Pancreatitis: Symptoms, Causes, Treatment, Pathophysiology [Nursing, USMLE]

Pancreatitis acute vs chronic pain, symptoms, location, treatment, diet, diagnosis, pathophysiology for nursing, USMLE, NCLEX, and medical learners!
Learn the difference between acute vs chronic types of pancreatitis, along with common causes including gallstones, alcohol, high triglycerides (fats), and more.
Review of the signs and symptoms of pancreatitis, along with the diagnosis and treatment including diet modifications, gallbladder surgery, and more.
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Timestamps:
00:00 Intro
00:40 What is Pancreatitis?
2:17 Acute vs Chronic Pancreatitis
4:11 Causes of Pancreatitis
5:10 Symptoms of Pancreatitis
6:11 Signs of Pancreatitis
7:01 Diagnosis of Pancreatitis
9:37 Treatment of Pancreatitis
10:44 High-Yield Learning Points
Thanks for watching!

[@ezmed]

🔸Lecture: www.ezmedlearning.com/blog/pancreatitis-causes-symptoms-diagnosis-treatment 🔸Study Guide: www.ezmedlearning.com/store/p/pancreatitis-study-guide 🔸Membership: www.ezmedlearning.com/member-area-study-guides 🔸Tutoring: www.ezmedlearning.com/medical-tutoring-services-online

[@olsonbrandon91]

I'm so sorry for anyone who is suffering with this.. I have only recently learned about it and got myself checked out due to pain I was having.. I seem to be fine but seeing people's stories on here I just want you all to know that I hope you feel better and get relief :(

[@jenniferkincaid6148]

The worst thing about chronic pancreatitis besides the PAIN is people thinking you're faking because they only see you when you're having a good day.

[@davidbarlow431]

Yep, had that and even more annoying is people who dismiss it as stomach ache.

[@CortezMusical]

I am guilty of telling my daughter she was overreacting when in fact she had pancreatitis, 😢

[@Dr4gonGirl319]

Ppl do that with M.E./CFS too. Because thaty see you for a hour on a good day they just don't understand the pain and exhaustion !Pancreatitis is almost as bad as natural childbirth. 😢

[@kennethjanczak4900]

It hurts like nothing else. I got 5 shots with fentanyl in the ambulance and it didn't help at all. I would prefer to have my leg ripped off instead of having pancreatitis again... Thanks for taking the time to make the video and share it.

[@ezmed]

No problem! I hope you're doing better! 🙏🏻 If you're still having issues remember this video is for educational purposes only and to see your provider. But I hope you're fully recovered! 👍

[@laceybanter5937]

I totally agree

[@kennethjanczak4900]

I'm ok again, thanks for asking... But i have to admit that i really didn't know, that there is 15 to 20 % mortality rate with pancreatitis.....thats scary to think about.... Well....to put the pain into some kind of perspective. Imagine you get 6 to 10 really really hard punches in your stomach, a couple of kicks in the testicles, the turned around to receive 5 to 10 hard punches in the kidneys and last a couple of really hard kicks in your liver and that pain just continue for 10 or more days. Then you are getting close to the pain you experience with pancreatitis....

[@Mystomach]

Omg yes. Once you have it you will never do anything ever again to irritate it. I don’t eat red meat and after four months did and went back into pain plus high fever. Never ever will I eat red meat.

[@kristennelson2480]

Was so sudden and painful it woke me up out of a dead sleep and was vomiting from the pain! The strong IV pain meds barely touched the pain at all 😩 I don’t wish it on anyone!!

[@cindywills5003]

I had my pancreas removed in 2012 because of idiopathic chronic pancreatitis at Johns Hopkins. I was the ninth person there to have their pancreas removed and islet cells harvested from my pancreas. The doctor placed my islet cells in my liver and I am still not a type 1 diabetic. Dr. Makary was totally awesome!

[@nickbardan3867]

Can you live without a pancreas????

[@cindywills5003]

@@nickbardan3867 you can live without a pancreas. You do need take

[@cindywills5003]

@@nickbardan3867 sorry, I hit the wrong button. Without your pancreas you need to take enzymes. In more case it’s called Creon. Most patients become a brittle type one diabetic. I started am not one.

[@nickbardan3867]

@@cindywills5003 wow. How long ago?

