Introduction

The pancreas is a glandular organ located in the epigastric region and the right upper and left upper quadrants within abdominal cavity. It is long and flat. When inflammation of the pancreas occurs, the condition is referred to as pancreatitis. Inflammation is a processes where the immune system of the body responds to insult or injury.

The pancreas performs crucial roles in the body, among them:

•   Helping in digestion by making and releasing enzymes such as pancreatic amylase and hormones such as glucagon and insulin.
•  Regulation of blood sugar levels.

Various digestive enzymes are delivered to the small intestine via the pancreatic duct.

Pancreatitis can occur over a short-term or a long-term. Acute pancreatitis lasts a short period of time whereas chronic pancreatitis lasts a long period.

 

 Key Facts & Statistics

What are the key facts and statistics about pancreatitis?

• Acute form of pancreatitis accounts for over 270,000 hospitalizations per annum in the United States of America. Of these, 2 out of every 10 cases are said to be severe.
• Chronic pancreatitis being less common is responsible for almost 85,000 hospitalizations every year.
• In accordance with clinicians, this condition is one of the most complicated illness of the abdomen.

 

 Risk Factors

What are the risk factors for pancreatitis?

There are several elements that raise the risk of developing this condition. These risk factors include:

• Excessive abuse of alcohol. According to scientific studies, overwhelmingly engaging in alcohol abuse can lead to pancreatitis.
• Smoking cigarettes. Smokers have a tripple chance of developing pancreatitis as compared to non-smokers.
• Obesity.
• Diabetes.
• Family history. This can increase chances of developing pancreatitis, especially when it is in combination with several other risk factors.

 

 Causes

What are the causes of pancreatitis?

There  are two most common causes of pancreatitis. They constitute almost 80% of cases.

These are:

•  Gallstones. They block the pancreatic duct. One function of this duct is delivery of digestive enzymes into the small intestine.
•  Heavy (uncontrolled) drinking of alcoholic beverages.

 

Other causes that are less common and account for about 20% of cases are:

• Autoimmune illnesses (autoimmune pancreatitis).
• Inherited genetic mutations (Hereditary pancreatitis)
• Medical procedures to open the bile duct such as endoscopic retrograde cholangiopancreatography (ERCP).
• Hypertriglyceridemia.
• Hypercalcemia cancer.
• Injuries due to trauma.
• Certain medications.
• Complications of cystic fibrosis.

 

 Signs & Symptoms

What are the signs and symptoms of pancreatitis?

The most general symptom of pancreatitis is pain in the abdomen.  This pain usually begins in the upper middle or left part of the belly, and it can spread to the back or up the left shoulder blade.

Other symptoms of acute pancreatitis:

• Rapid heart rate (pulse rate).
• Fever.
• Rapid and shallow breathing.
• Nausea.
• Vomiting.
• Upset stomach.
• Swollen and tender belly.

 

Other symptoms of chronic pancreatitis:

• Loss of appetite.
• Unexplained loss of weight.
• Diarrhea.
• Steatorrhea (fatty feces)
• Light-headedness (due to low blood pressure).
• Indigestion.
• Pain in the belly that worsens on eating.

 

Types

What are the most common types of pancreatitis?

There are two forms of pancreatitis, which are acute and chronic pancreatitis.

In acute pancreatitis, the pancreas becomes inflamed over a short time.

In chronic pancreatitis, the organ damage is permanent due to inflammation that occurs over several years.

 

 Diagnostic Procedures  & Tests

How is pancreatitis diagnosed?

• Patient history-taking.
• Clinical examination that includes checking the abdomen for pain and tenderness.
• Tests and procedures such as:

1.  Imaging tests. Computed tomography (CT) scan and magnetic resonance imaging (MRI) scan. These can be used to confirm a diagnosis. They are able to show swelling and fluid deposit in the pancreas.
2.  Endoscopic ultrasound.
3. Stool tests. Fecal fat analysis can be conducted to check for excess fat content in the stool. This is usually a sign of fat malabsorption. In addition, stool elastase test checks if adequate amounts of digestive enzymes are being made by the pancreas.
4. Blood tests. Glucose test checks if enough insulin hormone is being produced.

 

 Treatment and Management

Does pancreatitis have a cure?

No. Pancreatitis does not have a specific medication for cure.

 

How is pancreatitis treated?

Pancreatitis requires hospitalization. During this period, several strategies are employed to treat the condition.

Acute pancreatitis:

•  Supportive care;

1. Administration of pain killers. These medicines deal with severe pain. They can be administered either intravenously or orally.
2. Intravenous fluids. These ensure the patient is hydrated.
3. Parenteral nutrition. Patients with very severe pancreatitis can be fed through an intravenous line.
4. Tube feeding. Patients who experience nausea and vomiting or are unable to take food orally are fed through a tube that is placed through the nose.

 

• Removal of gallstones through;

1.  Endoscopic retrograde cholangiopancreatography (ERCP).
2.  Gall bladder removal surgery. This is done through a laparoscopic surgery and it is the standard form of treatment for gallstones causing complications.

 

• Additional support can be offered through giving antibiotic agents, draining fluid and intensive care of the patient.
• Once the signs and symptoms have been dealt with, other treatment strategies are employed to deal with and treat the underlying causes. They include:

1. Treating alcohol dependency.
2. Substitution of any medicines that are likely to cause pancreatitis.

 

Chronic pancreatitis

• Pain management. Chronic pain specialists help in managing long term pain.
• Enzyme supplements. Due to exocrine pancreatic insufficiency as a result of chronic pancreatitis, enzyme supplements are administered.
• Lifestyle modification. You must quit drinking alcohol and smoking cigarettes.
• Surgical procedures. These include:

1.  Resection (removal of a part of the pancreas)
2.  Total pancreatectomy (removal of the whole pancreas).

 Complications

What are the complications of pancreatitis?

• Pancreatic cancer. This is cancer of the pancreas.
• Diabetes. This metabolic disorder can occur when the islet cells of the pancreas that produce insulin are damaged.
• Malnutrition. It happens due to inability of the inflamed pancreas to produce adequate digestive enzymes leading to loss of weight.
• Pseudocyst. A cyst is an abnormal tissue pocket with enclosed matter. Pseudocysts, also known as false cysts, are cysts that lack specialized lining cells. When these form in the pancreas, usually the  enclosed matter consists of fluid and debris.
• Infections.
• Breathing difficulties.
• Kidney failure.

 

Prevention

How do we prevent pancreatitis?

Some causes of pancreatitis cannot be prevented. However, you can lower the risk of developing this condition by moderately drinking or stopping consuming alcoholic drinks.