Definition and Overview

Pancreatitis refers to the swelling of the pancreas, which is a gland located beside the small intestine and behind the stomach. It releases digestive enzymes into the small intestine, thus playing an important role in digesting the food that a person eats. It is also responsible for releasing glucagon and insulin, both of which are key hormones that control the way the body converts food into energy.

The inflammation of the pancreas is typically triggered when digestive enzymes are released and activated too early, causing them to attack the pancreas instead of helping digest food in the small intestine. This premature release of the enzymes can be caused by pancreatic damage due to disease (pancreatic cancer) or lifestyle issues (excessive smoking and drinking).

When the pancreas is under attack, a person may feel pain in the upper abdominal region. Those who suffer from pancreatitis should seek holistic treatment involving diet changes, lifestyle modifications, self-care, medications, and in some cases, surgery.

Causes of Condition

Pancreatitis occurs when the digestive enzymes are activated even before they reach the small intestine. This damages the pancreas, which then responds by triggering inflammation as part of the body’s natural healing process. Unfortunately, this inflammation can cause some problems and results in a variety of symptoms.

The following are the risk factors for the development of pancreatitis:

  • Abdominal injury or trauma
  • Complication of certain treatments, such as ERCP or endoscopic retrograde cholangiopancreatography, a procedure that treats gallstones
  • Cystic fibrosis
  • Family history of pancreatic disorders
  • Gallstones
  • Heavy alcohol consumption
  • Hypercalcemia, or having abnormally high levels of calcium
  • Hyperparathyroidism, or having an overactive parathyroid gland
  • Hypertriglyceridemia, or having abnormally high levels of triglycerides
  • Infection
  • Metabolic disorders
  • Pancreatic cancer
  • Previous surgery in the abdomen
  • Side effect of medications
  • Smoking
  • Stress
    Depending on the cause, pancreatitis can be either acute or chronic. Acute pancreatitis is a short bout of pancreatic inflammation that occurs suddenly and disappears after a few days, whereas chronic pancreatitis is longer-lasting or recurrent, usually developing after a person suffers from acute pancreatitis.

Acute pancreatitis is generally a milder form of the disease and can be treated completely. However, attacks can be unpredictable; in some cases, the sudden pain is mild, but in others, the condition may develop into a serious life-threatening health issue. If left untreated, there is a risk of some complications, such as tissue damage, bleeding, infection, cysts, and damage to other organs such as the kidneys, heart, and lungs.

Key Symptoms

The symptoms of pancreatitis tend to differ depending on whether it is an acute or a chronic case.

Acute pancreatitis

  • Upper abdominal pain
  • Pain radiating towards the back
  • Pain that gets worse when the patient eats food that has high-fat content
  • Swollen abdomen
  • Tenderness in the abdominal area
  • Vomiting
  • Nausea
  • Rapid heartbeat
  • Fever

Chronic pancreatitis

  • Constant pain
  • Pain radiating to the back
  • Malabsorption of food
  • Sudden or drastic weight loss
  • Diabetes, which can be triggered by the damage to the pancreatic cells that produce insulin

These symptoms, along with the following tests, help doctors confirm their diagnosis of pancreatitis:

  • Glucose tolerance tests – This is a test that checks whether the pancreatic cells that produce insulin are functional or damaged.
  • Pancreatic function test – This is a test that checks whether the pancreas is producing the correct amount of digestive enzymes. If a person has abnormally high levels of either one of the two enzymes, namely lipase and amylase, then pancreatitis is more likely.
  • Imaging scans – Imaging scans, such as ultrasound, CT scan, and MRI scan, give doctors a look at the physical condition of the pancreas to help them detect any problems more easily.
  • Biopsy – This procedure involves inserting a small needle into the pancreas to take a small sample of tissue so it can be further analyzed.
  • ERCP – This is a test that checks the condition of the pancreatic duct and bile duct.

Who to See and Types of Treatments Available

A person suffering from pancreatitis should seek treatment from a hospital, a general physician’s clinic, or a gastroenterologist, a medical professional specializing in the diagnosis and treatment of diseases affecting the gastrointestinal tract. Additionally, since pancreatitis may have a wide-scale effect on the body, there are pancreatic specialist centers as well as pancreatic specialists focused solely on the treatment and management of the disease.

The goals of pancreatitis treatment are:

  • To relieve the pain
  • To counter and fight off the risk of malnutrition
  • To keep the patient’s condition stable

Treatment may consist of:

  • Medications, especially pain medications
  • Low-fat diet
  • Pancreatic enzymes
  • Insulin supplements
  • Surgery – The purpose of a pancreatic surgery is to remove any damaged or dead tissue that has accumulated inside the body. By doing so, the patient will no longer be at high risk of developing an infection.

These should be accompanied by important lifestyle changes such as increased water consumption, smoking cessation, and avoiding high-fat foods.

References:

  • Forsmark CE. Pancreatitis. In: Goldman L, Shafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 146.

  • Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology Guideline: Management of Acute Pancreatitis. Am J Gastroenterol. 2013; 108:1400-1415.

  • Tenner S, Steinbert WM. Acute pancreatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 58.

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