The pancreatitis is an inflammation of the pancreas. The pancreas is a gland located behind the stomach, near the liver, which produces enzymes needed for digestion and hormones that help regulate sugar (glucose) in the blood. Pancreatitis causes damage to the pancreas and surrounding tissues.
There are two forms of pancreatitis:
- Acute pancreatitis occurs suddenly and lasts for several days. The majority of cases occur as a result of gallstones or because of excessive alcohol consumption.
- Chronic pancreatitis often occurs after an episode of acute pancreatitis and can last for several years.
Causes of pancreatitis
The majority of cases of acute pancreatitis are caused by gallstones or excessive alcohol consumption. Consumption of fatty foods, infection (such as mumps or viral hepatitis), and disorders following surgery, trauma to the abdomen or pancreatic cancer can cause acute pancreatitis. Some medications, for example, a pest such as pentamidine (Pentam), didanosine (Videx), used for HIV treatments or diuretics and sulfonamides may also cause acute pancreatitis. About 15% to 25% of cases of acute pancreatitis have an unknown cause.
About 45% of cases of chronic pancreatitis are caused by prolonged alcohol consumption, causing damage and calcification in the pancreas. Other factors, such as hereditary pancreatic disorders, cystic fibrosis, lupus, high triglyceride levels can cause chronic pancreatitis. About 25% of chronic pancreatitis cases have an unknown cause.
Complications of pancreatitis
Pancreatitis can cause serious problems:
- Respiratory disorders. Acute pancreatitis can lead to respiratory failure, which can cause a potentially dangerous drop in the level of oxygen in the blood.
- Diabetes. Chronic pancreatitis can cause damage to insulin-producing cells, which can lead to diabetes.
- Infection. Acute pancreatitis can make the pancreas vulnerable to bacteria and infections. An infection of the pancreas can be serious and requires surgery to remove infected tissue.
- Renal failure. Acute pancreatitis can cause kidney failure which, if it becomes severe and persistent, must be treated with dialysis.
- Malnutrition. Acute and chronic pancreatitis can prevent the pancreas from producing the enzymes needed to absorb nutrients. This can lead to malnutrition, diarrhea and weight loss.
- Pancreatic cancer. Prolonged inflammation of the pancreas caused by chronic pancreatitis is a risk factor for developing pancreatic cancer.
- Pancreatic cyst. Acute pancreatitis can cause the accumulation of fluids or debris in pouches similar to cysts in the pancreas. A cyst that breaks can cause complications, such as internal bleeding and infections.
Diagnosis of pancreatitis
Blood tests can confirm acute pancreatitis by the presence of high levels of digestive enzymes (amylase and lipase), sugars, calcium or lipids (fats).
CT scans can be used to identify pancreas swelling, fluid accumulation in the abdomen, or the presence of pseudocysts.
Magnetic resonance imaging (MRI) and computed tomography can detect the presence of gallstones in the gallbladder.
Symptoms of pancreatitis
Symptoms of acute pancreatitis
The severity of acute pancreatitis can vary from person to person.
- Intense abdominal pain that can radiate to the back.
- Abdominal pain that increases after eating.
- A swollen and painful abdomen.
- Nausea and vomiting.
- A sensitivity of the abdomen to the touch.
- An increase in the heart rate.
Symptoms of chronic pancreatitis
- Pain in the upper part of the abdomen.
- A loss of weight.
- Oily and smelly stools (steatorrhea).
Excessive alcohol consumption can cause pancreatic damage without causing symptoms for many years. Then, suddenly, the person may develop symptoms of severe pancreatitis such as:
- Intense pain in the abdomen.
- A loss of pancreatic function.
People at risk for Pancreatitis
- People with cystic fibrosis.
- People with high triglyceride levels (blood lipids transformed by the liver usually from excessive alcohol or sugar consumption).
- People with lupus.
- Chronic pancreatitis occurs more frequently in men between the ages of 30 and 45, but women can also be affected. Pancreatitis is rare in children.
- Have gallstones (cholelithiasis).
- Consume alcohol for prolonged and excessive amounts
|Why prevent pancreatitis?|
|The severity of acute pancreatitis can vary from person to person. The disease can cause mild abdominal discomfort to a serious life-threatening illness. Most people with acute pancreatitis recover completely after receiving appropriate treatment.|
|Can we prevent pancreatitis?|
|Most cases of first pancreatitis not related to alcohol abuse cannot be prevented. However, prevention of gallstones can help reduce the risk of pancreatitis.
|Basic preventive measures|
|Measures to prevent recurrence|
|People who have had an episode of pancreatitis caused by alcohol should completely avoid their use to prevent recurrence. Permanent damage can be caused to the pancreas and can lead to the appearance of the chronic form of the disease.|
Medical treatments for pancreatitis
Treatment of acute pancreatitis usually requires hospitalization for a few days to control inflammation. Then, the underlying cause of pancreatitis can be treated.
Fasting . As a first step, it is recommended to put the pancreas at rest (stop feeding, gastric suction) If necessary, the patient is fed intravenously. Once inflammation of the pancreas is controlled, food can be reintroduced, initially as a liquid diet. Intravenous fluids are administered to prevent dehydration.
Anti-inflammatory . Pancreatitis can cause severe pain. The pain may be treated with anti-inflammatory drugs (NSAIDs) if it is of mild to moderate intensity or, in more severe cases with opioid medications (morphine).
Antibiotics . In some cases, antibiotics may be prescribed to prevent or treat infection of the pancreas or surrounding tissues.
Surgery of the gallbladder (cholecystectomy) . If pancreatitis is caused by gallstones, the gallbladder can be removed to prevent recurrence.
Endoscopic surgery of the bile ducts . When the bile duct is obstructed or enlarged, retrograde cholangiopancreatography (ERCP) can be used to drain the duct. A long tube with a camera (called an endoscope) is inserted through the mouth into the esophagus, stomach and intestine, to observe the presence of stones or any abnormality. If necessary, surgery will free the duct or remove part of the pancreas.
For chronic pancreatitis
Chronic pancreatic therapy is used to relieve pain, improve pancreatic function, and prevent complications.
Treatment for alcohol dependence . If alcohol is involved, it is recommended to stop using it or follow the program to help reduce alcohol consumption.
Diet change . A reduced fat diet is usually recommended in combination with the consumption of pancreatic enzymes (in tablet form) to improve nutrient absorption.
Pancreas surgery . Laparoscopic pancreas surgery may sometimes be required to drain the fluid from the pancreas or to remove affected tissue.