Gallstones can trigger pancreatitis
DEAR DR. DONOHUE: Last month, I got a sudden, severe attack of stomach pain that doubled me over. My wife drove me to the hospital, and the emergency-room doctor thought I was having a gallbladder attack. He called for a surgeon. After much thought and many tests, the surgeon said I didn’t need an operation. He said I had an inflamed pancreas due to a gallstone. I was put on IV fluids, and the next day I began to feel better. By the third day, I was fine. I don’t understand any of this. What happened to me? — R.F.
ANSWER:
You did have a gallstone. It migrated out of your gallbladder and into a duct that the gallbladder shares with the pancreas. Lodged in that duct, it blocked the egress of pancreatic enzymes out of the gland. Those enzymes started to digest the pancreas. You had pancreatitis from a gallstone that interfered with pancreatic drainage. This is a common cause of acute pancreatitis.
This condition can be mild, or it can be most agonizing and prolonged. You were lucky. The obstructing gallstone moved out of the duct and into your intestine. Then the pancreatic enzymes could leave the gland without damaging it. If the stone hadn’t moved, then a doctor would have had to retrieve it with a scope passed into the small intestine through your mouth.
Gallstone blockage of the combined pancreatic-gallbladder duct is only one cause of acute pancreatitis, and it’s a very common cause. Excessive alcohol, high blood calcium and infections are some of the other causes of pancreas inflammation.
A mild case of pancreatitis subsides with intravenous fluids and resting the gland by not eating. One bright spot to your story is that such an attack of pancreatitis doesn’t usually recur.
DEAR DR. DONOHUE: I’d like some information on angina. Is it related to a heart attack? What medicines are given for it? How do they work? Is heart surgery ever done? — M.L.
ANSWER:
Angina is chest pain that comes on when a person is active and goes away when that person stops the activity. It comes from heart arteries that are partially plugged with plaque — the buildup of cholesterol, fats and other materials. Plaque obstructs the free flow of blood to the heart muscle. When a person is active, the heart has to beat harder to provide more blood to the working muscles. Clogged arteries don’t permit an increase of blood flow to the heart. That’s responsible for the chest pain of angina. The heart is voicing disapproval for this extra work. Angina isn’t a heart attack, but it can be a prelude to one if action isn’t taken to increase blood supply to heart muscle.
Medicines work by dilating the clogged heart artery or arteries. Other medicines slow the heart so that it doesn’t have to work so hard. If you’re a smoker, you must stop smoking. You have to lose weight if weight’s a problem. Your blood pressure has to be controlled, and you have to go on a diet that emphasizes fruits, vegetables and whole grains.
Heart surgery is sometimes done for angina; it’s the same kind of surgery used for heart attacks. The blocked arteries can be opened with a balloon; often, at the same time, a stent is put in those arteries. A stent is a device that expands to keep the artery wide open. Not all cases of angina, however, require surgical treatment.
The booklet on coronary (heart) artery disease explains angina and its treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S/$6 Can. with the recipient’s printed name and address.
DEAR DR. DONOHUE: Is it OK for someone with lactase deficiency to drink soy milk? — R.K.
ANSWER:
Yes, it’s OK. Soy has no lactose, milk sugar.
The intestine has lactase, an enzyme that digests milk sugar, lactose. Many people, as they grow older, lose much of the lactase enzyme. They become intolerant of milk sugar. It causes them to bloat, get stomach cramps and come down with diarrhea. Milk pretreated with lactase is tolerated. Taking lactase pills with dairy products also works. And not all dairy products provoke a reaction. Yogurt doesn’t usually lead to symptoms, and many lactase-deficient people can digest ice cream.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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