Pancreatitis: Symptoms and treatment - Part 1

PANCREATITIS is inflammation of the pancreas. The pancreas is a digestive organ located deep in the body behind the stomach. Normally, the pancreas makes digestive enzymes which go into the small intestine to help break down and absorb food. A special part of the pancreas makes insulin, the hormone that controls blood sugar levels.

THERE ARE TWO TYPES OF PANCREATITIS:

In ACUTE PANCREATITIS the pancreas becomes inflamed suddenly and rapidly. It is most commonly caused by either alcohol use, typically heavy drinking, or by gallstones blocking the release of enzymes from the pancreas. Less often viral infection, some medications, abdominal trauma, surgery, or even high blood lipid levels can be implicated. About 15% of cases are of unknown cause. Occasionally pancreatitis is a hereditary disease. Digestive enzymes normally sent to the intestine become activated within the pancreas, and the pancreas begins to digest itself.

Symptoms of acute pancreatitis include pain in the upper abdomen which can be severe. Nausea, vomiting, and fever are common. If a gallstone is blocking bile flow from the gallbladder, jaundice with yellowing of the skin and eyes may occur.

Most patients recover completely, but in severe cases, shock and even death can occur.

In CHRONIC PANCREATITIS, damage to the pancreas is an ongoing problem over time. It is usually caused by long term heavy alcohol use. Abdominal pain may be present continuously, or may occur in limited but recurrent episodes. Eventually the pancreas becomes scarred and looses function. The lack of digestive enzymes causes diarrhea, and weight loss. If insulin production is impaired, diabetes may result.

DIAGNOSTIC TESTS include blood tests and radiologic imaging tests:

The most important blood tests for pancreatitis are serum amylase and lipase. These enzymes leak into the blood in abnormally large amounts when the pancreas is inflamed. They are always elevated in acute pancreatitis. In advanced chronic pancreatitis, if enough of the pancreas is destroyed, levels of amylase and lipase may be normal. Elevations of liver enzymes and the white blood cell count occur. Serum calcium may be decreased. Disturbance of insulin production causes increased blood sugar.

Computerized Tomography (CT) scans and ultrasound examination of the abdomen detect signs of pancreatitis. Using endoscopic retrograde cholangiopancreatogram, a doctor can see the

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