Pancreatitis: Symptoms, Causes, Treatment & Tips

What is the pancreas?

The pancreas is a fundamental organ for human life that is located in the abdomen, at the level of the stomach and behind a “curtain” formed by the peritoneum, which is a membrane that internally covers the abdominal cavity. The pancreas is involved in multiple functions, but the most relevant are:

Digestive functions: among them, the production of chemical substances or enzymes that are responsible for digesting certain nutrients present in our diet stands out.

Hormonal functions: the best known is the regulation of sugar levels in our blood, through the balance between the production of insulin (which lowers said sugar levels) and glucagon (which increases them).

What is pancreatitis and what types are there?

Pancreatitis is the inflammation of the pancreas, and two types can be distinguished, according to their character:

Acute pancreatitis: when the inflammation occurs on a healthy organ, suddenly, acutely and after starting it lasts for days. Many times, it appears after an alcohol intake or a copious meal.

Chronic pancreatitis: if inflammation problems are repeated over time, they can cause chronic damage.

The remote and deep location of the pancreas in our abdomen means that a possible extension of the inflammatory reaction from this organ to the peritoneum may occur. This, together with the infection and its long-term consequences, make pancreatitis a potentially serious disease.

Who is affected by pancreatitis?

Pancreatitis usually affects people over 35-40 years of age who have a history of gallbladder or bile duct problems or alcoholism. In the latter case, the appearance can be very premature, in people even 25 or 30 years old.

What causes pancreatitis and how does it originate?

The most frequent causes and that, together, cause 8 out of 10 cases of acute pancreatitis are:

Biliary disorders.

Alcoholism: its direct action produces inflammation in the pancreas, as in other different digestive organs.

To explain how pancreatitis originates, it is necessary to know that in the anatomy of the pancreas there is a common “path” between the bile ducts, which come from the gallbladder with the function of releasing products necessary for the digestive processing of fats, and the own ducts of the pancreas, producers of enzymes that help in digestion. When the gallbladder presents calculations or stones (lithiasis), these can remain embedded in this common path. As a consequence of this blockage, an inflammatory reaction occurs in the pancreas.

In short, a stone, acute alcohol consumption or many other less frequent causes can affect the pancreas and trigger inflammation acutely or suddenly or in a more progressive way.

What are the symptoms of pancreatitis?

Symptoms of acute pancreatitis are:

Intense abdominal pain in the area above the navel. Sometimes it goes to the back.

Nausea and vomiting.

Fever : it can appear as an expression of the inflammation itself or secondary infection.

• In some forms where inflammation is accompanied by pancreatic bleeding, bruise-like patches of skin may appear on the sides or near the navel.

Cardiovascular collapse : the most severe cases can evolve into this situation.

Sometimes pancreatitis is painless, which usually leads to high severity due to the delay in its diagnosis.

Symptoms of chronic pancreatitis are:

• Repetition of episodes similar to those of acute pancreatitis: it occurs in the form of outbreaks.

Pain : which can vary in location or character with respect to that of acute pancreatitis, although it maintains a severe intensity.

• There is a problem in the absorption of fats as a result of the failure of the pancreas to produce certain enzymes. This materializes in fatty stools with a sticky and yellowish character, which is medically called steatorrhea.

• Pain can lead to dietary restriction, which, as it occurs mainly in subjects with alcoholism, can lead to weight loss and malnutrition.

What risk factors does pancreatitis present?

Along with gallstones, chronic alcoholism, obesity and being overweight as risk factors, pancreatitis can rarely occur in people who have undergone abdominal surgery, cancer patients that affect the exit region of pancreatic enzymes to the digestive tube, as well as in different infrequent diseases, among which cystic fibrosis stands out.

What complications arise from this disease?

Although most cases of acute pancreatitis are mild and uncomplicated, complications can be serious. Among them, the following stand out:

Sequelae of pancreatic inflammation : it can be limited to the pancreas in the form of a phlegmon, an abscess or a cyst-like formation.

