Question: My last GI doctor Dr. XXXXXXX who moved to another state, diagnosed me with chronic pancreatitis based on several EUS reports stating that my pancreas had lobularity, hyperechoic strands and foci,calcium,a coarse echotexture and was atrophic. She also diagnosed me with chronic pancreatitis based in my very low trypsinigen levels. My trypsinogen level was 24, but is now 7 or below. When she told me of the changes to my pancreas based on the EUS reports, I asked her if the changes in my pancreas were reversible. She told me that I had chronic pancreatitis and the changes to my pancreas were irreversible. After she moved and another GI doctor took over my care, everything for me went downhill. This GI doctor who took over my care did an EUS about a year ago, He said in his EUS report that my pancreas was completely normal. My parenchymal was completely normal. He also said that there was no lobularity, hyperechoic strands and foci, calcium, atrophy, or coarse echotexture in my pancreas. This GI doctor disagreed with all of the prior EUS reports and said that I did not have chronic pancreatitis. He and his physician assistant also made it clear to me that the trypsinogen level was not relevant and that they do not consider it in diagnosing chronic pancreatitis. I know some GI doctors diagnose chronic pancreatitis based on the trypsinogen levels alone. The only way the changes in my pancreas could have reversed is if God healed my pancreas. I hope that God heals me.

I am really frustrated now. I still have abdominal pain after I eat greasy food and this pain goes through my back. I have chronic nausea. My stool is covered in something that looks like a white glaze and my stool really floats on top of the water now. I have to use a plunger to hold down my stool just to flush it. When I go to the ER with abdominal pain, the ER doctors look for the amylase and lipase levels to be in the thousands to diagnose pancreatitis. My amylase and lipase do not elevate anymore, but they elevated in the thousands when I first got sick with pancreatitis. Some of my blood sugar numbers are high now too.

What should I do now doctor? Do you think I should have a MRCP done on my pancreas? Would the MRCP show changes in the pancreas like an EUS shows parenchymal changes in the pancreas? Should I still see a pancreas specialist? I look forward to hearing back from you doctor, Have a nice day!

Thank you Dr. RK for your opinión. I have another question. Is it possible for several EUS's to shows changes in the páncreas and then another EUS show no changes to the páncreas? Are changes in the páncreas that show up on an EUS irreversible? You mentioned that the EUS is the best test to diagnose chronic pancreatitis. Should I even get a MRCP at all or should I just have another EUS?

Additional question - Is the trypsinogen test an accurate and reliable test for diagnosing chronic pancreatitis based on the pancreatic function? My trypsinogen test number is getting lower and lower. It is now 7 or lower? Does that mean anything?