Pancreatitis

  • July 30, 2020
Pancreatitis

It is a swelling of the long flat gland behind the stomach called the Pancreas. Pancreas produces enzymes that help in the digestion process and hormone like insulin which helps to monitor the way body processes sugar. Pancreatitis can be mainly of two types:

Acute Pancreatitis – It appears suddenly and lasts for days

Chronic Pancreatitis – It occurs over many years

Causes

Pancreatitis occurs when digestive enzymes become activated while still in the pancreas, irritate the cells of your pancreas leading to inflammation. Repeated bouts of acute pancreatitis, leads to scar tissue formation in the pancreas, causing loss of function. Such a poorly functioning pancreas can cause digestion problems and along with diabetes.

Conditions that can lead to pancreatitis are:

  • Abdominal surgery
  • Alcoholism
  • Certain types of medications
  • Cystic fibrosis
  • Gallstones
  • High calcium levels in the blood caused by an overactive parathyroid gland
  • High triglyceride levels
  • Infection
  • Injury to the abdomen
  • Obesity
  • Pancreatic cancer
  • ERCP, a procedure used to treat gallstones, also can lead to pancreatitis.

Symptoms

Acute pancreatitis signs and symptoms include:

  • Upper abdominal pain
  • Abdominal pain that radiates to your back
  • Abdominal pain that feels worse after eating
  • Fever
  • Rapid pulse
  • Nausea
  • Vomiting
  • Tenderness when touching the abdomen

Chronic pancreatitis signs and symptoms include:

  • Upper abdominal pain
  • Losing weight without trying
  • Oily, smelly stools (steatorrhea)

Risk factors

Factors that increase the risk of pancreatitis are:

  • Excessive alcohol consumption – people consuming four to five drinks a day are at increased risk of pancreatitis
  • Cigarette smoking – Smokers are three times more likely to develop chronic pancreatitis, compared to non-smokers
  • Obesity – Obese people are more likely to get pancreatitis
  • Family history of pancreatitis – A family members with this condition, add to the risk when combined with other risk factors mentioned earlier

Complications

For some Pancreatitis may lead to serious complications like:

  • Pseudocyst – Pancreatitis can lead to fluid and debris collection in the form of cysts in the pancreas. Such cysts can rupture and cause complications like internal bleeding and infection
  • Infection – Acute pancreatitis makes the pancreas vulnerable to different types of infection. These may be serious and require intensive treatment, like surgery to removal of the infected tissue
  • Kidney failure – Acute pancreatitis can lead to kidney failure, leading to requirement of dialysis
  • Breathing problems – Acute pancreatitis can cause oxygen level in the blood to fall dangerously and can affect your lung function
  • Diabetes – Acute Pancreatitis can damage the insulin-producing cells in the pancreas leading to diabetes, which affects the way your body uses blood sugar
  • Malnutrition – Both acute and chronic pancreatitis can lead to lesser production of the enzymes that are needed to break down and process nutrients from the food we eat. This can lead to malnutrition, diarrhoea and weight loss
  • Pancreatic cancer – Chronic pancreatitis and long term inflammation of the pancreas can lead to pancreatic cancer.

Diagnosis

Tests and procedures used to diagnose pancreatitis include:

  • Blood tests to see if the levels of pancreatic enzymes are high/low
  • Stool tests to measure levels of fat suggesting whether your digestive system is/isn’t absorbing nutrients adequately
  • CT scan to look for gallstones and extent of pancreas inflammation
  • Abdominal ultrasound to look for gallstones and pancreas inflammation
  • Endoscopic ultrasound to look for inflammation or blockages in the pancreatic duct or bile duct
  • MRI to look for any abnormalities in the gallbladder, pancreas and ducts

Treatment

Treatment in the hospital may include:

  • Fasting – the doctors may advise you to fast for a couple of days in the hospital in order to give your pancreas a chance to recover. Once the inflammation subsides, one can begin drinking clear liquids and eating bland foods. With time, one can go back to the normal diet. If the pain continues when eating, your doctor may recommend a feeding tube to help you get nutrition
  • Pain medications – Pancreatitis causes severe pain. Your doctor at the hospital will give you medications to help control the pain.
  • Intravenous (IV) fluids. As the body devotes energy and liquid to repairing the pancreas, the body might get dehydrated. Thus, one may receive extra fluids intravenously.

After the inflammation is under control the doctor can treat the cause of your pancreatitis. It includes:

  • Procedures to remove bile duct obstructions – When Pancreatitis is caused by a narrowed or blocked bile duct, it may require procedures to open or widen the bile duct. ERCP can help in diagnosing problems in the bile duct and pancreatic duct and in helping in its repairs. However, in elderly people, ERCP can also lead to acute pancreatitis
  • Gallbladder surgery – If gallstones are the cause of your pancreatitis, then the doctor may recommend surgery to remove the gallbladder called cholecystectomy
  • Pancreas surgery – Sometimes surgery may be necessary to drain out the collected fluid from the pancreas or remove diseased tissue
  • Treatment for alcohol dependence – This can help in the treatment of Pancreatitis in a person dependent on Alcohol.

Additional treatments for chronic pancreatitis

Depending on one’s situation, chronic pancreatitis may sometimes also require additional treatments, like:

  • Pain management – Chronic pancreatitis leads to persistent abdominal pain. Doctor may recommend medications for this or refer you to a pain specialist. Severe pain can be relieved by endoscopic ultrasound or surgery to block nerves sending pain signals
  • Enzymes to improve digestion – Pancreatic enzyme supplements can help also help the body to break down and process the nutrients in the foods you eat
  • Changes to your diet – Diet change advised by the dietitian with plan low-fat meals that are high in nutrients can also help to treat pancreatitis

Thus, make an appointment with your doctor if you have persistent and continuous abdominal pain. Seek immediate medical help if the pain is so severe that you can’t sit still or find a comfortable position.

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