Pancreatitis
Pancreatitis is the inflammation of the pancreas. This happens when digestive juices or enzymes attack the pancreas.
The pancreas lies behind your stomach on the left side of your abdomen. It is close to the first part of your small intestine (the duodenum).
The pancreas is a gland. It does two main things:
- It makes enzymes and sends them into your small intestine. These enzymes help break down food.
- It makes the hormones insulin and glucagon and sends them into your bloodstream. These hormones control your body’s blood sugar level.
Pancreatitis may be sudden (acute) or ongoing (chronic).
Acute pancreatitis
- Is a sudden inflammation
- Lasts for a few days to weeks
- Usually is self resolving and does not happen again if the original cause was eliminated
- May cause serious problems or be deadly in severe cases
Chronic pancreatitis
- Is a long-lasting inflammation that comes and goes over time
- Causes permanent damage to the pancreas
- Often causes scarring of pancreatic tissue
- May cause the pancreas to stop making enzymes and insulin in severe cases
What causes pancreatitis?
The most common causes of pancreatitis include:
- Alcohol abuse
- Gallbladder stones. Gallstones block the pancreatic duct so the enzymes can’t get out of the pancreas.
Other causes of pancreatitis include:
- Abdominal injury or surgery
- High levels of fat (triglycerides) in the blood
- Very high levels of calcium in the blood
- Certain medicines, such as estrogens, steroids, and thiazide diuretics
- Infections, such as Mumps, Hepatitis A or B, or Salmonella
- Cystic fibrosis
- A tumor
- Certain genetic defects
- Congenital abnormalities in the pancreas
- Cigarette smoking
What are the symptoms of pancreatitis?
Each person’s symptoms may vary. Symptoms may include:
- Severe abdominal pain that may spread to your back or chest (it may feel worse after you eat)
- Nausea
- Vomiting
The symptoms of pancreatitis may look like other health problems. Always see your healthcare provider to be sure.
How is pancreatitis diagnosed?
The final diagnosis is done by checking the level of Lipase in your blood.
Ultrasound of the gallbladder can help determine if gallstones are the cause of your acute pancreatitis
ERCP or endoscopic retrograde cholangiopancreatography is a procedure that may need to be done by the gastroenterologist to remove stones from your bile duct. This is done under sedation by placing a camera down your mouth, food pipe and stomach.
How is pancreatitis treated?
The inflammation is usually self-resolving and requires an admission to make sure you are receiving enough fluids. Pancreatitis often gets better in a few days.
Surgery to remove your gallbladder is warranted when you have gallstones and acute pancreatitis. This is usually achieved laparoscopically (through small incisions) and should be done as soon as you recover from you pancreatitis, because in about one-third of patients the pancreatitis or even a worse inflammation will return within 3 months time.
The treatment of chronic pancreatitis involves:
- Alcohol avoidance (if your pancreatitis is caused by alcohol abuse)
- Smoking cessation
- Enzyme supplementation to help digest your food
- Insulin supplementation (if you get diabetes)
- Low fat meals, frequent and high in protein
Sometimes surgery may be necessary to remove a portion or your whole pancreas that is not functioning appropriately and may be causing you pain.
What are the complications of pancreatitis?
A small number of cases end up with fluid collections around the pancreas that require drainage.
Nutritional consideration for the patient with Pancreatitis
Pancreatitis refers to inflammation of the pancreas. As mentioned above, the pancreas is an organ that aids in digestion and produces hormones that control glucose levels in the body.
Common nutrition problems that may arise with pancreatitis:
- Nausea and vomiting
- Onset of diabetes mellitus
- Unexplained weight loss
It is recommended that pancreatitis patients consume a varied diet filled with whole grains, fruits, vegetables, protein, and dairy. Small, low fat meals and staying hydrated will lessen the pain. Alcoholic beverages should not be consumed.
Nutrition intervention summarized:
- Mild pancreatitis can often be managed with intravenous hydration and slow progression to oral diet within a week.
- Moderately severe pancreatitis may require nutritional support through other means before advancing to solid foods as tolerated.
Patients with chronic pancreatitis may be tested for nutritional deficiencies and prescribed the appropriate vitamin therapies as needed.