Pancreatitis: Symptoms, Causes, Diagnosis and Treatment
Pancreatitis is a disease characterised by the inflammation of pancreas. Its types include, acute pancreatitis and chronic pancreatitis. It’s is advisable to see a gastroenterologist when symptoms of pancreatitis appear.
Pancreas is a large gland which lies at the back of your stomach and surrounded by other organs like small intestine, gall bladder and spleen.
Functions of pancreas include the release of powerful enzymes for digestion and release of hormones, insulin and glucagon, into your bloodstream for energy.
Types of Pancreatitis
Types of pancreatitis include either acute or chronic pancreatitis. Acute pancreatitis left untreated can result into necrotising pancreatitis.
The symptoms of pancreatitis also depend deeply on its type. So, knowing the types play a significant role in diagnosis and treatment of pancreatitis.
Moreover, successful treatment depends on the severity of each type of pancreatitis.
Acute pancreatitis results due to the sudden inflammation of the pancreas. It can be mild, moderate or life threatening but it typically fades away with proper treatment.
Severe acute pancreatitis can have a direct effect on your heart, lungs and kidneys and can cause bleeding, infections and formation of cysts.
Gall stones, smoking and alcohol are the most significant reasons resulting in acute pancreatitis.
Global incidence of acute pancreatitis depicts the ratio of 5-80 people suffering from acute pancreatitis out of every 100,000 population. However, the highest incidence rate was reported in United States and Finland due to more frequent alcohol consumption.
The pancreatic inflammation is a long-term condition that can last for more than a year and occurs after multiple episodes of acute pancreatitis.
Its causes are the same as acute pancreatitis. You may not feel symptoms of pancreatitis due to alcohol consumption for a long time, but you unexpectedly face severe symptoms.
Global indicates that 50 individuals out of every 100,000 have chronic pancreatitis. Its prevalence is more in men than women.
Pancreatitis Signs and Symptoms
Symptoms of pancreatitis include abdominal pain which ranges from mild to severe depending on the type on pancreatitis.
You may develop the pain gradually over time or there might be sudden incidence of pain episodes.
Commonly the pain initiates and escalates after you eat food and it can sometimes be confusing to identify the cause due to similar symptoms with gallbladder and ulcer aches.
Basic symptoms include majorly the following,
- Uncontrolled pain in your upper abdominal area
- The pain navigating to the back to your back
- High fever and chills
- Fatigue and weakness
- Vomiting and constantly feeling nauseous
- Discomfort on touching the abdominal region
- Indigestion and heartburn
- Sudden involuntary weight loss
Characteristic symptoms include particular consistent variations in the colour of stool including,
- Deficiency of fat absorption because of pancreatic inability results in a pale-yellow, lubricious, stinky stool. Such stool can be observed with pancreatitis, pancreatic cancer and cystic fibrosis.
- Intestinal bleeding because of tumorous growth or ulcers result in a black, stinky stool. It can also result due to consumption of iron and bismuth.
- Intestinal bleeding occurring as a consequence of ulcers, tumours or inflammatory bowel disease, result in maroon coloured stool.
- Deficiency of bile due to blockage of the main duct resulting in clay coloured stool.
What Causes Pancreatitis?
Generally, pancreas’ digestive enzymes don’t initiate the breakdown of enzymes and proteins until the food reaches small intestine.
But if the digestive enzymes start the breakdown while still being in the pancreas, pancreatitis results due to the soreness and internal damage to the pancreas itself.
Alcohol, smoking and gallstones are the main causes of both pancreatitis types.
The consistent damage to the pancreas due to acute pancreatitis leads to the chronic pancreatitis. This may result in an injury to your pancreas causing scar tissue formation and loss of functional ability.
A pancreas having poor functional abilities can result in a number of other health problems.
Common causes of pancreatitis include the following,
- Alcohol intake
- Presence of gallstones
- Higher levels of triglyceride in blood
- Family history of pancreatitis
- Autoimmune diseases
- Cystic fibrosis
- Pancreatic cancer
However, the cause of acute pancreatitis is unknown in 15% of people and cause of chronic pancreatitis in unknown in almost 20% to 30% of the people.
The factors that increase the rate of pancreatitis are,
- Disproportionate alcohol consumptions habits
- Cigarette and tobacco intake
- Overweight- more chances of pancreatitis if you are obese
- Genetics and family history
Pancreatitis Diagnosis and Complications
The diagnosis of pancreatitis includes a series of blood tests and imaging reports done by your doctor.
The diagnostic results will indicate severe pain in abdominal region and high levels of enzymes in the pancreas. These enzymes play a significant role in digesting proteins and carbohydrates.
