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Pancreatitis

Pancreatitis

Pancreatitis is an inflammation of the pancreas, a gland located behind the stomach.  The pancreas secretes digestive enzymes through a duct into the small intestine.  These enzymes aid in the digestion of fats, carbohydrates and proteins.  The pancreas also secretes two hormones: insulin and glucagon, which aid in the absorption of sugar.

Inflammation occurs when the digestive enzymes produced are triggered to attack the pancreas.  In severe cases, bleeding, tissue damage, infection and cysts occur as a result of this inflammation.  Enzymes and toxins present in the pancreas can then spread through the bloodstream causing further damage to other organs such as the heart, liver, lungs and kidneys.

There are two types of pancreatitis: acute and chronic.  Acute pancreatitis is characterized by sudden attacks, which can be very intense and life-threatening, resulting in several complications.  Once treated, a complete recovery is common.  Chronic pancreatitis occurs when damage to the pancreas continues.  Symptoms are similar to the acute version but much more severe.  Pancreatic dysfunction may occur resulting in poor digestion and weight loss.

Pancreatitis typically occurs in individuals between 30 and 40 years of age.  This condition seems to be more common in men than women, and many scientists believe that it may be inherited.  Acute pancreatitis is most commonly caused by alcohol abuse.  If patients that have recovered from one acute attack continue to abuse alcohol, chronic pancreatitis may arise.  90% of chronic pancreatitis cases are caused by alcoholism.  Other causes of acute pancreatitis are gallstones, prescribed drugs, trauma to the area, surgery to the abdomen or infection.  In 15% of cases, the cause of acute pancreatitis is unknown.

Symptoms

In cases of acute pancreatitis, one of the first symptoms is intense and possibly constant pain in the upper abdomen.  This pain can then lead to the back and other areas, or be further aggravated when eating.  The abdomen may feel swollen and tender.  Other symptoms include:

bulletnausea
bulletvomiting
bulletfever
bulletincreased pulse rate

In 20% of cases, the acute attacks are severe.  In such cases the symptoms may include:

bulletdehydration
bullethigh blood pressure
bulletheart/lung/kidney failure
bulletpancreatic bleeding, which can lead to shock or death

Many of the symptoms associated with chronic pancreatitis may be similar to those of the acute version.  In chronic cases the pain may be more severe.  The pain may be constant and even disabling, and may go away as the condition advances.  Also, pancreatic dysfunction, is common among chronic patients and will result in a lack of pancreatic enzymes leading to poor digestion and weight loss.  If the insulin producing cells in the pancreas are also affected, diabetes may occur.

Diagnosis

Diagnosis of acute pancreatitis may be done with a combination of blood tests.  These tests will determine if there is an elevated amount of amylase (digestive enzyme) or elevated levels of sugars and fats--all of these are potential signs of pancreatitis.  Changes in levels of calcium, magnesium, sodium, potassium and bicarbonate in the blood may also help in diagnosis.  After recovery, the levels of all these substances should return to normal.

With chronic pancreatitis, the blood tests will be performed in combination with urine and stool tests in order to determine the severity of the condition.  Pancreatic function tests may be performed in order to determine if the pancreas is capable of producing digestive enzymes.  The physician may also decide to view the pancreas using techniques such as ultrasonic imaging or endoscopic retrograde cholangiopancreatography (ERCP).  Surgery may also be used in order to rule out other conditions that mirror pancreatitis.

