Dear Dr. B: When you have pancreatitis does it show up in a urine test? My son was having urine problems. He could not control it. He was seen at walk-in clinics and by his doctor and the urine test did not show anything. Then he turned yellow and he was seen by a doctor in emergency department. My son was diagnosed to have pancreatitis. It took a month for the doctors to make a diagnosis. My son survived but I am disappointed that it took so long to find out what was wrong with him.

Answer: The best way to discuss this question is to talk about pancreatitis in general and then talk about diagnosis and treatment. The information provided in the question is not sufficient enough to know why it took so long to make a diagnosis. Urinary frequency is not a classical presentation of pancreatitis.

The pancreas lies in the upper abdomen behind the stomach. Its function is to produce digestive enzymes and hormones such as insulin.

Pancreatitis is a chemical inflammation of the pancreas caused by its own digestive enzymes. Pancreatitis has two forms: acute and chronic. Most common causes of pancreatitis are gallstones and alcohol abuse. Sometimes no cause can be found. That leaves the patient and the doctor frustrated.

Patients with acute pancreatitis present with abdominal pain, nausea, vomiting, fever, and a rapid pulse. The diagnosis is made by a blood test to measure blood level of enzyme lipase. All pancreatitis patients require intravenous fluids, oxygen and pain killers to stabilize their condition. If the condition is due to gallstones then the patient will need surgical removal of the gallbladder.

An abdominal ultrasound is taken to look for gallstones and a CAT (computerized axial tomography) scan to look for inflammation or destruction of the pancreas. CAT scans are also useful in detecting cyst formation in the pancreas.

In about 20 percent of cases, acute pancreatitis can be severe, with many complications. Severe cases may cause dehydration and low blood pressure and the condition may become life threatening. The vital organs such as heart, lungs, or kidneys may fail. If bleeding occurs in the pancreas, shock and sometimes even death follow.

Chronic pancreatitis can present as episodes of acute inflammation in a previously damaged pancreas. There is intermittent or persistent abdominal pain. The chronic destruction of pancreatic tissue causes malabsorption of fat and diabetes.

Chronic pancreatitis is most often caused by alcoholism and alcohol abuse. Sometimes the cause of chronic pancreatitis cannot be determined. But any condition that causes repeated episodes of acute pancreatitis may result in chronic pancreatitis.

A quote from my friend George:

“Youth is not a time of life; it is a state of mind.” Anonymous.

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