Pancreatitis is a serious disease, in which the tissue of the pancreas is affected and becomes inflamed. The pancreas is located behind the stomach and has a function in the digestion of proteins and fats in the intestine and in the production of insulin. A distinction is made between an acute (short) and chronic (recurrent) pancreatitis.
Cause
In case of pancreatitis, digestive enzymes are already activated in the pancreas, while they actually only would have to work in the intestines. The enzymes damage the tissue of the pancreas, causing it to inflame. In most cases, a pancreatitis is caused by:
- Gallstones blocking the duct from the pancreas to the intestine.
- Excessive alcohol consumption. This is particularly common with chronic pancreatitis.
There is sometimes another cause, for example a metabolic disease (such as excessive calcium content), a viral infection (for example the mumps), a side effect of certain medications or a very uncommon hereditary form. Sometimes, the cause remains unknown.
Symptoms
Pancreatitis causes severe pain in the left middle of the abdomen, where the pancreas is located. This pain may radiate to the left side, left shoulder and back. Other signs and symptoms of pancreatitis are:
- Fever.
- Excellerated breathing.
- Nausea.
- Vomiting. This worsens after a meal.
- Poor appetite.
In addition to these symptoms, chronic pancreatitis often leads to digestive disorders, because the function of the organ continues to deteriorate. The pancreas produces, for example, fewer and fewer enzymes and therefore they will be less and less delivered to the intestine. So, the food mesh in the intestines thickens insufficiently, with diarrhea as a result. Diabetes can also occur, when the pancreas stops producing insulin. An acute pancreatitis usually lasts several weeks.
Diagnosis
The doctor makes the diagnosis based on the symptoms, combined with various examinations:
- Blood and urine tests. These measure the enzyme content of the blood.
- Ultrasound of the abdomen. This provides information about the state of the pancreas.
- CT scan. When ultrasound doesn’t provide enough clarity.
- ERCP. This examination is done when it's suspected that gallstones block the drain of the pancreas.
Treatment
In case of an acute pancreatitis, the patient is admitted to the hospital for treatment. If the cause of the inflammation is not clear, it is especially important to calm down the inflammation. The patient will get a tube in the nose that runs to the stomach. The gastric juices are drained with suction, so that the pancreas and intestines get rest. If the inflammation is very severe, the patient receives tube-feeding. Painkillers are given for the pain and also fluid is administered.
If the cause is known, then the treatment is aimed to eliminate this cause. Think of removing the gallstones, treating the metabolic disease or replacing harmful medicines.
If a revival of chronic pancreatitis requires hospitalization, the treatment will largely be the same as in the acute form: rest, pain relief and fluid. Sometimes surgery is necessary, when part of the pancreas is seriously affected by the inflammation. Especially if the patient is weakened, pancreas surgery is very drastic. If the chronic inflammation keeps causing pain, treatment by a pain specialist may help.
Prognosis
In case of mild to moderate pancreatitis, the patient recovers after a few days to more than a week and isn’t very ill, although the pain can be severe. The recovery is usually uncomplicated.
The inflammation is sometimes more serious, when digestic substances are released and damage the pancreas. In case of severe pancreatitis, the patient is very ill, should be mostly cared for in the intensive care unit, various organ systems can give up, there may be a shock and parts of the pancreas or even the whole pancreas may die. In that dead tissue, an infection with bacteria can easily occur. These patients have a poor prognosis. The mortality rate is high and those who don’t die, often have a slow and complicated recovery.
Considerations
- In order to prevent pancreatitis, it’s important to be moderate with alcohol. If there is already pancreatitis, drinking alcohol is strictly discouraged, even when alcohol is not the cause of the inflammation.
- It’s known that smoking, apart from the negative impact on overall health, has an additional adverse effect on the pancreas, when it is acute or chronic inflamed.
- For overall health, it’s wise to eat healthy and varied. Also try to drink sufficiently. A dietician can help with a personal nutritional advice.
