The pancreas is a long, flat, glandular organ that is located above the stomach in the upper portion of the abdominal cavity. It is a dual-purpose organ that helps the body digest fats, carbohydrates, and proteins and it also regulates sugar levels in the body by producing enzymes to raise and lower proper blood sugar levels.
When food being digested reaches the first portion of the small intestine, the digestive enzymes produced in the pancreas enter the digestive system to assist breaking it down. It also constantly monitors the level of glucose and creates insulin to lower blood sugar and glucagon, which raises the level of glucose in the blood.
When the pancreas becomes inflamed, it is called pancreatitis.
Causes of Pancreatitis
The clinical cause behind pancreatitis are digestive enzymes that become activated while still in the pancreas, causing irritation and inflammation to the pancreas itself. The accumulation of pancreatic fluids can cause the pancreas to try to self-digest. Mild cases may go away on their own, but severe cases can cause life-threatening complications.
Scarring of the pancreas – as can be caused by alcohol abuse, recurrent gallstones, genetic disorders like cystic fibrosis, traumatic injury, certain medications, high blood triglyceride levels, and infectious diseases like the mumps – can also contribute to the development of pancreatitis.
Acute Pancreatitis
Acute pancreatitis can come on suddenly and last for days. Sudden onset of acute pancreatitis is marked by intense pain located in the upper abdominal region that can radiate to the back, as well as nausea and vomiting.
There are two forms of acute pancreatitis, mild and severe. Mild acute pancreatitis can be successfully managed in a general hospital ward, but severe acute pancreatitis will require admission to an intensive care unit because the possible complications that can develop are quite severe and life-threatening such as organ failure, development of abscesses, and possible necrosis of the pancreas. Severe acute pancreatitis has a mortality rate of 2%-9% making immediate hospitalization and treatment crucial to avoid further complications.
Complications from acute pancreatitis can include shock, infection, systemic inflammatory response, high blood glucose levels, and dehydration. The intense pain can force a patient to breathe more shallowly and lead to lung collapse. Further recurrent episodes of pancreatitis can cause the development of pancreatic pseudocysts, portions of the pancreas being walled off by scar tissue, which can become infected, rupture, and bleed, necessitating immediate and invasive treatment, although these cases are rare.
The biggest cause of acute pancreatitis is the presence of gallstones. The second most common cause of acute pancreatitis is alcohol abuse.
Chronic Pancreatitis
Pancreatitis can be a chronic condition that starts slowly and takes place over many years. Chronic cases are accompanied by permanent damage to the pancreas over many years until symptoms appear. Often, patients are unaware they have pancreatitis until they have a symptomatic episode.
Chronic pancreatitis is marked by the same intense upper abdominal pain, nausea and vomiting signs and symptoms. In addition, patients with chronic pancreatitis may also have foul-smelling, oily bowel movements, weight loss, fatigue, and possibly the development of type 1 diabetes due to damage to the pancreas’ ability to regulate insulin.
Treatment of Pancreatitis
The condition is treated through IV fluids and pain medication; sometimes, antibiotics may be recommended. A nasogastric tube may be required for feeding and a CT scan or ultrasound may be ordered to verify the condition.
For acute pancreatitis, the method of treatment depends on its severity and underlying cause. If caused by alcohol, cessation of all drinking for 6-12 months is necessary to prevent a recurrence. If caused by gallstones, often removal of the gallbladder is performed to prevent further episodes.
For chronic pancreatitis, treatment revolves around the underlying cause as well, including management of pain and watching for malabsorption (the inability to absorb nutrients from food). Careful monitoring of diet, and a pancreatic enzyme replacement may be required to ensure proper digestion and absorption of nutrients. Avoidance of alcohol in any form may be needed as well as careful monitoring of glucose levels to guard against the development type 1 diabetes.
If you or a loved one has ever received a diagnosis of pancreatitis, careful monitoring of the condition is necessary to guard against complications and further episodes. It is necessary to add a gastroenterologist to your permanent lineup of doctors and committing to changes in your lifestyle.
If you have ever suffered a pancreatic episode, then you realize how important having a good gastroenterologist by your side can be. Contact the team from NorthShore Gastroenterology & Endoscopy Centers by calling (440) 808-1212 or request a consultation online to have one in your corner to protect against future issues.