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24 February, 2020 00:00 00 AM

Everything you need to know about pancreatitis

You can control pancreatitis with a healthy lifestyle and medical treatment when necessary. It’s particularly important to avoid smoking and drinking a lot of alcohol to reduce your risk of pancreatitis and to help you recover.
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Everything you need to know about pancreatitis

Pancreatitis is pathologic inflammation of the pancreas. Your pancreas sits behind your stomach, near your small intestine. It releases enzymes that help you digest food and also regulates how your body manages glucose.

Pancreatitis can come and go quickly, or it can be a chronic problem. Treatment will depend on whether your pancreatitis is acute or chronic.

Pancreatitis symptoms

Most people who have acute or chronic pancreatitis experience middle-left upper abdominal pain as their primary symptom. Some people who have chronic pancreatitis may show inflammation on diagnostic imaging scans, but otherwise may show no symptoms.

Other symptoms of pancreatitis may include:

pain that wraps around the upper body and involves the back in a band-like pattern

indigestion

nausea or vomiting

abdominal tenderness

unintentional weight loss

bloating with a distended (swollen) abdomen

hiccups

fever

People who have chronic pancreatitis may also experience steatorrhea, which is fatty stools that give off a foul odor.

Steatorrhea can be a sign of malabsorption. This means you’re not getting all of your essential nutrients because your pancreas doesn’t secrete enough digestive enzymes to break down your food.

Types of pancreatitis

Pancreatitis is generally acute or chronic. Necrotizing pancreatitis can result from extreme cases of acute pancreatitis. Treatment for each case of pancreatitis depends on the severity of symptoms.

Acute pancreatitis

Acute pancreatitis is a main cause of hospital admissions for gastrointestinal issues. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), around 275,000 Americans are admitted to the hospital for acute pancreatitis every year.

The onset of acute pancreatitis is often very sudden. The inflammation usually clears up within several days after treatment begins, but some cases could require a hospital stay.

Acute pancreatitis is much more common in adults than in children. Gallstones are the primary cause of acute pancreatitis in adults.

The condition can also develop into chronic pancreatitis, especially if you smoke or regularly drink alcohol.

Chronic pancreatitis

Chronic pancreatitis is an inflammation of the pancreas that comes back consistently or occurs over a long period of time.

People with chronic pancreatitis can have permanent damage to their pancreas and other complications. Scar tissue develops from this continuing inflammation.

Pancreatitis can damage cells that produce insulin, a hormone released by the pancreas that regulates the amount of sugar in your blood. This leads to diabetes in about 45 percent of people with chronic pancreatitis.

Long-term alcohol use causes around 70 percent of cases of chronic pancreatitis in adults. Autoimmune and genetic diseases, such as cystic fibrosis, can also cause chronic pancreatitis in some people.

Necrotizing pancreatitis

Severe cases of acute pancreatitis can develop into necrotizing pancreatitis, which refers to the death of cells due to disease. This occurs in about 10 percent  of acute pancreatitis cases, typically when pancreatitis is left untreated.

Inflammation from pancreatitis can cause digestive enzymes to leak into the pancreas. This can result in damage and death of the tissue, leading to necrotizing pancreatitis. Your doctor may order an abdominal ultrasound or CT scan to diagnose the condition.

If you have necrotizing pancreatitis, your doctor may take a sample of the dead tissue to make sure it hasn’t become infected. If you have an infection, you’ll likely need to take antibiotics and may need to have the dead tissue removed.

The infection of dead tissue increases the risk of death from necrotizing pancreatitis, so it’s very important to seek treatment as quickly as possible.  

Pancreatitis causes

Acute and chronic pancreatitis share many of the same causes. These include:

gallstones

drinking a lot of alcohol

some medications

pancreatic cancer

abdominal surgery

infections

cystic fibrosis

injury to your belly

High levels of calcium or triglycerides (a type of fat) in the blood can also lead to chronic pancreatitis.

Gallstones are the most common cause of acute pancreatitis. Gallstones are small, solid masses that form from bile, a fluid that helps with digestion.

A large enough gallstone can get stuck at the junction where the main pancreatic duct and the common bile duct come together. These ducts empty into the duodenum, the first part of the small intestine.

The pancreatic duct carries digestive enzymes from the pancreas. The common bile duct carries bile or other substances from the liver and the gallbladder. A stuck gallstone can cause a backup of these substances, leading to inflammation in both the common bile duct and the pancreas.

Diagnosis of pancreatitis

Your doctor will likely use a combination of blood tests and imaging studies to make a diagnosis. If you have acute pancreatitis, you’ll have severe abdominal pain and blood tests may show a significant rise in your level of pancreatic enzymes.

Different types of ultrasound, MRI, and CT scans can reveal the anatomy of your pancreas, signs of inflammation, and information about the biliary and pancreatic ducts. A fecal fat test can also determine if your stools have fat content that’s higher than normal.