[@cindywills5003]

@@nickbardan3867 I had it done July 2012

[@helenclaydon-goldstein1061]

Anybody else get excessive sweating day and night?

[@nonamecommonsense9089]

I enjoyed this video. Well done. Very systematic and clear.

[@ezmed]

Awesome! 👏 Glad you liked it!

[@ephremmaetoraanifaegia563]

Very informative. Thank you and God Bless you

[@ezmed]

Glad it was helpful! 👍

[@Mystomach]

This is the best video I’ve ever seen about pancreatitis.

[@ezmed]

Awesome, that means a lot! 🙏🏻 Glad you liked it! 👏

[@namwiingamwiinga3884]

Thank you so much doc, I've really understood the topic ❤

[@chanelv5373]

Excellent video! Thank you.

[@ezmed]

Appreciate it! 👏 Glad you liked it and thanks for watching! 🙏🏻

[@dawndalydardick7354]

EXCELLENT INFORMATION.EASY TO UNDERSTAND CLINICAL FACTS.THOROUGH.

[@ezmed]

Thank you 🙏🏻 Hope you learned something!

[@gopalanantwar]

Genuine video, thanks and appreciated ...

[@ezmed]

Appreciate the comment and you watching! 🙏🏻 Glad you liked it!

[@comfortnehemsmubanga6094]

I've just discovered you, and it has been really helpful.

[@ezmed]

Welcome to the channel! 🙌 Glad it has been helpful!

[@ginapetras8696]

Very informative , thank you.

[@ezmed]

Great to hear! Appreciate you watching and dropping a comment 🙏🏻

[@gwillis01]

Thank you for an informative video

[@ezmed]

Happy to hear it was informative, thanks for watching! 🙏🏻

[@johnnyquist8362]

I just got out of the hospital about three days ago after a nasty pancreatitis attack. This vid was very helpful. I have a lot to learn. I'm looking for more info. Thank you.

[@ezmed]

Hope you are feeling better! 🙏🏻 Glad this video could provide some education. Remember this is just for educational purposes and not medical advice, so hope you and your medical providers can continue to help you get better!

[@sumahibaby3910]

Same!

[@shanepalacio6659]

I have chronic pancreatitis. And I got out of the hospital Wed that just passed. And was admitted Wed before Christmas. What a awful 7 days in the hospital. Almost ended up in the icu. I was so sick I could of died if I didn't go to the hospital in time as I did by ambulance. It was not fun and I don't even wish it on my worst enemy. It's that bad. Please take care of your body as best you can eat right don't drink alcohol. Then you should be able to take better care of your body. If you feel an pancreatitic attack get medical attention as soon as possible. I'll save your life.

[@MrYorickJenkins]

Strewth sounds awful. Do you know what brought it about?

[@davidwheatley593]

Can you have mild pain with this? Or is it always severe?

[@Charky23]

Thank you for these on point educational videos.

[@ezmed]

No problem, glad you like them! 🙌

[@gonnfishy2987]

DEFINITELY!

[@ezmed]

@@gonnfishy2987 Appreciate it! 🙏🏻

[@sophieamirian6726]

THANK YOU SO VERY MUCH FOR YOUR INFORMATIVE VIDEO ❤

[@ezmed]

You bet! 👌

[@anette5468]

This was very helpful 👍🏻

[@PinkButterFly247A]

Thank you this really did help

[@ezmed]

Thanks for watching, glad it helped! 👏

[@bradleysmith3009]

My recent CT scan revealed "numerous pancreatic calcifications consistant with PRIOR pancreatitis". Never ever have I had any pain or trauma for even acute pancreatitis let alone chronic. My PCP consulted a GI specialist who said "only come in if you have pain and highly recommend to stop smoking." (lifelong smoker) I've been on statins and 1 blood pressure med 16 years and read Statins and blood pressure meds can lead to pancreatitis, as well as autoimmune disease which can lead to pancreatitis. This all has me stumped and Doctors response has been minimal. How can you have these calcifications if never any symptoms? Any comments with knowledge would be appreciated.

[@evalineponi3364]

THANKS FOR THE GREAT LECTURES. but i would like to know what health education can i give to a patient with acute pancreatitis who was put on a nil per oral, on the role of pancreatic enzymes on food digestion.

