Pancreatitis

• Symptoms: Mild to extreme upper abdominal pain, recurring pain that either builds up slowly or happens suddenly, discomfort while eating, tender and swollen abdomen, vomiting, nausea, fever, rapid heart rate, unexplained weight loss, foamy diarrhoea, and diabetes
• Causes: Certain medications that harm the pancreas, infections, high triglycerides in the blood, abdominal injury, and genetic disorders like cystic fibrosis
• Risk Factors: If an individual is male, an African American, frequent smoker and drinker, have a family history of gallstones or pancreatitis, obesity, diabetes, gallstones, and high levels of triglycerides
• Severity: Could be acute or chronic
• Which doctor to consult: Gastroenterologist

Overview

A pancreas is a flat, long gland that sits in the upper abdomen, behind the stomach. It is responsible for the production of enzymes that aid digestion. The organ also produces hormones that help the body process sugar or glucose in a regulated manner.

Sometimes, the pancreas may suffer from inflammation, and that's known as pancreatitis. It often occurs as acute pancreatitis, which means it can appear out of the blue and last for a couple of days. Although, some people may also suffer from chronic pancreatitis that may develop over the years.

Let’s take a quick look into both types of pancreatitis:

• Acute Pancreatitis

When the inflammation in the pancreas lasts for a very short time and happens suddenly, it's acute pancreatitis. It can bring along mild discomfort or pose life-threatening harm. Although, most individuals with acute pancreatitis recover from it very quickly. In severe cases, it can cause bleeding, infection, tissue damage, cysts, etc. If it becomes a painful condition, it can damage significant organs like the lungs, heart and kidneys.

• Chronic Pancreatitis

This kind of pancreatitis is long-lasting and usually happens right after acute pancreatitis. This could also occur if an individual drinks heavy amounts of alcohol on a regular basis for a long time. This may not cause sudden symptoms, but one day, the symptoms of severe pancreatitis may begin to appear.

That said, it can quickly improve with the proper treatment if it's a mild case of pancreatitis. On the other hand, severe cases could lead to fatal complications.

So, treatment and diagnosis at the right time are of absolute necessity!

When to consult a doctor?

If a person is suffering from pancreatitis, he/she should make sure to apprise the doctor of any new symptoms that might be worsening over time. It is absolutely necessary to visit the doctor if he/she experiences any of the following distressful situations:

• Nausea
• Vomiting
• Severe pain that painkillers can't fix
• Rapid heartbeat
• Chills
• Fever
• Fatigue
• Weakness and fainting
• Unintentional weight loss
• Greasy, smelly stool
• Jaundice-like symptoms
• Agitation and confusion
• Unconsciousness

Also, individuals should not hesitate to call a healthcare provider if they have any confusion about the treatment or want to try any herbal remedy or over-the-counter medications. A doctor can help one quit smoking and adopt a healthy diet to lose weight or make any other lifestyle changes required to manage pancreatitis.

Diagnosis

• Physical examination

If a doctor suspects there are any signs of pancreatitis, he/she may talk to the patient about the risk factors and symptoms. More than just a quick conversation about the same is required, though.

• Diagnostic tests:

1. Lab Tests

A doctor may recommend a blood test to check the levels of lipase and amylase enzymes produced by the pancreas. If these enzymes are at high levels, it can indicate acute pancreatitis. Besides that, a stool test may be conducted to check if the body is able to break down fat properly.

2. Advanced tests

Lab tests may not be enough, so your doctor may order some advanced tests, which include a CT scan and an ultrasound which can offer images of the bile duct, gall bladder and pancreas to spot any abnormalities. Besides that, an individual may also require an oral glucose tolerance exam to see the blood sugar level before and after drinking the sweet solution.

There's also a secretin pancreatic function test wherein a tube is inserted from the throat to the upper small intestine to release secretin hormone in the pancreas to check for the response. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography may also be done.

Treatment

Home treatment

1. An individual can certainly manage the situation with pancreatitis and relieve some pain with home remedies like:
2. Switching to a low-fat diet and consuming vegetables, fruits, whole grains, legumes, and non-fatty dairy alternatives such as almond milk.
3. If an individual is struggling with extreme pancreatitis symptoms, he/she should try to stay on a clear liquid diet until the pain and symptoms start to ease. So, feasting on broth, juice, jello and popsicles can help.
4. Consuming some over-the-counter digestive enzymes can ease some digestive discomforts.
5. Enhancing the antioxidant level and ensuring consumption of enough Vitamins A, C, and E because they boost recovery. Making it a point to eat berries, nuts and citrus fruits, can help lower the inflammation in the pancreas.