Treatment

The treatment of acute pancreatitis depends on the severity of the attack.  In many cases, if no complications arise, there is a full recovery without any treatment.  If treatment is necessary, the patient will be hospitalized and the complications will be treated immediately.  Intravenous fluids will be given to restore blood volume.  The kidneys, lungs and heart will be monitored in order to prevent failure.  If uncontrollable vomiting persists, a tube will be inserted through the nose and into the mouth in order to remove fluid and air.  If the attack is severe, food can be fed intravenously for as long as six weeks while the pancreas heals.  And, antibiotics will be administered to treat infection.  Surgery may be necessary for a number of reasons:

bulletremove cysts
bulletremove gallstones or the gallbladder
bulletrepair bile duct damage
bulletstop bleeding
bulletremove dead tissue

Gallstones are a potential complication of pancreatitis.  Physicians will use ultrasound viewing techniques to detect them and surgery will be performed to remove them.  Depending on the severity of the disease, gallstones will either be removed immediately, as with mild cases, or within a month or if the attack is severe and the pancreas needs time to heal.  Computerized Axial Topography (CAT) Scan can be used to determine the extent of the condition.  This information is important for determining when the gallstones should be removed.  After removal of gallstones, the inflammation should disappear and the patient should make a full recovery.  Individuals who have recovered from acute pancreatitis should avoid alcohol and large meals.

The treatment of chronic pancreatitis is mainly used to manage pain, aid in metabolism and bolster the absorption of food.  Pills containing pancreatic enzymes may be administered in order to aid in digestion, which can lead to weight gain and proper nutrition.  Insulin or other medications may be given to control blood sugar.  Surgery may be used to repair pancreatic ducts or remove part or all of the pancreas in order to relieve chronic pain.  Patients suffering from chronic pancreatitis should, by no means, drink alcohol.  Also, in order to relieve pain and have fewer attacks, individuals suffering from chronic pancreatitis should follow their prescribed diet and take their proper medication(s).

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BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner
Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov
Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
We treat a variety of gastrointestinal GI diseases and conditions including Achalasia
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series
BrooklynGI.com with offices in New York City Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and Connecticut. is dedicated to helping patients and physicians receive accurate and up-to-date information on the Gastrointestinal tract (GI Tract) The organs that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree) Dr. Scott Tenner. Physicians include Dr. Scott Tenner Dr. Robin Baradarian Dr. Susan Ramdhaney Dr. Nison Badalov.
Gastrointestinal GI diseases and conditions including Achalasia Private Practice at 2211 Emmons Ave. Other locations include Maimonides Medical Center 1025 48th Street, Beth Israel Medical Center at KD3201 Kings Highway, Kingsbrook Jewish Medical Ctr at 585 Schenectady Ave, Brookdale Hospital at One Brookdale Plaza, and Kings Highway Hospital at 2525 Kings Highway
Barrett's Esophagus Chronic Hepatitis Cirrhosis of the liver Celiac disease Collagenous Colitis Colorectal cancer Colorectal polyps Constipation Crohn's disease Diverticulosis And Diverticulitis Fatty liver (Steatohepatitis) Gallstones Gas Gastritis Gastric Cancer GERD Helicobacter pylori infection Hemochromatosis Hemorrhoids Hepatitis (Viral Hepatitis A, B, C etc) Hiatus Hernia Irritable Bowel Syndrome Lactose Intolerance Liver failure and transplantation Lymphocytic Colitis Microscopic Colitis Esophageal Cancer Pancreatitis Peptic Ulcer Primary biliary cirrhosis Reflux esophagitis Ulcerative colitis
A premier site for the diagnosis, treatment and management Gastrointestinal diseases, Drs. Tenner and Baradarian provide a variety of Patient Services.
Drs. Tenner and Baradarian are Board Certified Gastroenterologists performing a variety of tests and procedures at their private offices and at Maimonides Medical Center.
We perform many tests & procedure, including: Barium Enema Barium Esophagram Capsule Endoscopy Colonoscopy Colon Cancer Screening EGD (Esophagogastroduodenoscopy) Endoscopic Ultrasound ERCP (Endoscopic Retrograde Cholangiopancreatography) Esophageal Dilation Esophageal pH Fundoplication Hemorrhoid Banding Hemorrhoidectomy Lactose Tolerance Test Liver Biopsy PEG (Percutaneous Endoscopic Gastrostomy) Sigmoidoscopy Stool Acidity Test Upper GI Series

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