[@susanhaynes348]

Acute pancreatitis is really a serious diagnosis. As the head of a really large Pathologist Lab and a 14 year survivor of chronic pancreatitis and living a life of hell I would suggest the patient should start studying both acute and chro nic pancreatitis. And I mean study. It's one of the most important things you can do. Right now if she has acute she should rest completely for at least 5 days or until her tests show she is getting over it. Since she had this attack and not knowing if it was from a ERCP she had or if she smokes or drinks my first advice is to never smoke or drink alcohol And if she knew she was susceptable to this disease believe me it is a living hell. I was the luckiest person alive to have the world's most famous doctor and surgeon to save me .The number one hospital is Indianapolis University Research and teaching Hospital. My surgeon Dr. Glen Lehman you can look him up on the internet has a suite there. The doctors he taught are there. You are going to find out not many doctors know about how to treat this. When I got my first acute pancreatitis My surgeon kept me completely sedated and on pain medication thru IVs for five days until I pulled out of it. When you look him up you will see he has taught in 15 countries and has published hundreds of papers on this subject. He's been on the cover of Newsweek. He is the top surgeon and doctor on this subject. This is going to be rough if it turns into chronic pancreatitis and is the most difficult thing to diagnose. Because it doesn't always show up in tests. If this happens to you again and turns into Chronic you will want to know everything about it. I wish you the best. .

[@christineprice2411]

My pancreatitus is caused by opioid drugs which send the sphincter of Oddi into spasm. Still very painful and resulted in hospitalisation.

[@dknohoward6933]

God Bless you & your team Doc. I'm a candidate with much of the symptoms! Perhaps you could do a study on me!

[@ezmed]

Thank you! And this video is for educational purposes only, hope you feel better though and can work with your provider on it! 🙏🏻

[@dknohoward6933]

@@ezmed Absolutely. Keep on blessing folks.

[@lalithabadireddy8606]

Thank you so much sir

[@ezmed]

You're welcome! 👏

[@JamesKing2understandinglife]

Stopping my binge drinking of alcohol helped me completely and I have not had anoter episode in years.

[@ezmed]

That is so great to hear! 🙌 Congrats and glad you are doing well! Cheers to not having any more episodes! 🙏🏻

[@sallyboyd-daughtrey4515]

PLEASE don't' assume that a pancreatitis patient has been drinking alcohol if they say they have NOT! It is so rude!

[@johnnyteach8670]

I was just diagnosed with pancreatitus tonight I don't drink at all.

[@Ririboro]

Same here I don't drink and have a newborn. I had pancreatitis because of gallbstone

[@Jura_Cilean]

I am a very odd case (non-drinker and I'm not diabetic). I am a Cystic Fibrosis carrier. Didn't know it in 2017 when I was in the hospital. Along comes some genetic testing and my new MD put two and two together.

[@tarapalmer9140]

Ty

[@marieajackson1148]

Indeed...and there are several other causes!

[@amandawilliamson3725]

This is the second time I’ve had pancreatitis or diagnosed. I don’t have vomiting or diarrhea, just high liver enzymes and lipase enzymes are high. I’ll get a sever attack of pain, no inflammation after the scans are done or lesions on pancreas or liver.

[@wisewoman5245]

I know someone that had acute Pancreatitis, vomiting, just in pain. No inflammation after scans, he now has to see specialists, due to the abdominal pain....

[@m_m786]

Great 👍🩺👍

[@Namri]

When you mention smoking, what about smoking could contribute to pancreatitis? I’m guessing the general inflammation it can cause but does nicotine have a specific role? So would vaping also be included in “smoking”?

[@Seanyhwh-qu4sb]

never had problems till i had 2nd colonoscopy.

[@lilygarcia5668]

I regret my colonoscopy,everything is different

[@joyclark6192]

I’m not a drinker- I’m a sugar comfort eater😩😩😩now I have this.

[@rr1621]

My 70 year old sister just died of acute pancreatitis 5 days ago. She also was positive with covid . They also found a blood clot in her pancreas. Her heart and lungs were fine but she was having trouble breathing they put her on a ventilator. Her kidneys were not working 100% and on the 3rd day the did dialysis. The next morning they decided to cut her open to releave the pressure in her stomach which was 4xs the normal. After opening her up , there were multiple other blood clots forming and all her intestines were dead. They had to let her go. I havent heard of blood clots to the pancreas before. We are all devastated.. has anyone else ever heard of a case like this?

