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PANCREATITIS

Pancreatitis is the inflammation of the pancreas, a large gland located behind the stomach. The pancreas secretes digestive juices in the small intestine which help digestion and secretes enzymes that regulate glucose levels in the body. Pancreatitis occurs when the digestive enzymes start digesting the pancreas itself.

Types of pancreatitis

Pancreatitis is of 2 types, acute and chronic.

  • Acute pancreatitis- It occurs suddenly and lasts for days to months. The patient may develop mild discomfort to a severe, life-threatening illness. Most of the people recover fully after the treatment.
  • Chronic pancreatitis- It is a permanent inflammation of the pancreas which develops gradually over years and lasts for the longer duration. This condition is mainly caused by heavy alcohol use. It can be treated with intravenous fluids and avoiding alcohol intake.

Symptoms

The most common signs and symptoms of pancreatitis are severe pain in the upper abdomen which spreads to the back and aggravates while eating. The other symptoms include:

  • Fever
  • Nausea and vomiting
  • Abdominal tenderness
  • Reduced bowel sounds
  • Increased heart rate

The symptoms of chronic pancreatitis are:

  • Severe upper abdominal pain
  • Unintentional weight loss due to malabsorption
  • Diabetes
  • Oily, smelly stools

Causes

Pancreatitis is mainly caused by gallstones or heavy alcohol use. These two factors contribute up to 80% of the total pancreatitis cases. Other causes of pancreatitis include infection, trauma, hypothermia, smoking tumors, inheritance, and certain medications (such as corticosteroids, diuretics, anticonvulsants, and antipsychotics).

 Risk factors

Anyone can develop pancreatitis, but the risk in more in these people:

  • Gender: Males are at a greater risk of developing pancreatitis compared to females.
  • Age: chronic pancreatitis starts between the ages of 30 and 40 and is rare in children.
  • Family history: Inheritance of genes which result in conditions such as cystic fibrosis result in pancreatitis.
  • Chronic alcohol and tobacco abuse: This may be the primary cause for the development of chronic pancreatitis.
  • Blockage of pancreatic duct: Auto accidents or trauma may lead to blockage of pancreatic duct also known as distal pancreatitis.
  • Other health conditions- such as high triglycerides and lupus

Complications

Pancreatitis can cause serious complications such as infection, pseudocyst, diabetes, malnutrition, abscess formation, and organ failure. If the fluid levels drop suddenly, it results in hypovolemic shock which is a medical emergency. In few cases, chronic pancreatitis may also lead to pancreatic cancer.

Diagnosis

The doctors may initially perform a physical examination and review medical history. If pancreatitis is suspected, the doctor would recommend other tests and procedures such as:

  • Blood tests – to evaluate blood levels of pancreatic enzymes (serum amylase and lipase).
  • Imaging tests – computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound to detect the presence of gallstones and inflammation of the pancreas; abdominal ultrasound is the most reliable test to confirm the diagnosis.
  • Stool test – to identify fat content in the feces.

Pancreatitis is confirmed if the patient has following conditions:

  • Upper abdominal pain radiating to the back
  • Elevation of pancreatic enzymes by more than three times the normal value
  • An imaging test showing characteristic changes

Treatment

The treatment of pancreatitis varies depending on the underlying cause. In general, the first-line treatment involves:

  • Fasting to help pancreas rest and recover
  • Providing intravenous fluids to prevent dehydration while fasting
  • Proving intravenous pain medication to help relieve the pain

Once the pancreatitis is controlled, treatment is given to manage the underlying cause. If alcohol abuse is the main cause, the doctor recommends treatment program to abstain alcohol. If pancreatitis is due to the presence of gallstones, cholecystectomy is performed to remove the gallbladder. Surgery to the pancreas is performed in some cases to remove diseased tissue.

Self-Management

The patient should take following measures for a speedy recovery and prevent further complications:

  • Consuming low-fat food
  • Eating small meals to minimize burden on digestive system
  • Stopping alcohol abuse to prevent further damage
  • Quitting smoking to fasten recovery
  • Trying yoga and relaxation techniques such as deep breathing to reduce pain
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