Slone’s Disease

Circa 1996 – Medical researchers from three universities are combing the family’s DNA in a high-tech search for the cause of — and a possible cure for — the mysterious ailment that some in this slice of southern Pike County used to call “the Slone’s disease.”

Medically, it is known as hereditary pancreatitis, an inherited, incurable disorder in which the pancreas, instead of producing enzymes crucial to digestion, tries to digest itself, says Dr. Lawrence Gates, a gastroenterologist at the University of Kentucky and one of the investigators on the project.

Hereditary pancreatitis is caused by a mutation in a particular human gene, which is passed from parent to child. The gene has never been identified.

Gates and colleagues at the University of Pittsburgh and the University of Cincinnati hope to find that gene by studying members of the Rose, Puckett, Sweeney and Belcher families. These families are thought to be part of only 100 families in the world that carry the genetic mutation, and therefore are plagued by hereditary pancreatitis.

After a year of work, and tracing the families back through eight generations, the gene hunters might be closing in on their quarry. Last month, the Pittsburgh third of the research team announced it had narrowed the search for the pancreatitis gene to a tiny segment of chromosome seven (human cells contain 23 pairs of chromosomes).

Armed with that information, scientists can tell with 95 percent accuracy whether a person has inherited the pancreatitis gene, even if the person has no symptoms, says Pittsburgh’s Dr. David Whitcomb, chief investigator on the study.

Finding the gene itself would make it possible to predict pancreatitis even more accurately, and provide genetic counseling for these family members who might fear passing the gene to their children. In the long run it might lead to a cure.

The families, still somewhat surprised to find themselves the focus of a major scientific study, are keeping their fingers crossed.

“They tell us this research is mostly for the kids coming up, the ones who haven’t had symptoms yet,” said Bobby Slone, 49, who operates a sporting goods store in Elkhorn City. “I don’t know how that would affect our son, since his pancreas is already scarred. But maybe a treatment would keep him from having more attacks.”

Bobby’s son disease was not firmly diagnosed until he was examined at Cleveland Clinic in Ohio. “They started talking about hereditary pancreatitis, and we said, `What’s that?’ ”

At the clinic’s suggestion, Bobby began asking relatives if they had ever had serious stomach problems. He began a chart, tracing his own family tree. When he found someone who’d had stomach complaints, he underlined the name in green. Soon, green sprouted all over his homemade chart.

“When I saw that, I didn’t need any doctor to tell me it was hereditary,” Bobby said. “Every time I found somebody who’d had stomach trouble and traced them back, they were always related to a Slone. When I showed them the chart at Cleveland Clinic, they just couldn’t believe it.”

Cleveland Clinic had wanted to study the Slone family, but the plan fell through. Nothing happened until the winter of 1994, when their son Kevin checked into University of Kentucky Hospital to be treated for one of his periodic attacks.

And when the phone rang in Larry Gates’ office with word that a young Eastern Kentuckian named Slone was in the hospital with hereditary pancreatitis, he almost leaped out of his chair.

Gates and Pittsburgh’s Whitcomb, who were old friends, began organizing a study of the Slone family, with researchers from the University of Cincinnati joining in, aimed at pinpointing the pancreatitis gene.

As a first step, Bobby Slone arranged a family picnic on Memorial Day 1995 so researchers from the three universities could interview family members, take blood samples and run tests. At a follow-up picnic this Memorial Day, the scientists reported to the family on their progress.

Diet

I distinctly remember a weekend while in high school that mom and dad were gone and I was home alone.  Craving something sweet I found the perfect solution, chocolate pudding. Yes, I ate the entire pot and yes it triggered a HP attack!

Why is a proper diet so important to reducing HP attacks? The primary function of the pancreas is to produce insulin which regulates your blood sugar.  The second function the pancreas preforms is it creates digestive juices that assist in breaking down nutrients that the stomach’s acids weren’t effective at metabolizing.  The digestive juices start out alkaline in the pancreas, but when they meet substances bathed in stomach acid in the duodenum, they become acidic. These enzymes include lipase, which digests fat and protein, and amylase which digest carbohydrates.

Lipase and Amylase, Oh My!  If lipase helps digest fat and protein and amylase helps digest carbs, what can we eat?  The goal of a good HP diet is to eat foods that will keep the pancreas from working too hard. For many of us, our pancreatic duct(s) (the minor duodenal papilla and major duodenal papilla) are blocked and the lipase and amylase build up in our pancreas and are unable to escape.  High levels of both lipase and amylase are detected in our blood during an attack. Eating certain types of food will trigger the pancreas to excrete the two enzymes and we need to avoid or greatly reduce these foods.

There are many “Pancreas Friendly” diets out there along with recipe books geared for the pancreas. So what does a pancreas diet look like, it’s simple, low fat.   First, let me make this perfectly clear, NEVER EVER drink alcohol if you have HP! Some other things we should avoid are spicy foods, pizza, eggs, cheese, fried food, bacon, sausage, butter, tea, sugar and coffee.  Some good foods are baked potatoes, brown rice, pasta, fruits, vegetables, soups, salads, whole grain breads and high fiber healthy cereals like oatmeal are excellent. Limit dairy to yogurt and low fat milk such as skim or 1%. Personally, I would avoid dairy as much as possible.

Stress

Having Hereditary Pancreatitis for 53 years has provided me with real experiences that many doctors can’t speak to.  I personally have attributed many attacks to stress and some were within minutes of becoming stressed.   The medical community does not directly associate stress with causing HP attacks.  Their explanation (scientifically speaking) is some of the affects stress has on the body can, one of which is dehydration.  When one is stressed, most often their focus is not on proper hydration but on the situation which caused the stress. This is not only true with proper hydration, but other things such as poor eating habits, lack of sleep, high blood pressure, and even self-destructive tendencies. In an article written by Kathianne Sellers R.D., she states; “Proper hydration is important in the health of all people, but especially for people with chronic pancreatitis. While many people with chronic pancreatitis are aware of the need for fat restriction, few are aware of the need for adequate hydration. Many of our patients at The Pancreas Center at Beth Israel Deaconess Medical Center, in Boston, MA have flares (increased pain) when they are dehydrated. While the exact reason is not known at this time, it is assumed that the lack of fluid assists in the accumulation of pancreatic sludge. This sludge can then lead to blockages which can irritate the pancreas.”

I get stressed when the doctors tell me I am a drug addict.  I get stressed when I am asked how much alcohol I consume.  I get stressed when doctors tell me my enzyme levels are normal and I should not be in pain.  I get stressed when I see my daughter and grandson suffer from HP. I get stressed when I know more than the physician treating me in the emergency room.  Am I crazy or arrogant, no but I am not stupid either.  Why is it that a doctor can scientifically dispel what we know is true?  We are going to have stress and stress will cause attacks, so what can be done to reduce the stress?

For me, I listen to my body and when I have reached the edge, I stop everything and do something I enjoy or that relaxes me. Each of us must find that “Something” we can do or “Place” we can go to separate us from the situation that is causing us stress.  For me, a camping trip, fishing, listening to music and yes a movie can do the trick. For others, just talking to a friend, talking to their minister and yes even a professional counselor can help. Stress is something that affects everyone and is unavoidable, how we deal with will keep us from getting sick.

Whether your stressed or not, don’t forget to drink lots of water!