Pancreatitis

Overview

A pancreas is a flat, long gland that sits in the upper abdomen, behind the stomach. It is responsible for the production of enzymes that aid digestion. The organ also produces hormones that help the body process sugar or glucose in a regulated manner.

Sometimes, the pancreas may suffer from inflammation, and that's known as pancreatitis. It often occurs as acute pancreatitis, which means it can appear out of the blue and last for a couple of days. Although, some people may also suffer from chronic pancreatitis that may develop over the years.

Types of Pancreatitis:

Let’s take a quick look into both types of pancreatitis:

• Acute Pancreatitis

When the inflammation in the pancreas lasts for a very short time and happens suddenly, it's acute pancreatitis. It can bring along mild discomfort or pose life-threatening harm. Although, most individuals with acute pancreatitis recover from it very quickly. In severe cases, it can cause bleeding, infection, tissue damage, cysts, etc. If it becomes painful, it can damage significant organs like the lungs, heart and kidneys.

• Chronic Pancreatitis

This kind of pancreatitis is long-lasting and usually happens right after acute pancreatitis. This could also occur if an individual drinks heavy amounts of alcohol on a regular basis for a long time. This may not cause sudden symptoms, but one day, severe pancreatitis symptoms may begin to appear.

That said, it can quickly improve with the proper treatment if it's a mild case of pancreatitis. On the other hand, severe cases could lead to fatal complications.

So, treatment and diagnosis at the right time are of absolute necessity.

Symptoms:

Some of the symptoms of pancreatitis are:

- Pain in the upper belly that radiates to the back
- Nausea and vomiting
- Fever and rapid pulse
- Swelling and tenderness in the belly
- Diarrhea and weight loss
- Oily, smelly stools

The symptoms may vary depending on whether the pancreatitis is acute or chronic. Acute pancreatitis is sudden and severe, while chronic pancreatitis is long-lasting and progressive. You should seek medical attention immediately if you have any of these symptoms. Pancreatitis can cause serious complications and damage to your pancreas and other organs.

Causes:

Pancreatitis can be caused by various factors that damage or activate the pancreatic enzymes inside the gland, leading to swelling and pain. Some of the common causes of pancreatitis are:

Gallstones: These are hard deposits of bile that can block the common bile duct, which connects the pancreas to the liver and the small intestine. This can prevent the pancreatic enzymes from flowing out and cause them to back up and damage the pancreas.
Alcohol abuse: Heavy or long-term alcohol use can irritate and inflame the pancreas, as well as increase the production of pancreatic enzymes and reduce their secretion. Alcohol can also interact with other factors, such as genetics, infections, or medications, to increase the risk of pancreatitis.
Medications: Certain drugs, such as steroids, antibiotics, diuretics, or anti-seizure medications, can cause allergic reactions or toxic effects on the pancreas, leading to pancreatitis. The risk may depend on the dose, duration, and type of medication.
High triglycerides: Triglycerides are a type of fat in the blood that can increase due to obesity, diabetes, or genetic disorders. High levels of triglycerides can cause fatty deposits in the pancreas, which can trigger inflammation and damage.
High calcium: Calcium is a mineral that is important for bone health and muscle function. However, high levels of calcium in the blood, which can occur due to hyperparathyroidism, kidney failure, or vitamin D overdose, can cause calcium deposits in the pancreas, which can interfere with its function and cause pancreatitis.
Infections: Viral, bacterial, or fungal infections can affect the pancreas and cause inflammation and damage. Some of the common infections that can cause pancreatitis are mumps, hepatitis, HIV, salmonella, and candida.
Trauma or surgery: Physical injury to the abdomen, such as from a car accident, a fall, or a gunshot wound, can damage the pancreas and cause bleeding and inflammation. Surgery on the pancreas, the stomach, or the bile ducts can also cause complications that can lead to pancreatitis.
Genetic disorders: Some people may inherit gene mutations that affect the structure or function of the pancreas or its enzymes, making them more prone to developing pancreatitis. Some of the genetic disorders that can cause pancreatitis are cystic fibrosis, hereditary pancreatitis, and alpha-1 antitrypsin deficiency.

