Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas lies behind the Stomach and it has a double function: (1) creating insulin and glucagon for sugar metabolism; (2) producing enzymes or chemicals that enter into the small intestine for the digestion of food.

Diabetes is the most common form of pancreatic disease, and pancreatitis, inflammation the pancreas probably the second most common disease of this organ. In pancreatitis, the digestive enzymes contained within the gland escape into the unprotected surrounding tissues, which they proceed to digest and destroy. This results in considerable swelling or inflammation. This can be very serious and sometimes fatal. Repeated attacks eventually will further damage pancreas, and may result in the chronic or permanent form of the disease.

CAUSES

• Alcohol is by far the leading cause, especially for the chronic form. Alcohol is a powerful stimulant of gastric acid, hydrochloric acid secreted by the stomach to digest food. While the precise mechanism of action is not known, it is suspected that the increased level of gastric acid, in turn, stimulates the pancreas to secrete excessive amounts of the enzymes that do the damage in pancreatitis. Alcohol may also directly injure the pancreatic tissue.
• Gallstones or biliary tract disease are the second most common cause
• Other factors that are thought to contribute to the disease include nutritional deficiencies
• Prolonged use of certain drugs, such as diuretics and oral contraceptives
• Cigarette smoking
• Hereditary pancreatitis can occur
• In cases, the cause is not determined

What are the symptoms of pancreatitis?
Attacks of acute pancreatitis are usually signaled by severe abdominal pain and swelling. Other symptoms include vomiting, constipation, fever and jaundice. In very severe cases, the pancreas may bleed, resulting in shock. The level of pancreatic enzymes in the blood quickly rises above normal a few hours after the onset of acute pancreatitis.

In the chronic form of the disease, abdominal pain may be constant. A history of previous attacks of acute pancreatitis is the best lead to the diagnosis of chronic pancreatitis. The chronic patient is often diabetic with impaired digestion, resulting in steatorrhea, that is, increased excretion of fat the stools.

Despite normal appetite, weight loss is common, due to malabsorption of food resulting from destruction of the pancreas and the lack of pancreatic enzymes. If the pancreas has been excessively damaged, it may be unable to produce sufficient insulin and diabetes may develop.

MANAGEMENT
For the relief of pain, analgesic drugs and Narcotics are usually prescribed. In milder cases, this may be the only treatment required. In severe cases, specifically in those involving shock, blood transfusion and fluid replacement may be necessary. In those relatively few cases that do not respond to treatment, become infected or where hemorrhage occurs, surgery may be indicated. With prompt and proper treatment, patients with mild to moderate acute pancreatitis usually recover in several days. To prevent future attacks, abstinence is strongly advised. If the condition is caused by some other factor, such as gallstones or a metabolic disturbance, this is corrected surgically or medically.