for scouting out information for us, SK! I've been taking probiotics since I got sick last fall and my test showed I had a healthy amount in my intestines. But, wow, that last sentence was scary about pancreatitis! I didn't know taking probiotics could be dangerous if we have pancreatitis. Something to really think about. Now I'm glad I cut back on the probiotics several months ago when my test showed I had such a high amount in my tract.

I definitely have problems digesting and weird pains inside too. This comment made me feel a lil less crazy

gmabuster said:

GEE, I NEVER HEARD OF THIS, BUT MAKES A LOT OF SENSE TO ME NOW, AS I HAVE RECENTLY STARTED HAVING THESE DIFFICULTIES DIGESTING FOOD AS WEL. AND PAINS INSIDE, I SWEAR I DON'T KNOW WHAT IS GOING ON IN THERE. WILL DEFINITELY HAVE TO RESEARCH THIS ONE.

I know it Kay, we have such a wide spectrum of ills, it's hard to believe there is so many seemingly unrelated things going on with us! Just remember this is a systemic disease!

I unfortunately had cdiff. When nothing else worked, I had a fecal transplant with the donor being my son. This was a year ago in December. About a month later, I started having excessive gas and bloating. Doctors didn't pay much attention to me. My son lives out of state and mentioned my symptoms to his gastro doctor. This guy never even met me! The doctor said I probably had bacterial overgrowth. I started researching this and also found some of the same symptoms are caused by pancreatic insufficiency. At my suggestion, I have been tested for bacterial overgrowth, pancreatic insufficiency and malabsorption. Guess what?? I have all three.

Within the last several months, I have been diagnosed with Sjogren's Syndrome. When I mention a connection, I am told no.A rheumatologist put me on Exovac to produce more saliva. I have enough saliva--it's the tears in my eyes that I need. I now stopped taking Exovac and the rheumatologist suggested a medicine with quinine. My medical records show I am highly allergic to quinine so I won't be taking that. I am going to switch rheumatologists.

As was said, misery loves company so very interesting to hear someone else thinks there's a connection between these maladies.