Complications of the whole organism : very varied and that can be life-threatening due to pulmonary, cardiovascular, gastric, renal, metabolic and central nervous system damage.

• In chronic pancreatitis, complications are mainly related to the failure of the pancreas to perform hormonal and digestive functions. It appears like this:

Increased sugar levels.

Deficiency of vitamin A or micronutrients : in turn, they can damage organs such as the retina.

Rarer long-term reactions.

Pancreatic cancer : depending on how pancreatitis evolves.

How is pancreatitis treated?

In both types of pancreatitis, there is no curative treatment. The one for acute pancreatitis focuses on “letting the pancreas rest” through an absolute diet between 2 and 4 days. This usually involves the placement of a nasogastric tube, and the administration of intravenous analgesics and hydration by vein. This process must be carried out in an inpatient hospital setting, both because of its specific needs and because of the risk of serious complications.

If there is proven stone disease, an endoscopic or surgical technique can be performed to open the closed duct. Similarly, there are serious circumstances that require intensive and highly specialized treatment that may include surgery.

In summary, in acute pancreatitis, it is necessary to preserve the pancreas and the functioning of the organs through general measures that allow the remission of inflammation.

On the other hand, if the cause of pancreatitis is known and it is eradicable with surgery, action should be taken in this direction. Occasionally, even pain that is not treatable with medication may require a surgical approach, as well as some of the complications that we have mentioned.

In chronic pancreatitis, the treatment is analgesic and drugs are administered that help the pancreatic enzymes perform their function properly. It must be taken into account that, in these cases, with each outbreak there will be more damage that will limit the functioning of the pancreas.

10 Tips for pancreatitis

• 1. Educate yourself thoroughly: You should do everything possible to know the disease and its symptoms well, especially if you belong to a population group that has risk factors (alcoholism, gallstones, obesity, overweight…) in order to act accordingly.

• 2. Limit fat intake: A healthy, balanced and low-fat diet can reduce the increase in cholesterol and hypertriglyceridemia, which are causes of acute pancreatitis.

• 3. Do not neglect your diet: It is important that you respect and follow to the letter the indications given by professionals regarding the type of food and the hydration that you must follow. Do it especially in case of unexplained abdominal pain or pain that has been classified as colic, in order to try to avoid the formation of stones and fat digestion problems.

• 4. Pay attention to your weight: On the one hand, obesity and being overweight are risk factors for pancreatitis, but you should also watch out for rapid weight loss, due to the increase in cholesterol that it can cause and the consequent formation of lithiasis (stones or gallstones).

• 5. Avoid toxic habits: Avoid habitual alcohol consumption above the established recommendations, as well as high intakes at specific times. Tobacco is another poison that increases the risk of pancreatitis.

• 6. If you have a history, completely abandon alcohol consumption: If you have suffered from acute pancreatitis or already have a diagnosis of chronic pancreatitis, it is essential that you seek professional help in order to quit alcohol with complete abstinence as soon as possible.

• 7. Pay attention to blows in the abdomen: Try to avoid them and stay alert in case of abdominal trauma, since the pancreas can develop an inflammatory process after a strong blow, for example in sports or risky practices.

• 8. Do not self-medicate: Limit the taking of drugs without supervision by a pharmacist or health professional. Some very useful and common medications in common pathologies can influence the appearance of acute pancreatitis in certain cases.

• 9. Watch for certain symptoms if you are a risk patient: If you have undergone abdominal surgery or endoscopic techniques for biliary or pancreatic problems, be extremely cautious and consult your doctor before the appearance of symptoms compatible with pancreatitis such as pain, fever or nausea.

• 10. Follow your doctor’s advice: Your specialist doctor is the one who will monitor your case, in terms of diagnosis, treatment and evolution of the disease. Take into account his indications in terms of the need for endoscopic surgery or another type in case of pathology of the bile duct.

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Dr. Ashwani Kumar is highly skilled and experienced in treating major and minor general medicine diseases.