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Question

A few years ago, my mother was diagnosed with a calcified formation that does not accumulate contrast, which was suspected to be echinococcus. Almost a year ago, in October, my mother fell seriously ill—she could not eat anything and could only drink water. Initially, the doctors suspected the echinococcus formation. An ultrasound with contrast was done, after which the doctor diagnosed her with pancreatitis. IV treatment was prescribed, similar to the one prescribed now, except with a different antibiotic and for a longer duration (I’ll attach the details further down). The treatment helped, and a strict diet was followed—if she ate even a spoonful more, the pain would return, though not as severe as before.

In March, after eating a small piece of turkey kebab without spices, she experienced a severe attack, and after 5 days of IV treatment, she recovered.

Three weeks ago, she caught a cold (acute respiratory viral infection) and took Ajisept lozenges. After that, she had another attack. She contacted the doctor, and they started IV treatment again with complete fasting. From day 1 to 3, there was improvement, but on the evening of day 4, her condition worsened. Today is day 5, and after eating a few spoonfuls of liquid oatmeal in water, her symptoms returned. She is very weak, in pain, and mostly sleeping.

The IV treatment consists of:

	•	Aprotex or Gordox or Kontrical: 2 ampoules in 400 ml saline, once a day.
	•	Octreotide 100 mcg, 1 ml, three times a day, subcutaneously.

Additionally, during one attack, Ceftriaxone was prescribed, and three weeks ago, Cefazolin was given since her leukocytes were elevated twice.

On October 5th, she was admitted to surgery at BSMP, where more glucose was administered, and injections were given as before. An ultrasound revealed stones in her pancreas. She was discharged on October 9th, and her condition was more or less stable.

However, on October 14th, her pain and fever returned. We went to the regional hospital for a consultation, but they refused to admit her. Today marks the 3rd day of treatment since then, and her condition has worsened again. Yesterday, she managed without painkillers, but today she’s in severe pain, running around the house.

Please help—what should we do? Why are we seeing this pattern despite the treatment?

Dr. Surya Bhagwati · Accepted Answer

Hello Meera, It sounds like your mother is dealing with a very complex and recurring condition that likely involves chronic pancreatitis or a similar severe inflammatory issue in the pancreas, along with possible complications such as pancreatic stones and a past suspicion of echinococcosis. The fact that her condition worsens despite treatment, and that there are recurring episodes of severe pain following even minor dietary deviations, suggests that her pancreatitis is chronic and perhaps complicated by other factors like infection, stone formation, or past echinococcal infection. Pancreatic stones can block the pancreatic ducts, causing pain, inflammation, and poor digestion. When the pancreas is inflamed, it cannot release digestive enzymes effectively, leading to pain after eating, even small amounts.
The recurrence of severe pain after dietary changes (like eating turkey or even oatmeal) is typical of chronic pancreatitis, where the pancreas is extremely sensitive to any dietary load.
 Aprotex (aprotinin) and Octreotide, aim to reduce pancreatic enzyme secretion and inflammation, but these medications are often only short-term solutions.
Infections such as those requiring Cefazolin and Ceftriaxone suggest that secondary bacterial infections might be occurring during these acute attacks, which can worsen the inflammation and her overall condition.
The stones in the pancreas are concerning, as they can continually aggravate her condition by blocking the flow of digestive enzymes, leading to repeated attacks and infections.
Even though her pancreas is healing during treatments, any deviation from a very strict, low-fat, low-protein diet could immediately trigger another attack due to the pancreas's inability to manage even small amounts of food.
Chronic pancreatitis can lead to ongoing damage to the pancreas. Once the pancreas is inflamed and has stones, it becomes highly vulnerable to repeated inflammation.
The presence of stones suggests that her pancreatic ducts might be blocked, preventing proper drainage of digestive enzymes and causing a buildup of pressure and inflammation.
 It’s critical to have her re-admitted to a specialized medical center, particularly one with expertise in gastroenterology and pancreatic surgery. If the current hospital is refusing admission, consider seeking care at a larger, more specialized center where they may have the tools to treat chronic pancreatitis and its complications effectively.
 If her stones are significant, an ERCP (Endoscopic Retrograde Cholangiopancreatography) or even surgery may be required to remove the stones or create better drainage of the pancreatic ducts. These procedures can alleviate the blockages and reduce the frequency of these attacks.
If her condition is not improving or if there is a lack of specialist care at her current hospital, it’s essential to seek referral to a higher-level center with expertise in pancreatic disease, where they may offer more advanced diagnostic tools (like MRI, ERCP) or even surgery if needed.

