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:
| nausea |
| vomiting |
| fever |
| increased pulse rate |
In 20% of cases, the acute attacks are severe. In such
cases the symptoms may include:
| dehydration |
| high blood pressure |
| heart/lung/kidney failure |
| pancreatic 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:
| remove cysts |
| remove gallstones or the gallbladder |
| repair bile duct damage |
| stop bleeding |
| remove 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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