[@kimwilliamson3615]

Was she vaccinated for covid previously? Lots of clot problems from that injection. (mrna)

[@rr1621]

@@kimwilliamson3615 no never. I am convinced she had a preexisting problem . Ive been told that the blood clot is a result of the pancreatitis. As well as the mutlple forming bloodclots. I think she had something developing for years.

[@kalkidangobezie4078]

i have this problem after removal gallblader help

[@HarpreetKaur-ti2xp]

Very informational video❤ I have got a CT scan which shows loss of normal pancreatic lobulations , normal signal intensity and an enlarged pancreas Is that something serious

[@bhoopathybalasubramanian9045]

Short and sweet 👍

[@ezmed]

Thanks 👍

[@jonienglish3231]

How about Pancreas ATROPHY ??? Shrinkage

[@easyenglish4154]

Is occassionally taking panzynorm N tablet safe in pregnancy

[@sallyboyd-daughtrey4515]

Porphyria is also a cause of pancreatitis and is more common than previously believed.

[@leaveittolefty]

thank you for mentioning porphyria

[@marieford5488]

What does it mean if One spot showed up on a cat scan cat scan on my pancreas I was told it's very small like the tip of a ballpoint Pin should I be concerned

[@Mystomach]

Don’t drink alcohol. No red meat. No animal fats. Keep it healthy

[@fernandochiquette8716]

I have had chronic pancreatitis for at least 24 years I used to drink before that and just recently I hadn't had any attacks and I had one ended up in the hospital and they had me waiting for over 6 hours they denied pain medicine and they put me on the wheelchair and told me if I did not stop complaining that they would actually throw me out of the hospital and I sit what is wrong with you people you do not know a damn thing about pancreatitis the pain is so horrible he kept asking me if I was drinking right before I came to the hospital or how long how you had been drinking and I just felt like they were just denying me from getting admitted I was headed to work at a ranch when I started feeling the pain so I went to a sister's house cuz I have my dogs and my sister looked at me and said you look terrible you look yellow you look jaundiced so I could not stand the pain so she drove me to the hospital and I told her to go ahead and leave me there. She had to work next day early in the morning that was a Big mistake it was not till they did my blood test that they figured out that my liver was not working properly and my enzymes and my white blood cells were all out of whack and they finally said oh my God you know it's like you are having a pancreatitis attack I was treated horribly before the doctor saw me so I don't know what to do I feel like filing a complaint with a medical board what are you recommend does anyone know anything about that please any advice would help thank you and God bless you all that suffer this horrible pain horrible disease just because you have horrible stomach pain does not mean that you're a drug addict or you're an alcoholic I've been a successful businessman since I was 22 years old and here they are treating me like I was some poor drunk from the street HELP

[@RashihaYXE]

Sir my daughter she is at 18 years old now she affected by acute on chronic pancreastitic Please tell us is it continue for long term . Here in India tamilnadu . Doctors tell us the pain & problem will be rise often how can u help us

[@aleasndroperes4870]

you save humans lifes thank you

[@ezmed]

You're welcome! 👍

[@fleadoggreen9062]

Mine was from way too much alcohol over a week long,when I finally stopped my stomach started hurting after about an hour snd lasted about 30 hours of super bad pain, it hurt so bad non stop Nothing helped ,no way I could sleep, I knew if I had a few beers it would help a little but also prolong it, it’s been about 40 hours , a lot better now if I could fall asleep I should be almost outta this , hope I never drink beer again

[@double_joseph327]

Is the pain on your right side?

[@bluewave7120]

Are the symptoms the same for type 1 and type 2 ?

[@elandrahovisjones8154]

I have severe pancreatic symptoms. I usually am in hospital once a year so far for these attacks. The last bout I had they did blood transfusions. They wanted my diet changed, and then I got cirrhosis of the liver, they'll be checking that soon, pain bad whatever your body chooses, ya know? I've held my head partially high, now I'm tired, tired of being tired, and no one should criticize, make fun, talk about what they nothing about, karma has a way of getting things turned around. Pray and find others that will be their for you and all for people like us, we're people too did ya know? We are just in pain and want it too stop, even if just for a day, ok?

[@bluewave7120]

@@elandrahovisjones8154 Agreed..I feel for you and best wishes for you always.