Dr. Maitri Bhavesh Kumar Acharya · Answer

I'm sorry to hear about your mother's health challenges. Given her complex condition, particularly the history of pancreatitis and suspected echinococcus, it’s crucial to approach her treatment comprehensively. In Ayurveda, pancreatitis is often linked to an imbalance in the Pitta dosha, which governs digestion and metabolism. Symptoms like pain, weakness, and food sensitivity indicate aggravated Pitta, leading to pancreatic inflammation. To support her recovery, a few dietary adjustments can be beneficial: she should consume warm, light, and easily digestible foods such as rice congee, moong dal khichdi, and well-cooked vegetables, while avoiding spicy, oily, and heavy foods. Staying hydrated with warm water or herbal teas is essential. Herbal remedies like Bhumyamalaki can support liver and pancreatic health, turmeric can reduce inflammation, ginger may assist with digestion, and Triphala can promote detoxification. If appropriate, Panchakarma therapies such as Basti (medicated enemas) and Shirodhara (oil therapy) can be considered under the guidance of a qualified Ayurvedic practitioner. Lifestyle modifications, including adequate rest and stress management techniques, are also crucial. Given her history and current symptoms, maintaining close communication with her healthcare providers is essential. If her symptoms worsen, seeking a second opinion or hospitalization for intensive care might be necessary. While these Ayurvedic treatments can provide relief and support overall health, they should complement her existing medical treatment rather than replace it. Please consult a qualified Ayurvedic practitioner to tailor these recommendations to her specific needs and condition.

Dr. Ravi Chandra Rushi · Answer

It really sounds like you’re going through such a tough time with all this back-n-forth, and I can only imagine how stressful it's been for your mom and the whole fam. Based on what you've shared, it seems like your mom might be facing complications related to chronic pancreatitis or possibly biliary-related issues like gallstones or pancreatic stones. Her symptoms, like pain, weakness, and flare-ups, can be related to these issues. Now, I don't knw if I can give full medical advice like a doctor in person, but let's look at what might be happening and also explore some Ayurvedic perspectives.

First off, considering the chronic nature and recurring crises, making sure she gets access to immediate medical attention seems crucial. If her pain persist or worsens, it's so important to seek help at an emergency facility even if it previous visits have been unfruitful.

From an Ayurveda lens, the digestive system is quite central, with the concept of "agni" or digestive fire being core. When it's off balance, it can lead to accumulation of "ama" or toxins. It seems her "agni" might have been compromised over time from specific diet triggers, stress or even maybe lingering illness or infection. Keeping a simple, bland diet that avoids heavy fats, spices, and hard-to-digest foods could be essential. Medicated fasting, with very controlled intake, can possibly help. She can sip warm water through the day to keep the digestive system clear, but ensure all additions are in consultation with her doctors there.

Simple meals like kitchari—rice and moong dal cooked soft—are often advised in Ayurveda during digestive issues. Spices like cumin or fennel can be nice in small amounts but again, checking in first is good. Also, ginger tea can sometimes help enhance digestion, but with her condition, any new addition should be careful.

Paying attention to rest is important too. Stress impacts digestion a lot, and just having that time to recover and reset might assist somewhat.

But all things aside, heavy reliance on Ayurveda should and must be complementary. Priority here should be resolution of underlying medical issues—think pancreatitis, stones, or potential infections. That really would involve close cooperation with medical professionals nearby. Ayurveda is about sustaining once the immediate health threats are under control.

Remember, its okay, though frustrating, to seek a second opinion or different perspectives if care requirements aren't fully aligning with your mom's needs. Keep close tabs on any sudden change of patterns, fever spikes or prolonged pain —medical interventions should be robust and adaptable there, right?

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