Pancreatitis prevention: this ailment is commonly believed to be the result of overindulgence in alcohol but, while those who overindulge may suffer from this ailment, it is also seen among those who do not use alcohol.
The pancreas is an organ located on the rear of the abdominal wall. This organ secretes digestive juices into the small intestine. It also produces and secretes insulin to regulate blood sugar level. Pancreatitis is the inflammation and/or infection of the pancreas. The inflammation begins when pancreatic enzymes escape into the pancreatic tissue. This causes chemical irritation, collection of fluid, and blood vessel congestion. There may be severe pain, fever, nausea, vomiting, and elevated blood pressure. After one of these episodes, the irritation and symptoms generally subside, although there may be bleeding, formation of pus or the death of pancreatic tissue. Severe attacks can cause the skin to become cold and/or moist with a below normal body temperature. Shock and dehydration may follow.
ACUTE PANCREATITIS
The main causes of acute pancreatitis in adults are gallstones, related gallstone disease and alcohol consumption. Other causes may be viral infections (mumps, pneumonia, etc.), injury, pancreatic surgery, heredity, hormone imbalances or certain medicines. This type of pancreatitis generally begins with severe upper abdominal pain, radiating through the back and under the shoulder blades. The pain can last for several days or longer, usually running its course within a week. This discomfort is usually worse when the patient is lying flat on the back, with eating or after drinking alcohol. Often patients can relieve this pain by sitting up and bending forward, though vomiting and nausea may still follow. Other symptoms include swollen abdomen, bloating, mild jaundice, fever, skin rash and light-colored stools.
In severe cases of acute pancreatitis the pancreas becomes infected, requiring antibiotic treatments. In these cases, hospitalization may be necessary with intravenous fluid replacement therapy to restore blood volume. Endoscopic surgery may be performed to remove gallstones if they are blocking drainage of the pancreas or rarely, the pancreas may be removed. For those with another type of acute pancreatitis, hemorrhagic pancreatitis, the death rate is high, particularly when other health problems such as heart, kidney or liver disease are present.
The diagnosis of acute pancreatitis can be difficult because of the deep location of the pancreas within the body. A physical examination and various blood tests are performed to monitor the levels of amylase and lipase, pancreatic enzymes. If these tests are inconclusive and imaging tests are necessary, ultrasound imaging, CAT scans and other methods may be used to get a clear picture of the degree of pancreatic inflammation.
Four to six weeks after the onset of acute pancreatitis, pancreatic abcesses (pseudocysto) may form in a small number of patients. These may be surgically removed, if necessary. Pseudocysts occur in about 20% of those with acute pancreatitis. These are collections of fluid, enzymes and blood which amass in the pancreas about one to four weeks after the onset of pancreatitis. These often clear up untreated while some require surgical drainage. Patients having acute pancreatitis generally make a full recovery if the underlying cause can be removed.
Acute pancreatitis can affect all ages and sexes but it is more commonly seen in men than women. When found in children, it is usually associated with another ailment such as cystic fibrosis, mumps, Reye's syndrome, abdominal trauma or some viral illness.
Prevention can include:
---limiting alcohol intake
---avoidance of abdominal trauma
---careful food preparation techniques
---avoidance of aspirin in treating children to reduce risk for Reye's syndrome
---immunization of children against mumps
CHRONIC PANCREATITIS
Chronic pancreatitis occurs after repeated attacks of acute pancreatitis, as a result of the damage to the pancreas in prior episodes. The pancreas becomes progressively unable to supply digestive juices and hormones. This progression slowly destroys the pancreas. The sufferer may experience upper abdominal pain, diarrhea, malnutrition and drastic weight loss. Often patients will develop diabetes when insulin secretion is reduced.
Treatment for chronic pancreatitis depends upon the stage of progression. Tests may be performed to detect pancreatic calcification and, although it is not always present, it is a definite sign that extensive damage has taken place. Other diagnostic methods may include untrasound imaging and scanning procedures.
Pain management is key at this stage. Enzymatic supplements may also be prescribed, as is insulin for those who develop diabetes. Alcohol is strictly forbidden in cases of chronic pancreatitis. Chronic pancreatitis may result in numerous and progressively more damaging attacks. A small number of cases are unresponsive to treatment and are fatal.
