Pancreatitis - An Overview

What Is Pancreas?

The pancreas is a 6-inch long organ present in the abdomen behind the stomach. It does both digestive and endocrinal functions. Its endocrine function includes regulating the blood sugar levels by secreting hormones insulin, glucagon, somatostatin, and pancreatic peptide. It also helps in digestion by secreting pancreatic juice (digestive juice) through the pancreatic duct into the duodenum.

What Is Pancreatitis?

Inflammation of the pancreas is called pancreatitis. This inflammation can appear suddenly or last for days. Mild cases resolve on their own without treatment, but some severe and acute cases might result in life-threatening complications.

What Are the Risk Factors for Pancreatitis?

Gallbladder stones and heavy alcohol use are the two most common risk factors for developing pancreatitis.

What Are the Types of Pancreatitis?

The two types of pancreatitis are:

• Acute pancreatitis.

• Chronic pancreatitis.

Acute Pancreatitis:

This type of inflammation develops quickly. The milder forms do not require treatment, but its severe form should be managed promptly to avoid fatal complications. It can result in the death (necrosis) of pancreatic tissues and sepsis, which can lead to multiorgan failure. Acute blood and fluid loss can result in hypovolemic shock, which can lead to oxygen deprivation and death.

Symptoms of Acute Pancreatitis:

The symptoms of acute pancreatitis are:

• Sudden pain in the center of the upper abdomen.

• Pain spreads to the back.

• Pain increases on eating.

• Vomiting and diarrhea.

• Loss of appetite.

• Fever.

• Rapid pulse.

• Diarrhea.

• Yellowish discoloration of skin and sclera (jaundice).

• High or low blood pressure.

Causes of Acute Pancreatitis:

The common causes of acute pancreatitis are:

• Gallstones can get stuck in the bile duct, which also prevents the pancreas from releasing enzymes into the duodenum, resulting in inflammation.

• Bacterial infections like Salmonellosis and Legionnaire’s disease.

• Viral infections like mumps, measles, chickenpox, and hepatitis B.

• Autoimmune conditions like lupus.

• Alcoholism results in activation of trypsin inside the pancreas, which damages the pancreas and causes inflammation.

• High calcium and triglyceride levels.

• Genetic mutation.

• Certain medications.

• Pancreatic cancer.

• Abdominal injury.

Treatment of Acute Pancreatitis

1. For mild cases, medicines are given to relieve symptoms as the pancreas heals itself. The treatment includes -

• Painkillers.

• A tube to remove excess liquid and air (nasogastric tubes).

• Restricting food and liquid intake through mouth.

• Fluids to prevent dehydration.

2. For severe cases -

• If caused by a bacterial infection, antibiotics are given intravenously.

• To prevent hypovolemic shock, intravenous fluids are administered.

• Ventilation to assist breathing.

• Nutrition is provided through feeding tubes.

• Necrotic tissues in the pancreas are surgically removed.

Chronic Pancreatitis:

Chronic pancreatitis is a slow and progressive disease of the pancreas, which leads to permanent damage to the structure and function of the pancreas. Men are more commonly affected than women.

Symptoms of Chronic Pancreatitis:

The common initial symptoms include:

• Severe upper abdominal pain.

• Pain is accompanied by vomiting and nausea.

• Foul-smelling stools.

• Stomach cramps.

• Bloating.

• Abdominal gas.

This can damage the pancreas, which eventually is not able to produce insulin, resulting in type 1 diabetes. At this stage, the patient experiences symptoms of diabetes like increased thirst and hunger, frequent urination, weight loss, fatigue, and blurred vision.

Causes of Chronic Pancreatitis:

The common causes include:

• Recurrent episodes of acute pancreatitis.

• Alcoholism.

• Gallstones.

• When the cause is not known, it is called idiopathic chronic pancreatitis.

• Autoimmune condition.

• Cystic fibrosis.

• Family history.

Treatment of Chronic Pancreatitis

The following are the treatment options:

Lifestyle Modification -

• The pain is significantly relieved by giving up alcohol.

• Quit smoking, as it can make the disease progress quickly.

• Painkillers are given to manage pain and depression, which result from chronic pain.

• If the patient has developed type 1 diabetes, Insulin injections are given for the rest of the life.

Surgery -

• Endoscopic Surgery - This is done to open blocked ducts in the pancreas.

• Pancreas Resection - The head of the pancreas is removed.

• Total Pancreatectomy - The entire pancreas is surgically removed.

• Autologous Pancreatic islet cell transplantation (APICT) - After a total pancreatectomy, islet cells from the removed pancreas are injected into the portal vein of the liver. These cells produce insulin.

What Is the Diet to Be Followed for Pancreatitis:

If a persons is suffering from acute or chronic pancreatitis, make sure they consume a diet rich in protein, low in animal fats, and rich in antioxidants.

Food items that should be included are-

• Lean meats.

• Beans.

• Lentils.

• Clear soup.

• Blueberries.

• Spinach.

• Cherries.

• Dairy replacements.

• Whole grains.

• Cherry tomatoes.

• Cucumbers.

Food items that should be avoided:

• Deep-fried foods.

• Red meat.

• Dairy products.

• Butter and mayonnaise.

• Sugary beverages.

How Is Pancreatitis Diagnosed?

If your doctor suspects pancreatitis, he or she might tell you to perform the following tests:

Blood Test - To check levels of pancreatic enzymes.

Stool Test - To check the fat levels.

Computed Tomography Scan or Abdominal Ultrasound - To look for gallstones.

Magnetic Resonance Imaging - To check any abnormalities of the pancreas and surrounding organs.

Endoscopic Ultrasound - To check pancreatic or bile duct blockage.

What Are the Complications of Pancreatitis?

Pancreatitis can result in the following complications:

• Makes the pancreas susceptible to viral or bacterial infections.

• Type 1 diabetes.

• Kidney failure.

• Pseudocyst (collection of fluid and debris in the pancreas).

• Breathing problems due to a drop in oxygen levels.

• Malnutrition.

• Increased risk for developing pancreatic cancer.

How Is Pancreatitis Prevented?

One can reduce the risk of pancreatitis by:

• Limiting alcohol consumption.

• Avoiding smoking.

• Consuming a low-fat diet.

• Exercising regularly.

• Reducing weight, in case of overweight.

• Avoid going on crash diets.

Pancreatitis can be managed with a few alterations in lifestyle and by taking proper medications.

Conclusion:

In summary, pancreatitis is a dangerous medical disorder marked by inflammation of the pancreas, a crucial organ in charge of manufacturing hormones and enzymes needed for digestion and blood sugar management. The illness can be acute or chronic, and there are several potential reasons, including gallstones, drinking alcohol, certain drugs, and underlying medical issues.