Pancreatitis

Pancreatitis – Understanding the pain

Pancreatitis is a medical condition where the pancreas gets inflamed. The pancreas is a long and flat gland tucked behind the stomach, next to the small intestine. It releases digestive enzymes into the small intestine and also produces the hormones insulin and glucagon. The inflammation of pancreas occurs when the digestive enzymes get activated before reaching the intestines and start attacking the pancreas itself. This leads to a severe pain in the upper abdominal region which radiates into the back causing nausea and vomiting.

There are two types of Pancreatitis – Acute Pancreatitis and Chronic Pancreatitis.

Acute Pancreatitis

This is characterized by a sudden inflammation of the pancreas which lasts for a short time (few days to weeks). The patients generally recover completely with the right treatment and regulated dietary changes.

Chronic Pancreatitis

It is a long-lasting inflammation of the pancreas, which often happens after an episode of Acute Pancreatitis. In this case, the damage to the pancreas can lead to more serious complications including Exocrine Pancreatic Insufficiency.

Identifying each type of Pancreatitis

Even though the symptoms of both the types are somewhat similar (upper abdominal pain), there are certain distinctions between them.

Acute Pancreatitis symptoms:

• Upper abdominal pain that radiates to your back.
• Worsening of the pain after eating.
• Fever, nausea, and vomiting.
• Rapid pulse
• Tenderness of the abdomen.

Chronic Pancreatitis symptoms:

• Constant pain in the upper abdomen.
• Sudden weight loss due to poor absorption of food.
• Fatty stool and diarrhea.
• Diabetes may develop if insulin-producing cells of the pancreas are damaged.

Pancreatitis could also cause some serious complications including kidney failures, breathing issues, malnutrition, pseudocysts and even pancreatic cancer.

Revealing the underlying causes of Pancreatitis

Normally, the enzymes released by the pancreas are activated to break down fats and proteins only once the enzymes reach the small intestine.

When these get prematurely activated within the pancreas, the result is an inflammation causing damage to the pancreatic cells.

Below mentioned are some of the reasons behind Pancreatitis:

• Alcoholism – Binge drinking of alcohol interferes with the normal working of enzymes which start digesting the pancreas. In 70% of patients, alcoholism leads to Chronic Pancreatitis.
• Gallstones – Gallstones block the opening of the pancreas restricting the outward flow of enzymes. The activated enzymes start attacking the pancreatic cells causing the inflammation.
• Abdominal injuries or surgeries.
• Exposure to certain medications such as corticosteroids and diuretics which increase the triglyceride levels in the blood.
• Smoking
• Cystic fibrosis
• High levels of calcium in the blood due to hyperparathyroidism.
• Hereditary factors or a family history of Pancreatitis.

Out of these factors, gallstones and alcoholism are the major causes of Pancreatitis. Gallstones lead to Acute Pancreatitis cases while alcoholism is the single most common reason for Chronic Pancreatitis.

A visit to the doctor explained

You should visit the doctor when the abdominal pain is severe and the region turns tender to touch.When no amounts of change in postures or sitting position relieve the pain, consult the physician.To diagnose this condition, doctors mainly conduct certain blood tests which check the levels of the enzymes- amylase, and lipase.

If the levels are high, they indicate Acute Pancreatitis. The doctor may also conduct the following tests:

• Stool tests, in the case of Chronic Pancreatitis, to measure the levels of fats. High levels indicate that the fat cells aren’t being broken down in the intestine or absorbed properly in the body.
• CT scan to check for gallstones and the extent of pancreatic inflammation.
• Glucose Tolerance Test to measure damage in insulin-producing cells of the pancreas.
• Biopsy to remove a small sample of the pancreas to study the spread of inflammation.
• ECRP to observe the pancreas and the bile ducts using X-rays.

Treating the inflammation

Depending on the severity of the inflammation, the patient would either be hospitalized or treated in an outpatient setting.

The initial treatment protocol includes:

• Fasting for a couple of days which gives the pancreas the time to heal. Once it’s under control, the patient can start drinking fluids and eating bland foods.
• Pain medications to control the radiating pain.
• IV (intravenous) fluids which keep the body hydrated.

Once the inflammation is controlled, the underlying cause is identified and the suitable treatment method is adopted. It may include removal of bile duct obstructions, gallbladder surgery or pancreas surgery to remove the dead tissues. If alcoholism is the cause then the doctor may recommend you an alcohol addiction treatment program. Pancreatic enzyme supplements may also be prescribed to aid proper digestion of food along with a low-fat diet.

Best preventive measures against Pancreatitis

• Since alcohol is the leading cause of Pancreatitis, to prevent the inflammation one must strictly restrict the amount of alcohol intake. If you have recently recovered from this condition it would be wise to reduce the intake to zero.
• A gall-bladder friendly diet (low-fat) must be incorporated to prevent the formation of gallstones.
• A low-fat diet also takes care of the surging triglyceride levels, which trigger Acute Pancreatitis. One must refrain from sugary diet and high-calorie beverages.
• In addition to the low-fat diet, one must also keep a check on the intake of breads and grains, high-fat dairy products, red meat, desserts and deep-fried items.
• Increasing the intake of omega-3 fatty acids also keeps your pancreas healthy.
• Being overweight increases the chances of gallstones and in turn, increases the likelihood of Acute Pancreatitis. Hence, regular exercises and maintaining a healthy weight can keep this condition at a bay.
• Studies have revealed that smoking at least one pack of cigarettes every day doubles the risk of Pancreatitis. Leading a smoking-free lifestyle can thus substantially help prevent Pancreatitis.
• Avoid crash diets since sudden weight loss can make your liver to ramp up the cholesterol production. The excess cholesterol may crystallize forming gallstones.

References