Medications

Pancreatitis may sometimes lead to immense pain, so the doctor may prescribe some pain medications to help control and manage the troubles. Also, an individual might get dehydrated over time due to all the fluids and energy used to repair the pancreas. So, a patient may need extra fluids, which a healthcare team can provide through an IV during hospitalisation.

Surgical treatment

Depending on the reason behind pancreatitis and the severity of it, a healthcare team may find surgery a suitable option. The treatment in this regard will include gallbladder surgery. If the reason for the pancreatitis is gallbladder, it will require surgery for the same (cholecystectomy).

Alternative management

Besides all the medications and surgical treatments, there are some alternative procedures at disposal:

1. ERCP: If pancreatitis occurs due to a blocked or narrow bile duct, doctor may conduct an ERCP to widen or open this bile duct. This procedure (endoscopic retrograde cholangiopancreatography) includes putting a long tube with a camera attached to one end down the throat of the patient. The camera clicks pictures of the digestive system and helps in monitoring and examining the bile ducts and pancreas. It can also help clear the path from any obstructions, such as gallstones.
2. Endoscopic procedures: If the pancreas needs fluid draining or removal of diseased tissue, the doctor can suggest some endoscopic procedures. Endoscopic ultrasound may also help to manage the pancreatitis pain.
3. Dietary changes and low alcohol intake: A dietician may create a low-fat diet plan rich in nutrients. A dietician may also help the patient get enrolled in an alcohol addiction therapy if he/she is unable to stay off it.
4. Enzyme supplements: In cases of chronic pancreatitis, enzyme supplements are provided to help the body break down food and process the nutrients one has consumed.

Risks & Complications if Left Untreated

If pancreatitis is left untreated, it can pose severe health troubles, which can cause lasting and life-threatening complications. These complications may include the following:

• Breathing problems

Acute pancreatitis often brings a chemical change in a person's body which may impact the lung function. This can pull the oxygen levels down to a shallow level, which is dangerous.

• Kidney failure

Acute pancreatitis leads to kidney failure, which can be dealt with with proper dialysis treatment.

• Pseudocyst

Sometimes, pancreatitis can cause a collection of debris and fluid in the pancreas and look like a pocket of cysts. If it ruptures, it can cause serious infection and internal bleeding.

• Infection

This is utterly common since the disease leaves the pancreas vulnerable and prone to infection. This infection may sometimes be severe and require surgery to remove the tissue.

• Diabetes

Chronic pancreatitis often damages the insulin-producing cells, which causes diabetes.

• Malnutrition

Both forms of pancreatitis leave the pancreas unable to produce substantial enzymes that can properly break the food down to process essential nutrients. This can lead to weight loss, diarrhoea, and malnutrition, even though an individual is eating healthy food.

• Pancreatic cancer

If the inflammation in the pancreas lasts too long, it can put a person at risk of getting pancreatic cancer.

Additional information

What is the pancreas, and where is it located?

The pancreas is an organ in the belly or the upper abdomen. It is connected to the duodenum or the small intestine and comprises a pancreatic duct essential for draining necessary digestive enzymes into the small intestine.

This organ has two primary responsibilities. One is to create digestive enzymes and transmit them to the small intestine. There, the enzymes help to break down the fats, proteins and carbohydrates from the food an individual is consuming.

The second function is the production of multiple hormones and releasing them into the bloodstream. One of the essential hormones among all is insulin which controls the blood sugar level and helps store energy in the body.

Is there any way to prevent or avoid pancreatitis?

Specific lifestyle changes can help with the symptoms of pancreatitis and help a person avoid gallstones altogether. Gallstones are 40% of the cause of acute pancreatitis. So, here are the things that an individual can try to ensure the prevention of pancreatitis:

1. Exercise regularly
2. Maintain a healthy weight
3. Avoid consumption of alcohol
4. Abstain from smoking

If these lifestyle changes don't help and an individual get a gallstone anyway, the doctor might also suggest removing the gallbladder.