Pancreatitis

What is pancreatitis?

Pancreatitis is a condition that occurs when the pancreas becomes inflamed. This happens when digestive enzymes produced by the pancreas start digesting the pancreas itself. Pancreatitis can be acute or chronic. 

The pancreas is a gland that sits behind the stomach in close proximity to the duodenum, or the first part of the small intestine. The pancreas is both an exocrine and endocrine organ, meaning it plays a role in the chemical digestion of our food by secreting digestive enzymes into the small intestine, and it plays a role in balancing of our blood sugar by releasing insulin and glucagon into the bloodstream. 

Acute pancreatitis begins suddenly and typically goes away in a few days with treatment. It can; however, be extremely serious and life threatening and requires prompt medical attention by a trained medical professional like Dr. Sinha.

What causes Acute Pancreatitis?

Often, the cause of acute pancreatitis is a lodged gallstone stuck somewhere around the duodenal papilla. This is the location where the common bile duct (from the liver and gallbladder) and pancreatic duct join together and secrete their contents into the duodenum.

…The common hepatic duct (from the liver) and cystic duct (from the gallbladder) join together to form the common bile duct. This tube like structure carries bile produced in the liver and stored in the gallbladder to the duodenum where it is secreted after meals to help us digest fats. The pancreatic duct dumps digestive enzymes produced in the pancreas into the duodenum. The two tubes join together at the duodenal papilla and secrete their contents into the duodenum.

A mobile gallstone can become lodged at the duodenal papilla, blocking both the common bile duct and the pancreatic duct, preventing pancreatic enzymes from being released into the duodenum. When you eat, the pancreas releases digestive enzymes to aid in digestion. In the case of a lodged stone, pancreatic enzymes continue to be released after eating, but they have nowhere to go because the stone is blocking their entrance into the duodenum. Pancreatic enzymes start to build up in the pancreas and digest the pancreas itself resulting in inflammation and acute pancreatitis.

What are the symptoms of acute pancreatitis?

Typical symptoms include:

  1. Severe pain in the upper abdomen, often on the left hand side in the area of the pancreas,
  2. Pain that radiates around to the back,
  3. Nausea,
  4. Vomiting,
  5. Lack of appetite, and
  6. Fever

How is acute pancreatitis diagnosed?

Often a combination of blood work, imaging studies (like CT scan), and a detailed history and physical exam will produce the diagnosis. Classically, lipase and amylase blood test levels are elevated.

How is acute pancreatitis treated?

Treatment typically involves bowel rest, IV fluids, antibiotics, and medications to aid with pain relief. Sometimes removal of the gallbladder may be required.

What is chronic pancreatitis?

Chronic pancreatitis occurs when the pancreas does not heal or improve. It is long lasting. It gets worse over time and can lead to permanent damage within the pancreas.

What causes chronic pancreatitis?

The most common cause of chronic pancreatitis is heavy alcohol abuse, although other causes exist and include: 

  1. Inherited conditions that can result in grossly elevated triglycerides or fats in the blood stream,
  2. Cystic fibrosis, and
  3. Other autoimmune disorders.

What are the symptoms of chronic pancreatitis?

Symptoms include:

  1. Nausea,
  2. Vomiting,
  3. Weight loss, and
  4. Oily appearing stools or stools that float and are hard to flush.

How is chronic pancreatitis treated?

Treatment options involve treating any underlying diseases that may be contributing to the condition such as high cholesterol, supplementing with pancreatic enzymes, and making appropriate dietary modifications.

Avoidance of alcohol and tobacco is paramount, and surveillance for secondary complications is advised. Hospitalization, IV fluids and antibiotics may also be required at times throughout the course of the disease. 

Can pancreatitis increase my risk for developing cancer?

Yes.

Chronic pancreatitis can increase one’s risk for developing pancreatic cancer especially in smokers. Sometimes chronic pancreatitis can be due to an inherited gene mutation, which can substantially increase affected individuals lifetime risk of developing pancreatic cancer.

Five years after diagnosis, patients with chronic pancreatitis have an 8 fold increased risk of developing pancreatic cancer compared with the general population. Close follow up with a trained gastroenterologist like Dr. Sinha is strongly advised. 

**The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a health care professional. For a thorough and comprehensive evaluation please call our office at 908-788-8200 to schedule a consultation.

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