Pancreatitis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 7, 2016
StartDiseasesPancreatitis

The pancreas is a major organ of the digestive system located behind the stomach that releases enzymes and insulin to aid in the digestion of food and absorption of nutrients. When the pancreas becomes damaged, due to trauma, gallstones, alcohol abuse, or a variety of other causes, pancreatitis can develop. Pancreatitis is a painful swelling of the pancreas that is often treatable through medication but can also be chronic.

Contents

Definition & Facts

Pancreatitis is a condition that develops when the pancreas becomes inflamed and painful. The pancreas is a gland located behind the stomach and next to the small intestine responsible for producing enzymes that aid in digestion as well as insulin.

There are two forms of pancreatitis, acute and chronic. Acute pancreatitis is a sudden inflammation of the pancreases that diminishes completely after treatment, leaving no permanent pain or damage. Chronic pancreatitis is the continual inflammation of the pancreas as a result of long-term damage to the organ. In these cases symptoms are managed but the disease may persist for years. Acute cases are much more common and can be completely treated with immediate medical attention. If medical attention is not received, in some cases acute pancreatitis will develop into chronic pancreatitis.

Symptoms & Complaints

The most obvious symptom of pancreatitis is pain that is constant and sharp. Pancreatic pain, often made worse by eating, is caused by an inflammation of the pancreas. This pain starts in the stomach and upper abdomen and can radiate into the back. As the pancreas becomes further inflamed and possibly infected, patients may also develop a fever, a tender and swollen abdomen, nausea, vomiting, and increased heart rate.

Because the pancreas is responsible for producing enzymes that help digest food, chronic pancreatitis can also lead to weight loss due to the body's inhibited ability to absorb nutrients properly. In extreme cases, patients with chronic pancreatitis may develop diabetes, as the insulin-producing part of the pancreas becomes damaged and unable to function. For these reasons, it is imperative that anyone experiencing symptoms goes to a medical professional immediately, especially if the pain is debilitating or a fever develops.

Causes

Pancreatitis has many known causes, and some that doctors are unable to identify. Both kinds of pancreatitis result from damage to the pancreas either from outside factors like alcohol use or trauma, or from internal issues like gallstones or genetic factors (hereditary pancreatitis). Acute pancreatitis is often a result of damage to the pancreas caused by either gallstones or sustained alcohol consumption. Cases not caused by gallstones or alcohol usually develop as a result of medication or trauma to the pancreas, and in 15 percent of all acute cases, the cause is unknown.

Chronic pancreatitis is overwhelmingly caused by long-term, sustained alcohol consumption. At least 7 out of 10 cases can be linked to alcoholism. Approximately 1 in 5 cases of cases are secondary conditions that result from cystic fibrosis or hereditary diseases of the pancreas. The remaining cases of chronic pancreatitis are often a side effect of medication used to treat another condition. Both chronic and acute cases resulting from unknown causes are believed to be due to some undiagnosed trauma to the organ. Pancreatitis usually occurs in people in their 30s and 40s and is more common in men than women.

Diagnosis & Tests

The procedures to diagnose both acute and chronic pancreatitis are the same, though in suspected cases of chronic pancreatitis, more tests will be administered to ensure that the patient has not become diabetic as well. The most common method of diagnosis is to test the blood for elevated levels of the enzymes amylase and lipase which indicate malfunction of the pancreas.

To confirm the diagnosis most doctors will perform one of several tests, which includes a pancreatic function test. The doctors may also choose to get a visual of the pancreas using an ultrasound, CT scan, or MRI to check if it is enlarged. Biopsies can also be performed to test for damage of the pancreas. Most tests administered will rely on blood, urine, or stool samples though some may use imaging equipment or stool samples to get a better idea of the situation.

Treatment & Therapy

Acute pancreatitis is usually treated with IV fluids, pain medication, and close monitoring in the hospital. Patients stay in the hospital to ensure that there isn't damage to the heart, lungs, or kidneys. If gallstones are causing pancreatitis, the gallbladder may be surgically removed. In some severe cases, pancreatitis can lead to permanent damage to the organ and the affected area will need to be surgically removed. Once the organ is no longer swollen and painful and tests show normal pancreatic function, acute pancreatitis patients can be sent home.

Typically patients with chronic pancreatitis receive symptom management, but there may be no immediate cure for the persistent condition. Doctors will usually use medication to help with pain management and provide digestive enzymes and insulin to ensure that nutritional needs are met. Sometimes surgery is required to help clear a blocked pancreatic duct and assist with drainage of the pancreas. All sufferers of pancreatitis are told to stop smoking, abstain from alcohol consumption, and follow a low fat diet to relieve stress on the pancreas.

Prevention & Prophylaxis

The number one way to prevent pancreatitis is to cut back on the consumption of alcohol. If pancreatitis runs in the family or any other pancreatic or gallbladder diseases are present, abstaining from alcohol completely is recommended.

Additionally, because gallstones are a major cause of pancreatitis, it is advised that those who are susceptible follow a low fat diet to increase gallbladder function. A diet rich in whole grains, and fresh fruits and vegetables is recommended. To increase the healthy function of all major organs, smoking should be avoided.