Pancreatitis

What is Pancreatitis?

The pancreas is an organ or gland that lies behind your stomach, in the upper abdomen, and closer to your back. It has 2 main functions:

  • It produces digestive enzymes that help break down food.
  • It produces hormones such as insulin and glucagon that help regulate the body’s blood sugar level.

Pancreatitis refers to inflammation or swelling of the pancreas. Pancreatitis can be acute (occur suddenly in the matter of hours or days) or chronic (have a prolonged course over the years).

SYMPTOMS
  • Severe abdominal pain or tenderness, that may be associated with back pain
  • Nausea and vomiting.
  • Fever, chills or rigours.
  • Palpitations or fast heartbeat.
  • Shortness of breath.
  • Jaundice (Yellow coloured skin or eyes)
WHEN to See a Doctor

Seek medical attention immediately if you’re experiencing severe abdominal pain, that is out of the ordinary for you, or if the pain is getting worse or you are worried. Acute pancreatitis is a serious condition that can result in severe complications, such as:

  • Multi-organ failure
  • Infections
  • Necrotizing pancreatitis (the death of some sections of the pancreas
  • Breathing difficulty due to adult respiratory distress syndrome (ARDS)

 

Chronic pancreatitis is associated with diabetes, malnutrition, unintentional weight loss, diarrhoea due to fat malabsorption, and pancreatic cancer. Patients often may see their doctor because of one of the symptoms associated with these complications.

CAUSES

The most common cause of acute pancreatitis is gallstones, which are stones that develop in the gallbladder and may fall into the common bile duct and obstruct the pancreatic duct. Chronic alcohol use can also cause acute pancreatitis and is the most common cause of chronic pancreatitis. Pancreatitis can also occur in cases of trauma to the pancreas or due to certain medications or infections. A family history of pancreatitis is also associated with an increased risk of pancreatitis. For example, individuals with cystic fibrosis are predisposed to pancreatitis. In rare instances, pancreatitis can be hereditary, where a person has recurrent episodes of pancreatitis leading to chronic pancreatitis.

RISK FACTORS
  • Gallstones
  • Excessive alcohol consumption. 
  • Cigarette smoking.
  • Obesity.
  • Diabetes.
  • Family history of pancreatitis.
DIAGNOSIS

Tests and procedures used to diagnose pancreatitis include:

  • Blood tests to look for elevated levels of pancreatic enzymes (amylase and lipase), white blood cell count, kidney function tests and liver function tests.
  • Ultrasound to identify gallstones, gallbladder inflammation or bile duct obstruction.
  • Computerized tomography (CT) scan to assess for pancreas inflammation
  • Magnetic resonance imaging (MRI) to look further evaluate the gallbladder, pancreas and bile and pancreatic ducts
  • Endoscopic ultrasound to identify blockages in the pancreatic duct or bile duct or identify signs associated with chronic inflammation.

 

Stool tests in chronic pancreatitis to measure fat globules that suggest malabsorption.

TREATMENT

Treatment for acute pancreatitis usually involves admission to the hospital. Inpatient treatment involves:

  • Aggressive intravenous (IV) fluids
  • Analgesia or pain relief medicine, 
  • Antibiotics in certain cases
  • Supportive nutrition 
  • Treatment of the underlying cause such as gallstones.

 

Treatment of chronic pancreatitis usually involves treatment of the complications including treatment for diabetes, malabsorption and analgesia/pain relief.