Risk factors:

Factors that increase your risk of pancreatitis are:

• Excessive alcohol consumption: According to research, having four or five drinks per day increases your risk of developing pancreatitis.

• Cigarette smoking: Smokers are about three times more likely than nonsmokers to develop chronic pancreatitis. Quitting smoking reduces the risk.

• Obesity: People who have a BMI of 30 or higher are more likely to develop pancreatitis.

• Diabetes: Diabetes increases the risk of pancreatitis.

• Pancreatitis runs in my family: Several genes have been linked to chronic pancreatitis. A family history of the disease is associated with an increased risk, particularly when combined with other risk factors.

Possible Complications:

If pancreatitis is left untreated, it can pose severe health troubles, which can cause lasting and life-threatening complications. These complications may include the following:

• Breathing problems

Acute pancreatitis often brings a chemical change in a person's body which may impact the lung function. This can pull the oxygen levels down to a shallow level, which is dangerous.

• Kidney failure

Acute pancreatitis leads to kidney failure, which can be dealt with with proper dialysis treatment.

• Pseudocyst

Sometimes, pancreatitis can cause a collection of debris and fluid in the pancreas and look like a pocket of cysts. If it ruptures, it can cause serious infection and internal bleeding.

• Infection

This is utterly common since the disease leaves the pancreas vulnerable and prone to infection. This infection may sometimes be severe and require surgery to remove the tissue.

• Diabetes

Chronic pancreatitis often damages the insulin-producing cells, which causes diabetes.

• Malnutrition

Both forms of pancreatitis leave the pancreas unable to produce substantial enzymes that can properly break the food down to process essential nutrients. This can lead to weight loss, diarrhoea, and malnutrition, even though you eat healthy food.

• Pancreatic cancer

If the inflammation in the pancreas lasts too long, it can put a person at risk of getting pancreatic cancer.

Prevention:

There are some steps you can take to prevent pancreatitis or reduce the risk of future attacks, such as:

• Avoid alcohol consumption, as it is a major cause of pancreatitis.

• Quit smoking, as it can worsen the inflammation and increase the risk of pancreatic cancer.

• Eat a balanced and low-fat diet, as it can help prevent gallstones, another common cause of pancreatitis.

• Maintain a healthy weight or lose weight safely, as it can improve your pancreatic function and lower your chance of getting gallstones.

• Seek medical attention if you have symptoms of pancreatitis, such as abdominal pain, nausea, vomiting, fever, or diarrhoea. Early and aggressive treatment can improve your outcomes and prevent further damage to your pancreas.

When to consult a doctor?

If a person suffers from pancreatitis, he/she should apprise the doctor of any new symptoms that might be worsening over time. It is absolutely necessary to visit the doctor if he/she experiences any of the following distressful situations:

• Nausea

• Vomiting

• Severe pain that painkillers can't fix

• Rapid heartbeat

• Chills

• Fever

• Fatigue

• Weakness and fainting

• Unintentional weight loss

• Greasy, smelly stool

• Jaundice-like symptoms

• Agitation and confusion

• Unconsciousness

Also, individuals should not hesitate to call a healthcare provider if they have any confusion about the treatment or want to try any herbal remedy or over-the-counter medications. A doctor can help one quit smoking and adopt a healthy diet to lose weight or make any other lifestyle changes required to manage pancreatitis.

Diagnosis:

• Physical examination

If a doctor suspects there are any signs of pancreatitis, he/she may talk to the patient about the risk factors and symptoms. More than just a quick conversation about the same is required, though.

• Diagnostic tests:

1. Lab Tests

A doctor may recommend a blood test to check the levels of lipase and amylase enzymes produced by the pancreas. If these enzymes are at high levels, it can indicate acute pancreatitis. Besides that, a stool test may be conducted to check if the body is able to break down fat properly.

