What is Pancreatitis

Posted by Healthfitline On Tuesday, June 11, 2013
Pancreatitis is the inflammation of a pancreas. A pancreas is a important organ found deep inside behind the stomach and attached by ducts to both small intestines and gall bladder. Its primary purpose it to secrete enzymes that help in digestion and to produce insulin that regulate the blood glucose levels.

Although it is not well known the mechanism that leads to pancreatitis. However, it is believed that pancreatitis can develop from any condition that lead to obstruction of the pancreas, pancreatic duct, cystic duct and common bile duct. Once there is an obstruction, the pancreatic enzyme get trapped inside the pancreas and together with the bile, they initiate an inflammation process, attacking the pancreas (auto-digestion).
 
Risk Factors of Pancreatitis
  • Penetrating peptic ulcers
  • Alcoholism
  • Use of contraceptive pills
  • Neurological problems
  • Kidney failure
  • People who had previous history of kidney transplant.
  • Abdominal defects
  • Biliary disease
  • High cholesterol
  • Thyroid problem
  • Surgical injuries or trauma  
Types of Pancreatitis
There are two different types of pancreatitis: Acute and Chronic
 
Acute Pancreatitis
Acute Pancreatitis occurs suddenly and can range from mild to several, fatal inflammation that does not respond to any treatment. In mild cases, the inflammation is usually confined within the pancreas and characterized by edema with minimal organ dysfunction. The inflammation usually heals within 6 months and rarely causes any other complication.
 
However, severe inflammation can lead to bleeding (pancreatic enzymes damage the local blood vessels), cysts formation and circulatory problems, leading to kidney failure, pulmonary problems or even shock.
 
Chronic Pancreatitis
Chronic pancreatitis is usually diagnosed after an episode of acute pancreatitis or when 80% - 90% of pancreas has already been destroyed. It more common in men between the ages of 40 - 45 years with history of alcoholism or women between the ages of 50 - 55 with previous history of suffering from a gallstone disease.
 
Signs and Symptoms of Pancreatitis
Signs and symptoms of pancreatitis may include; 
  • Abdominal pain - felt at the middle area (epigastrium region), below the sternum and radiates to the back. Pain mostly occurs after eating a heavy meal, a fatty meal, drinking alcohol or when lying on the back. 
  • Pain is not relieved by taking antacid. However, it may be temporary relieved by a knee-chest position (a position in which a person rests on the knees and upper part of the chest).
  • Pain may be followed by an abdominal distention.
  • Malnutrition due to poor food absorption rate (usually chronic cases)
  • Fatty stool (steartorrhea)
  • Nausea and vomiting
  • Fever
  • Decreased bowel sound
  • Jaundice and itchiness
  • Diabetes due to destruction of islet and beta cells 
Severe Pancreatitis
  • Bleeding leading to discoloration of the abdomen and peri-umbilical area (Cullen's sign)
  • Hypovolemic shock
Pancreatitis Diagnosis
The diagnosis of pancreatitis is based on the presenting symptoms and presence of any known risk factor. Tests performed to diagnose pancreatitis may include;
 
  • Pancreatic Function Test - to measure the level of amylase and lipase. In acute cases, it is usually increased 3 times the normal amount within the first 24 hours.
  • Urinary amylase - used to measure the enzymes levels in urine.
  • Blood test - increased white blood cells due to infection.
  • X-ray to study the abdomen and chest.
  • Ultrasound to produce images of the pancreas.
  • CT scans to produce images of the damaged pancreas part.
  • ERCP (endoscopic retrograde cholangiopancreatography) used to rule out pancreatitis caused by gallstone.
Pancreatitis Treatment
Pancreatitis treatment is directed towards preventing possible complications and relieving symptoms. Acute pancreatitis is usually treated with intravenous fluid and medications to relieve pain. In some cases, it may require the patient to be put under intensive care unit for close monitoring and to prevent development of serious complication.
 
Respiratory care and monitoring is also maintained to prevent possible hypoxemia (low oxygen levels inside the blood). Some patient may require supplemental oxygen or intubation using a mechanical ventilator.
 
Other way to treat pancreatitis include;
  • Biliary drainage - to drain bile and establish a pancreatic drainage.
  • Surgical intervention - to relieve pain, establish a drainage, resect or remove a necrotic (dead) part of the pancreas. A small incision about 5- 10 millimeter is usually made into the abdomen. The surgeon or the doctor is then guided by a laparoscope to produce images of the pancreas into the monitor.
Patients are also advised to stop alcohol consumption and other medications that can lead to acute pancreatitis. The doctor also discusses about follow-ups visits to determine whether the pancreatitis is resolving and to assess other problems that may be arising from the inflammation.
 
How to Prevent Pancreatitis
Though the cause of pancreatitis is different on each individual. There are various measures that you can take to minimize the risk of acquiring pancreatitis, such as;
 
  • Avoiding alcohol abuse
  • Eating low fat diet to prevent increase in cholesterol.
  • Use medications as directed by your doctor and avoiding over the counter medications or self medication.
  • Consult medical help as soon as possible whenever you feel unwell.
  • Follow the doctor's advice and maintain all the follow up schedules as indicated by your physician.
  • If you cannot stop drinking alcohol, talk to your doctor or a health care provider about it.
Labels: Diseases and Conditions, home, Pancreatitis

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