HomeAnswersMedical Gastroenterologysystemic lupus erythematosusWhy do I have persistent discomfort after undergoing ERCP?

How can a patient with SLE and ampullary stricture overcome abdominal pain and discomfort after undergoing the ERCP and stricture dilatation surgery?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

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Published At October 11, 2022
Reviewed AtOctober 9, 2023

Patient's Query

Hello doctor,

I am 24 years old. I was diagnosed with SLE ten years ago. I have stomach pain now. The MRCP showed a stricture at the ampulla, so ERCP and partial stricture dilatation were done. Still, l have discomfort. Now amylase and lipase levels are normal. I am taking enzyme supplements.

Answered by Dr. Ghulam Fareed

Hello,

Welcome to icliniq. com.

I have reviewed your case history and attached investigations (attachments removed to protect the patient's identity). There were features suggestive of chronic pancreatitis and ampullary stricture dilated during the surgery. It is great that your current amylase and lipase levels are normal, but it is also important to find the cause of your chronic pancreatitis. I am sure your physician must have done some workup related to that. Unfortunately, sometimes chronic pancreatitis is idiopathic, and we cannot find the cause. Still, if one can establish the underlying cause, a specific treatment can be done to improve the symptoms. I suggest you continue taking enzyme supplements for the management of SLE (systemic lupus erythematosus). If they have established that chronic pancreatitis is also a sequence of SLE, then it should improve with time.

Patient's Query

Thank you doctor for the reply,

Can it be related to autoimmune pancreatitis?

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

Yes, recurrent abdominal pain and pancreatitis are associated with the above two conditions. Therefore, MRCP (magnetic resonance cholangiopancreatography) and ERCP (endoscopic retrograde cholangiopancreatography) are excellent investigations for diagnosing pancreatic divisum. One should think of this for sure, but there are other causes as well. You can find a complete list of the causes online.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

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