The detailed information about the anatomy of your pancreas and related ducts can be assessed using ultrasounds, MRI, CT scans and some other techniques discussed in this section.
Diagnosis of Pancreatitis
1. Fecal Test
In order to assess the fat content in your stools, a fecal fat test can play a significant role.
2. Blood Tests
The higher levels of enzymes are mostly elevated in the case of acute pancreatitis. However, the increased levels might not depict in the case of chronic pancreatitis.
The blood tests for pancreatitis are the initial tests to be carried out, as they are extremely easy and convenient to use.
Other tests which may be performed include,
- Liver and kidney function
- Tests to check for infection
- Complete Blood Count (CBC) tests
3. Imaging Studies
Computed Tomography, normally referred to as CT scan, of the abdominal region can prove to be very helpful in assessing the anatomy of pancreas and to check the degree of harm caused to it due to inflammation.
It can also be very helpful in finding out other related complications due to it like bleeding and formation of cysts.
It can also help in identifying gallstones which lead to pancreatitis and other structural anomalies in the biliary system.
Ultrasound imaging can also be helpful in identifying gallstones and other structural anomalies. It is the preferable initial imaging test as this modality doesn’t emit radiation and is safe to use.
The need for further testing depends entirely on the illness severity and the underlying cause of pancreatitis.
Complications Due to Pancreatitis
Some serious complications due to pancreatitis include,
- Pseudocyst: Fluid filled cyst pockets can result to due to the high inflammation in the pancreas. And if these large pseudocyst ruptures, it can result in internal bleeding and infection.
- Infection:Pancreas can grow more prone to bacteria and other infections due to acute pancreatitis. These pancreatic infections, if occur, can get serious and involve surgical removal of the infected portion.
- Renal failure.Pancreatitis can end up in renal failure which may require dialysis in severe cases.
- Breathing problems.Chemical changes can occur as a result of pancreatitis and it involves changes in the lung capacity and lung function which can affect the oxygen concentration in your blood to fall dramatically.
- Diabetes Miletus.The pancreatitis can cause damage to the insulin producing cells leading towards diabetes. Diabetes is a disease that alters the way blood sugar is used by your body.
- Pancreatic cancer.Untreated and constant inflammation of pancreas can increase to risk for developing pancreatic cancer. Therefore, it necessary to go see a gastroenterologist whenever you feel the need.
Best Treatment for Pancreatitis and Its Cure
The pancreas plays a major role in the digestion process and needs rest to cure. Pancreatitis treatment often involves hospitalisations for both its types.
The insertion of nasogastric tube might also take place to provide you with the important nutrients and fluids intravenously. It goes directly from your nose to your stomach.
The medications may include artificial digestive enzymes along with other drugs, mostly in case of chronic pancreatitis where the pancreas itself is not producing enough of them.
The recovery period to continue oral diet intake highly depends on the type and condition of pancreatitis. Some may recover in a day or two, while a few take a week or two to heal sufficiently to continue oral diet.
After taking control over your pancreatitis, the health professionals work to treat the main cause of your pancreatitis. The treatment might include the following depending highly on the type of pancreatitis,
1.Bile Duct Removal Procedures
A narrowed down or completely block bile duct involves the procedure to open and broaden the bile duct.
A long tube with camera on one end is used to examine the pancreas and bile ducts in detail. The procedure involves sending tube down the throat and producing pictures of internal organ on a monitor.
This procedure is referred to as Endoscopic Retrograde Cholangiopancreatography (ERCP)
It is noticeable that ERCP in the older adults can also lead to acute pancreatitis.
2. Gall Bladder Surgery
Surgical removal of the gallstones might be recommended by your doctors if the cause of your pancreatitis in gallstones.
3. Pancreas Surgery
Surgical removal of the diseased tissue or to drain fluid from your pancreas might be necessary to lead a healthy life.
4. Treatment for Alcohol Dependency
Excessive drinking habits over years can have a drastic effect on your pancreas. You might not feel any pain or notice the issue until one day you unexpectedly start getting symptoms for pancreatitis.
If alcohol causes you pancreatitis then treatment for alcohol dependency resolves the issue and lead for long term recovery. But continuing to drink even after that, results in decline in the condition and eventually lead to a more serious complication.
5. Additional Treatments
- Pain management using painkillers or the surgical procedures if medications proves ineffective.
- Artificial pancreatic enzymes intake to improve digestion
- Permanent changes to diet comprising of low fat food intake.
So, it is important to go to your gastroenterologist for regular check-ups when faced with any of the symptoms mentioned above. As the famous saying goes by, precaution is better than cure.