Why do I have stomach discomfort despite treatment for SLE?

Question

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.

Please help.

Thank you.

Answer 1

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.

Thank you

Answer 2

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.

Thank you