Pancreatic function test

The pancreatic function test, also called the secretin stimulation test, shows whether your pancreas is responding normally to secretin. Secretin is a hormone that causes your pancreas to release a fluid that helps digest food.

During the test, your doctor will run a tube through your nose or throat and down into your small intestine. They’ll inject secretin into your vein, then take samples of fluid through the tube.

Your doctor will send the fluid to a lab to help diagnose pancreatitis or other conditions affecting your pancreas.  

Pancreatitis treatment

Treatment for acute or chronic pancreatitis often involves hospitalization. The pancreas is a key contributor to your digestive processes and needs to rest to heal.

For this reason, you may receive specifically tailored fluids and nutrition intravenously (IV) or through a tube that goes from your nose directly into your stomach. This is called a nasogastric feeding tube.

Medication may help control the pain. You may also receive artificial digestive enzymes for chronic pancreatitis if your pancreas isn’t producing enough of them on its own.

Restarting an oral diet depends on your condition. Some people feel better after a couple of days. Other people need a week or two to heal sufficiently.

Surgery

You may need surgery if other treatments aren’t working. If your doctor diagnoses gallstones, surgery to remove the gallbladder may help. Surgery can also remove diseased parts of your pancreas.

Pancreatitis diet

A low-fat, healthy diet plays a major role in recovering from pancreatitis. People with chronic pancreatitis in particular need to be careful about the amount of fat they consume, since their pancreas function has become compromised. Try to limit or avoid the following foods:

red meat

fried food

full-fat dairy

sugary desserts

sweetened beverages

caffeine

alcohol

Eat small meals throughout the day to put less stress on your digestive system. Stick to foods that are high in protein and antioxidants, and drink lots of fluids to stay hydrated.

Your doctor might also give you vitamin supplements to ensure that you’re getting the nutrients you need.  

Pancreatitis home remedies

It’s important to see your doctor if you think you have pancreatitis, especially if you have consistent pain in your abdomen. There are steps you can take at home to supplement your treatment and help prevent pancreatitis.

Lifestyle changes

Stop smoking tobacco and curb drinking alcohol in excess to help you heal more quickly and completely. Discuss these issues with your doctor if you need help.

Maintaining a healthy weight can help you avoid gallstones, a primary cause of pancreatitis. Eating a balanced diet and staying hydrated can also help you recover from and prevent pancreatitis.

Alternative techniques for pain control

You’ll probably be given IV pain medication in the hospital. Alternative therapies may also help reduce pancreatitis pain.

You can try yoga, relaxation exercises such as deep breathing, and meditation if conventional treatments don’t reduce your pain. These alternative treatments focus on slow, measured movements that can take your mind off your discomfort.

A 2017 study found that acupuncture may provide short-term pain relief for people with chronic pancreatitis. Although more studies are needed, some research has also suggested that taking antioxidant supplements may help relieve pain from pancreatitis.

Pancreatitis pain

Pain associated with pancreatitis may last from a few minutes to several hours at a time. In severe cases, discomfort from chronic pancreatitis could become constant.

Your pain is likely to increase after you eat or when you’re lying down. Try sitting up or leaning forward to make yourself more comfortable.

Activities like yoga, meditation, and acupuncture may help with pain from pancreatitis. You can also try taking pain medication or antioxidant supplements to help relieve pain.

Surgery is currently a last resort for treating pancreatitis, but research from 2013 indicated that performing surgery earlier in the course of treatment may help with pain relief.

Pancreatitis complications

Some people may develop complications. These complications are rare, but they’re more common in people with chronic pancreatitis:

kidney damage

pancreatic cancer

diabetes

malnutrition

pancreatic infections

Acute pancreatitis may increase your risk of developing breathing difficulties. It can also cause pseudocysts to form when tissue and other debris collect on your pancreas. These may go away by themselves. If they rupture, it can cause infection and bleeding that can be fatal if untreated.

Pancreatitis risk factors

Several factors increase your risk of developing pancreatitis. These include:

heavy alcohol use (more than two drinks per day)

obesity

smoking cigarettes

genetics

Men are more likely to develop chronic pancreatitis than women.

A combination of risk factors, like smoking and having a family history of pancreatitis, increases your chances of getting pancreatitis. Smoking or drinking alcohol may also increase the risk of acute pancreatitis developing into chronic pancreatitis.

Pancreatitis prevention

Depending on the cause, you may not be able to prevent pancreatitis. Still, there are several things you can do to reduce your risk:

Limit your alcoholic drinks.

Stop smoking.

Maintain a healthy weight.

Eat a balanced diet.

Eating high-fiber foods and avoiding sugar may help you prevent gallstones, which are the main cause of acute pancreatitis.

Outlook

You can control pancreatitis with a healthy lifestyle and medical treatment when necessary. It’s particularly important to avoid smoking and drinking a lot of alcohol to reduce your risk of pancreatitis and to help you recover.

If any of your symptoms reappear, speak with your doctor as soon as possible.

 

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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