[@tommytwogloves16]

You completely missed traumatic chronic pancreatitis. Blunt trauma causing retroperitoneal damage and in my case six vertebrae fractures LI-L-6. I don’t drink much and I never smoked. These causes are antiquated. There is also a genetic predisposition to CP. Please update your material. Thanks.

[@ezmed]

Thank you for the comment. You are correct that trauma and genetics are potential causes. Both of these were listed in the video as causes and were not missed. Gallstones, alcohol, and hypertriglyceridemia are still the most common causes as discussed in the video. Smoking is not a cause. It is a risk factor as mentioned in the video. Hope that helps! 🙏🏻

[@missyannp36]

I had my gallbladder removed years ago due to gall sludge. I have the symptoms of pancreatitis but wasn't sure if this is possible without a gallbladder?? I'm going to end up at the hospital this weekend from this pain. I have never been a drinker, smoker, but I am on a bunch of medication due to a chronic illness.

[@gopalanantwar]

This can be a study case . Regular medication may cause , behave, uncertain. Which medicines being bunched explain and ask guidance to the author.

[@nonamecommonsense9089]

Hi, Melissa, I had gall stones removed in the last century. :-) I think that pancreas might work harder with no support of gallbladder. I have discovered that the pancreas needed regulary serving food otherwise it got lazy stopping to product insuline etc. So instead of eating twice a day I eat 5 times a day. My pancreas is happy, no painful signals, no other symptoms.

[@quinnrivera5075]

I had my gallbladder removed 2 years ago. Had acute pancreatitis 2 months ago. So yeah you can get it even if your gallbladder is removed.

[@jenniferkincaid6148]

I was miss diagnosed for years. All my symptoms were clear but they never considered pancreatitis because of my age. They almost killed me by their assumptions.

[@salvadorestrada5021]

Does Acute Pancreatitis surgery cause diabetic for people who were not diabetic before?

[@samanthaporter6662]

Mt mom got pancreatitis from drinking too much, had surgery.... Kept drinking till she killed herself by destroying her liver!

[@KangenAlec]

Best way fight inflammation is drinking anti-inflammatory Kangen water

[@1949LA-ARCH]

I do not drink alcohol or smoke ! CREON and ZENPEP gives me headaches from hell, increases my tinnitus causes severe stomach pain. I stopped the PERT pig enzymes. I eat a low fat diet several times a day plus take fat soluble vitamins. I have an appointment in January 2023 with a pancreatic doctor at Johns Hopkins Hospital. I do not have any of the CAUSES you mention.

[@mvbroz1450]

Are u chronic pancreatitis

[@leaveittolefty]

how didnyour Jan 2023 appt go?

[@gladiatorxxx7520]

I got chronic pancreatitis after covid. Don’t Drink,no smoke. For me covid was the trigger, But no one talk about it, this will be very common issue for ppl whom got infected with covid.

[@sallyboyd-daughtrey2034]

Me too! Exactly! COVID CAUSES PANCREATITIS!

[@gaelle4328]

Jupp, same here. Don’t drink or smoke and have a collegue who also doesn’t in her early 30’s we both got covid me twice long covid and after that.

[@gladiatorxxx7520]

Make sure you guys check the hot pepper,like jalapeño or habaneros,cerramos This help me a LOT to tolerate food, because I was loosing so much weight, from 180 to 127, now I am get it back a few pounds, but that’s a gain for me! God help us this ugly thing ,called pancreatitis !!!

[@rathey7999]

Or it could be the shot. The mnra shot isn't staying localize and settling where it shouldn't.

[@lorizeimet1192]

@@rathey7999 no before shot

[@Ririboro]

I had pancreatitis due to gallstone. Now that I have removed my gallbladder. Will it get healed completely. Don't know

[@ezmed]

Hope that takes care of it! Wishing you the best! 🙏🏻 And remember to keep following up with your provider as this is for educational purposes only 👍

[@nonamecommonsense9089]

Hi, good luck. I have my gall bladder removed many years ago so pancreas had to work harder. Diet helps. I have to be careful of what to avoid, fortunately I am quite disciplined. I don´t eat yogurts, ice cream, no coffee whatsoever. These thinks should tear me apart. :-)

[@46doony]

My son has a damaged pancreas, he does not have cancer, but the pancreas is damaged and no longer produces enzymes. When he takes the prescribed Enzymes he gets sever pancreatitis. Any ideas?? He is losing weight and we are not sure what to do, and neither do the dr's. His diet has been very healthy for the last 10 years.

