Dr. Ertan Beyatlı

Pancreatic Inflammation (Pancreatitis)

(Update: ) - Digestive System Diseases

Pancreatitis is a disease in which the pancreas becomes inflamed. The pancreas is a long, large gland located behind the stomach and on the side of the small intestine.

The pancreas does two main things:

  • It releases powerful digestive enzymes into the small intestine to help digest food.
  • It releases insulin and glucagon into the bloodstream. These hormones control the energy (Glucose) required by our body from food.

If digestive enzymes start working before the pancreas releases them, the pancreas can be damaged.

Types

There are two main forms, acute and chronic.

Acute pancreatitisis sudden, short-term inflammation (may take several days). It can range from mild discomfort to a serious, life-threatening illness. Most people recover completely after receiving the right treatment. In severe cases, acute pancreatitis can cause bleeding, severe tissue damage, infection, and cysts. It can also damage other vital organs such as the heart, lungs, and kidneys.

Chronic pancreatitis is prolonged inflammation (may continue for years). It occurs most often after an acute pancreatitis attack. Another important reason is drinking too much alcohol for a long time. Damage to your pancreas from heavy alcohol use may not cause symptoms for many years, but your severe pancreatitis symptoms may develop suddenly.

Symptoms

Symptoms of acute pancreatitis

  • Fire
  • Higher heart rate, palpitations (tachycardia)
  • Nausea and vomiting
  • Belly swelling, tenderness (Belly button pain)
  • Abdominal pain. Pain in the upper abdomen that hits the back. Eating, especially foods high in fat, can make complaints worse.

Symptoms of chronic pancreatitis

In addition to the symptoms of acute pancreatitis, the following may occur:

  • Abdominal pain. Continuous tiring pain in your upper abdomen that spreads to your back.
  • Diarrhea and weight loss because your pancreas doesn't secrete enough enzymes to break down food. Oily, foul-smelling stools (steatorrhea, steatorrhea).
  • Nausea and vomiting

Causes and Risk Factors

  • Abdominal surgeries
  • Alcoholism, consuming too much alcohol (alcoholic pancreatitis)
  • Some drugs (ACE inhibitors, Statins, P-450 3A4, Pravastatin, oral contraceptives OX, Diuretics, Hydrochlorothiazide, Furosemide, antiretroviral HIV, Valproic acid, Sugar drugs.)
  • Cystic fibrosis
  • Gallstones (Cholelithiasis) especially small stones
  • High levels of calcium in the blood (hypercalcemia), which may be caused by an overactive parathyroid gland (hyperparathyroidism)
  • High triglyceride levels in the blood (hypertriglyceridemia)
  • infection
  • Autoimmune diseases
  • Metabolic disorders
  • Abdominal injury, Trauma
  • being overweight (obesity)
  • Pancreatic cancer

In 20% of cases it is unknown (ideopathic pancreatitis).

People with chronic pancreatitis are usually men between the ages of 30-40 who drink excessive alcohol and cigarettes.

Pancreatitis Complications

Very serious complications can occur:

  • Diabetes may develop if there is damage to insulin-producing cells.
  • Pancreatic infection
  • Kidney failure
  • Malnutrition if your body cannot get enough nutrients from the food you eat due to lack of digestive enzymes
  • Pancreatic cancer
  • Pancreatic necrosis, when tissues die, your pancreas doesn't get enough blood and rots (pancreatic rot)
  • There may be problems with your breathing when chemical changes in your body affect your lungs
  • When fluid collects in pancreatic pockets, a pseudocyst may occur. These cysts can burst and become infected.

Pancreatitis Diagnosis

Your doctor will test your blood to measure two digestive enzymes: amylase and lipase. High levels of these two enzymes mean you likely have acute pancreatitis.

Other tests may include:

  • Pancreatic function test to find out if the pancreas is making the right amount of digestive enzymes
  • Imaging the pancreas, ultrasound, CT scan and MRI
  • ERCPYour doctor can do imaging using a long tube with a camera to look at your pancreas and bile ducts.
  • Your doctor will remove a small piece of tissue from your pancreas to be examined.biopsymay do a needle biopsy to remove)
  • In some cases, your doctor may test your blood and stool to confirm the diagnosis. They may also perform a glucose tolerance test (GTT) to measure damage to insulin-making cells in your pancreas.

Pancreatitis Treatment

Mild cases of pancreatitis may resolve spontaneously without treatment, but severe cases can lead to life-threatening complications.

Acute pancreatitis treatment

You may need to stay in the hospital during the treatment process:

  • Have a pancreatic infection antibiotics
  • Intravenous (IV) serums given intravenously through a needle
  • Low-fat diet or fasting. You may need to stop eating for the pancreas to heal. In this case, you will receive nutrition through the feeding tube.
  • Pain medications

In more severe cases, the treatment may include:

  • ERCP: Gallstones obstruct the bile or pancreatic duct
  • Cholecystectomy: If gallstones cause pancreatitis, the gallbladder is surgically removed.
  • Pancreatic surgery: to drain fluid, remove dead or diseased tissue

Chronic pancreatitis treatment

  • Insulin in the treatment of diabetes
  • Pain medications
  • Pancreatic enzymes to help your body get enough nutrients from food
  • Surgical surgery to relieve pain, aid with drainage, or treat blockages

Prevention

Many cases of pancreatitis are caused by excessive and prolonged use of alcohol. Prevention often focuses on limiting how much you drink or not. If you are concerned about drinking, talk to your doctor or healthcare professional about an alcohol treatment center.

Stop smoking, follow your doctor's and dietitian's recommendations for your diet, and take your medications so you have fewer and milder pancreatitis attacks.

Prepared by: Dr. Ertan BEYATLI

Benefited Resources: webmd, mayoclinic.

SUMMARY
• Disease: Pancreatitis, Inflammation of the pancreas.
Causes: Alcohol, gallstone, surgery, obesity, medication, trauma, etc.
Symptoms: Abdominal pain, vomiting, palpitations, fever.
• Diagnosis: Hormones (amylase, lipase), USG, CT, MR, ERCP
• Treatment: Diet, antibiotics, pain relief, surgery.

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