2. Advanced tests

Lab tests may not be enough, so your doctor may order some advanced tests, including a CT scan and an ultrasound, which can offer images of the bile duct, gall bladder and pancreas to spot abnormalities. Besides that, an individual may also require an oral glucose tolerance exam to see the blood sugar level before and after drinking the sweet solution.

There's also a secretin pancreatic function test wherein a tube is inserted from the throat to the upper small intestine to release secretin hormone in the pancreas to check for the response. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography may also be done.

Treatment:

Home treatment

1. An individual can certainly manage the situation with pancreatitis and relieve some pain with home remedies like:

2. Switch to a low-fat diet and consume vegetables, fruits, whole grains, legumes, and non-fatty dairy alternatives such as almond milk.

3. If an individual is struggling with extreme pancreatitis symptoms, he/she should try to stay on a clear, liquid diet until the pain and symptoms start to ease. So, feasting on broth, juice, jello, and popsicles can help.

4. Consuming some over-the-counter digestive enzymes can ease some digestive discomforts.

5. Enhancing the antioxidant level and ensuring enough Vitamins A, C, and E consumption because they boost recovery. Making it a point to eat berries, nuts, and citrus fruits can help lower the inflammation in the pancreas.

Medications

Pancreatitis may sometimes lead to immense pain, so the doctor may prescribe some pain medications like Acetaminophen and Ibuprofen to help control and manage the troubles. Also, an individual might get dehydrated over time due to all the fluids and energy used to repair the pancreas. So, a patient may need extra fluids, which a healthcare team can provide through an IV during hospitalisation.

Surgical treatment

Depending on the reason behind pancreatitis and the severity of it, a healthcare team may find surgery a suitable option. The treatment in this regard will include gallbladder surgery. If the reason for the pancreatitis is gallbladder, it will require surgery for the same (cholecystectomy).

Alternative management

Besides all the medications and surgical treatments, there are some alternative procedures at disposal:

1. ERCP: If pancreatitis occurs due to a blocked or narrow bile duct, doctor may conduct an ERCP to widen or open this bile duct. This procedure (endoscopic retrograde cholangiopancreatography) includes putting a long tube with a camera attached to one end down the throat of the patient. The camera clicks pictures of the digestive system and helps in monitoring and examining the bile ducts and pancreas. It can also help clear the path from any obstructions, such as gallstones.

2. Endoscopic procedures: If the pancreas needs fluid draining or removal of diseased tissue, the doctor can suggest some endoscopic procedures. Endoscopic ultrasound may also help to manage the pancreatitis pain.

3. Dietary changes and low alcohol intake: A dietician may create a low-fat diet plan rich in nutrients. A dietician may also help the patient get enrolled in an alcohol addiction therapy if he/she is unable to stay off it.

4. Enzyme supplements: In cases of chronic pancreatitis, enzyme supplements are provided to help the body break down food and process the nutrients one has consumed.

Additional information

What is the pancreas, and where is it located?

The pancreas is an organ in the belly or the upper abdomen. It is connected to the duodenum or the small intestine and comprises a pancreatic duct essential for draining necessary digestive enzymes into the small intestine.

This organ has two primary responsibilities. One is to create digestive enzymes and transmit them to the small intestine. There, the enzymes help break down the fats, proteins and carbohydrates from the food an individual consumes.

The second function is the production of multiple hormones and releasing them into the bloodstream. One of the essential hormones is insulin, which controls the blood sugar level and helps store energy in the body.

Is there any way to prevent or avoid pancreatitis?

Specific lifestyle changes can help with the symptoms of pancreatitis and help a person avoid gallstones altogether. Gallstones are 40% of the cause of acute pancreatitis. So, here are the things that an individual can try to ensure the prevention of pancreatitis:

1. Exercise regularly

2. Maintain a healthy weight

3. Avoid consumption of alcohol

4. Abstain from smoking

If these lifestyle changes don't help and an individual gets a gallstone anyway, the doctor might also suggest removing the gallbladder.