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(Friday, 24th Oct, 2014)
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Pancreatitis

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Pancreatitis

What is pancreatitis?

This is a disease in which the pancreas becomes inflamed. The pancreas produces enzymes, which digest fats, proteins and carbohydrates in the small intestine.

Damage to the gland occurs when digestive enzymes which are normally harmless, begin attacking the very tissue that produces them. Enzymes and toxins may also enter the bloodstream, affecting other organs like the heart and lungs. If the disease progresses, the pancreas loses its ability to generate vital enzymes needed for digestion and absorption of nutrients. It may also affect the ability of the pancreas to produce insulin resulting in diabetes.

What causes pancreatitis?

Sometimes the exact cause is unknown. Alcohol and drug abuse and gallstones are contributing factors, as well as trauma, surgery to the abdomen and infections.

What are the symptoms of pancreatitis?

Pancreatitis can provoke a number of symptoms, including:

  • Pain in the upper abdomen, slowly building up to a steady persistent pain, reaching the back and other areas. The pain can be quite severe.
  • Fast pulse.
  • Nausea.
  • Vomiting.
  • Fever.
  • Unexplained weight loss.
  • Dehydration and low blood pressure in severe cases.
  • In extreme cases, bleeding of the pancreas can lead to shock.

What will the doctor look for?

Your doctor will ask if you are a heavy drinker. As gallstones are a known contributor to pancreatitis, your doctor will also check for these.

During attacks there may be evidence of high levels of the digestive enzymes that form in the pancreas. Amylase is the principal enzyme involved and this can be measured with a simple blood test.

How is pancreatitis treated?

Your doctor may prescribe painkillers to manage the pain. You should reduce the level of fat in your diet. If gallstones are the cause, they will need to be removed.

If there is significant damage to the pancreas supplementary pancreatic enzymes may be recommended. These assist the process of digestion and help prevent the loss of nondigested nutrients through the gut.

In severe case surgery is required to remove part of the pancreas but this is rarely necessary.

What does the future hold?

Most people suffer just the one attack and do not require ongoing treatment. Some will progress to develop chronic pancreatitis and may require continuing with pancreatic enzyme supplements. Some cases of chronic pancreatitis will go on to develop carcinoma of the pancreas. This is a very rare development and is usually associated with excessive alcohol consumption contrary to medical advice.

Who is most at risk from chronic pancreatitis?

In more than 90% of cases, chronic pancreatitis is caused by excessive alcohol consumption, and generally develops between 30-40 years of age. The first symptoms may not develop for many years despite long-term heavy drinking.

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