Pancreatitis: Causes, Symptoms, Diagnosis, Treatment, and Prevention.
What is Pancreatitis?
Pancreatitis is a condition that refers to inflammation of the pancreas. The pancreas is a gland which is located behind the stomach. Pancreas produces insulin that regulates blood sugar levels in the body. It also releases enzymes that facilitate the process of digestion. In severe cases, pancreatitis can result in serious tissue damage, infection, and bleeding into the gland itself.
Acute pancreatitis: It is a sudden inflammation of the pancreas that is usually short-lived. It results in extreme abdominal pain, which usually reduces on its own within one week.
Chronic pancreatitis:Chronic pancreatitis is a long-term condition, which impairs the functioning of the pancreas. It affects the body’s ability to digest food and other functions.
What are the Causes of Pancreatitis?
In some cases, the digestive enzymes in the pancreas react within the pancreatic cells causing inflammation of the pancreas.
The two main causes of pancreatitis are gallstones and excessive consumption of alcohol. Gallstones enter into the small intestine through the bile duct. When gallstones get stuck in the bile duct, they obstruct the flow of pancreatic fluid, thereby resulting in pancreatic injury.
Some of the other causes of pancreatitis include:
- Injury to the abdomen
- Cigarette smoking
- High levels of triglycerides
- A family history of pancreatitis
- Pancreatic cancer
- Pancreas divisum (a disorder present by birth in the structure of pancreas)
- Trauma or abdominal surgery
- Exposure to certain chemicals
- Injury to the abdomen
Symptoms of Pancreatitis:
The typical signs and symptoms of acute pancreatitis include:
- Pain in the upper abdomen
- Rapid heartbeat
- Abdominal tenderness
- Skin discoloration around the belly button
The symptoms of chronic pancreatitis include:
- Upper abdominal pain
- Unintentional weight loss
- Decreased ability to produce insulin
Risk Factors for Pancreatitis:
The individuals who are at an increased risk of developing pancreatitis are:
- Gender: Men are at an increased risk of developing pancreatitis than women.
- Medical conditions: People with medical conditions, such as cystic fibrosis, Reye’s syndrome, and Kawasaki disease are more prone to the risk of pancreatitis.
- Viral infections: Children and adults suffering from viral infections, such as coxsackievirus and mumps are at an increased risk of developing the condition.
- Metabolic disorders: Individuals suffering from hyperparathyroidism are at a higher risk of acquiring the condition.
- High triglycerides: People who have high levels of triglycerides or with a family history of hypertriglyceridemia are prone to the risk of developing pancreatitis.
- Systemic lupus erythematosus: People suffering from Systemic lupus erythematosus (a chronic autoimmune disease) are more susceptible to the risk of pancreatitis.
Complications of Pancreatitis:
Although most of the people recover without experiencing any complications, severe acute pancreatitis can develop complications, such as:
- Pancreatic necrosis and infection: Sometimes, pancreas loses its blood supply, which can cause death to a part of the tissue of the pancreas. Due to this, the pancreas gets infected, and spread of infection into the blood can result in organ failure.
- Pseudocyst: Acute pancreatitis can develop cyst-like sacs filled with fluid and debris, which are known as pseudocysts. A large pseudocyst formed in the pancreas can rupture and result in internal bleeding.
- Breathing problems: The chemical changes that occur in the body can decrease the levels of oxygen in the blood and also affect the lung function.
- Abdominal swelling: Pancreatitis may result in severe abdominal swelling and pain, which can also result in abnormal movement of the contents in the intestine.
- Kidney failure: If pancreatitis is left untreated, it can develop kidney problems that may even result in kidney failure.
- Malnutrition: Pancreatitis can decrease the ability of the pancreas to produce the enzymes that are essential to break down and process the food. This often leads to malnutrition and weight loss.
- Diabetes: Pancreatitis can cause damage to the insulin-producing cells and can lead to diabetes.
- Pancreatic cancer: Chronic pancreatitis can increase the risk of developing pancreatic cancer.
Diagnosis of Pancreatitis:
To diagnose pancreatitis, the doctor performs a physical examination to check the pain or tenderness of the abdomen. He would also assess the symptoms and review the medical history. The doctor will recommend the following tests to confirm the diagnosis of pancreatitis:
- Blood test: A sample of the blood is collected and tested for the elevated levels of the pancreatic enzymes. Also, the doctor would test the levels of blood glucose and blood fats (lipids) from the blood sample.
- Stool tests: The doctor would recommend stool test to measure the levels of fat in the stools sample, which enables to check if the digestive system is absorbing the nutrients efficiently.
- Transabdominal ultrasound: An ultrasound scan uses sound waves that generate electrical impulses of the internal organs to create images. It helps to look for the presence of gallstones and inflammation of the pancreas.
- Endoscopic ultrasound: In this procedure, a thin, flexible tube (catheter) is inserted down into the stomach. A camera is attached to the tip of the catheter, which helps to obtain images of the blockages in the pancreatic duct or bile duct. It also helps to visualize the abnormalities in the pancreas.
- Computerized tomography (CT) scan: A CT-scan enables to produce three-dimensional images of the internal organs. CT scan helps to determine the extent of the pancreatic damage.
- Magnetic resonance imaging (MRI): MRI scan uses strong magnetic fields and radio waves to produce detailed images of the internal organs, such as gallbladder and pancreas.
Treatment of Pancreatitis:
The initial treatment for pancreatitis would require a hospital stay. The treatment would include:
- Pancreatitis can make the patient dehydrated. Hence, the doctor will recommend intravenous (IV) fluids until the food and fluids are taken by mouth.
- The doctor will prescribe oral antibiotics or through an IV to treat infection in the pancreas.
- The doctor will recommend to eat bland foods and be on a liquid diet until the inflammation in the pancreases is completely controlled.
- The doctor will prescribe pancreatic enzyme supplements to break down and process the nutrients from the food.
Surgery: If gallstones are the underlying cause of pancreatitis, the doctor may recommend surgery to remove the gallbladder. The doctor performs a procedure known as endoscopic retrograde cholangiopancreatography (ERCP)to remove the obstructions in the bile duct and pancreatic duct. Also, the doctor may perform surgery to drain the fluid in the pancreas or to remove the diseased tissue.
Prevention of Pancreatitis:
The following are certain measures that can reduce the risk of pancreatitis:
- Quit smoking
- Limit alcohol consumption
- Maintain a healthy weight
- Eat a low-fat diet
- Avoid eating fried and processed foods