[@dayanadeleon5096]

I think I have chronic pancreatitis 🤢 I think I took too many ibuprofens because of my back pain and periods😔

[@mvbroz1450]

How is it

[@jajasatorashi136]

How are you feeling now?

[@jocelynfernandez850]

Pain only on left side for pancreatitis? Can you have pain on the right side?

[@ezmed]

While left upper quadrant and epigastric pain is typical for pancreatitis, it's not impossible to present in other locations such as the right side.

[@leaveittolefty]

thank you for asking-my pain is RUQ and no one can sort it.

[@mohamedemad1145]

👍

[@ezmed]

👍

[@deanvu2222]

Can we live without pancreatitis .

[@Alexi7666]

I'm currently in the hospital with acute pancreatitis. My lipase levels on admission were 3800. After three days of NPO, my lipase levels are 1140. I've been given 50mcg of Fentanyl for the pain, which manages the pain for about an hour. Any help would be greatly appreciated.

[@johnnyquist8362]

I was in the hospital for Pancreatitis earlier this month. The best pain relief came from dilaudid , morphine, fentanyl and tylenol cocktail. It still hurt like hell, but the meds helped.

[@Alexi7666]

@@johnnyquist8362 : What brought on your attack? My lipase level was at 3800. Should've been under 300.

[@vineshreddy7276]

When i got attack my lipase levels are 2600

[@vineshreddy7276]

Now i have 300 lipase levels

[@vineshreddy7276]

I won't have pain but still feeling difficulty having a diet and which one to eat and which one not

[@stingylizard]

Worse pain ever!

[@ezmed]

Hope you're doing better! 🙏🏻

[@karrimaabdul2261]

Had this last year and almost died

[@mechanicman8687]

I almost died from alcohol induced chronic pancreatitis. Dr. told me to quit drinking or I will die…14 years ago. I quit drinking

[@user-tw3fn1nx4x]

Well done , I wish my partner had your resolve . He died on 25/02/2023 from respiratory problems brought on by his panreatitis.

[@mace1633]

@@user-tw3fn1nx4x rest his souls. I’m in same boat

[@lisacarver1128]

It was caused by Ozempic in my case

[@bobboscarato1313]

I take Ozempic 1 mg. but Dr. keeps monitoring it. I lost about 15 lbs. Was 240; I'm 86 y/o.

[@GeorgettaKauffman-qj2bs]

Mine was caused by Mounjaro. I think as time goes on we will see more pancreatitis with these GlP 1s.

[@lilygarcia5668]

I'm having pain in my lower abdomen after starting Ozempic. I'm thinking I will have to stop.No other symptoms but pain.

[@lilygarcia5668]

Did you have to stop taking Ozempic afterwards?

[@itsFrancis254]

👍👍👍💓

[@ezmed]

👍

[@matthewsmith1547]

I haven’t touched alcohol since the 90s.

[@damon2874]

Medications on tv can cause pancreatitis or drinking beer to an excesss.

[@barrydixon7944]

I don't drink and got it

[@ezmed]

Thank you for watching. Remember there are other causes as discussed in the video and it's important to discuss with your provider 👍

[@phubblewubbphubblewubb]

Of course you could change your diet and consume enzymes and B vitamins to fix this instead of surgery but that's too intelligent isn't it......

[@lizr9894]

I’ve had symptoms off and on for 20 years, but never been diagnosed. By the time I get to the Gastro Dr. my symptoms are gone. I think digestive enzymes help and I try to avoid high fat meals.

[@RichiRich11]

Pancreatitits or pancrea titis

[@Adara007]

Medications often cause pancreatitis. Mirtazapine is just one commonly prescribed drug which can cause pancreatitis.

[@kenchorfriday3016]

Have you tried using herbal remedies for this illness it works perfectly well.

[@Adara007]

@@kenchorfriday3016 For which illness?

[@kenchorfriday3016]

Chronic chest and back pain stomach hurts ETC

[@ReapingTheHarvest]

I was on that for a couple years, but that was 5 years ago that I stopped and now suspect I have pancreatitis.

[@patriceneversettlemcmorris]

@@kenchorfriday3016 You can't say that it works perfectly well, because everyone's body is different. Herbal isn't thee answer for everyone. Is it better for us? Yes, but again, it just depends.