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Everything You Need to Know About Pancreatitis

By Dr. Purushottam Vashistha in Nanavati Max Institute of Gastroenterology, Hepatology & Therapeutic Endoscopy

Apr 24 , 2023 | 8 min read

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Inflammation of the pancreas is called pancreatitis. Pancreatic enzymes and hormones control the blood sugar, and a pancreas infection may develop quickly and last days. Some people suffer from chronic pancreatitis that lasts for a long time. Pancreas infection treatment can alleviate symptoms in mild cases of pancreatitis, but severe cases can quickly become life-threatening.

The functions of the pancreas include:

  • Production of digestive enzymes to help you digest food
  • Boosts insulin production, which controls energy use from food

What is Pancreatitis?

An infection in the pancreas results in inflammation or pancreatitis. The digestive enzymes are unable to empty into the digestive tract, thereby affecting digestion and leading to malnourishment, weight loss, and diarrhoea. Moreover, the digestive enzymes trapped in the pancreas now attack the pancreatic tissue, leading to a painful outcome.

Types of Pancreatitis

Here is what you should know more about the different types of pancreas infection and their symptoms.

Acute Pancreatitis

  • In the case of acute pancreatitis, the inflammation happens over a small period of time and is often caused by gallstones or excessive alcohol consumption. 
  • Acute pancreatitis doesn't cause any permanent damage to the pancreas and can be easily treated and cured. 
  • The main treatment for acute pancreatitis includes hydration through IV. In fact, patients with acute pancreatitis are provided with aggressive intravenous hydration, almost 250 to 500 milliliters of fluid per hour.
  • IV hydration treatment at the very start of acute pancreatitis will help prevent it from turning into chronic pancreatitis.

 

Generally, the symptoms of acute pancreatitis include:

  1. Sudden severe pain in the upper abdomen or centre of your tummy
  2. Pain spreading to the back
  3. Pain that lasts for several days
  4. Vomiting
  5. Fever
  6. Nausea
  7. Tender or swollen abdomen
  8. Increased heart rate

 

Chronic Pancreatitis

  • Chronic pancreatitis is a condition caused by ongoing inflammation of the pancreas.
  • This type of pancreatitis is a much more severe illness than acute pancreatitis and can lead to severe complications, such as severe diabetes or kidney failure. 
  • Chronic pancreatitis cannot be cured. However, symptoms and pain can be alleviated with drugs like ibuprofen and Acetaminophen, weak opioids like Ultram and codeine, and stronger opiates like fentanyl and morphine, if necessary. Sometimes surgery might be required to ease the pain.
  • As chronic pancreatitis is often caused by alcohol consumption, abstinence from alcohol itself can help ease the pain and other symptoms.
  • Doctors also prescribe vitamins and other medications to help with your digestion as chronic pancreatitis often results in malnutrition.

 

Generally, the symptoms of chronic pancreatitis include:

  • No pain or pain in the upper part of the stomach
  • Severe pain after having food
  • Nausea
  • Diarrhoea
  • Weight loss
  • Fatty stool with a foul odour

Pancreatitis Symptoms

Depending on the cause, the symptoms of pancreas infection may differ:

  • Back pain originates in the upper abdomen and can be moderate to severe
  • Pain that develops quickly or gradually over a few days
  • Experiencing more discomfort after eating
  • Abdominal swelling and pain
  • Feelings of nausea and vomiting
  • Fever
  • Increased heart rate

 

Chronic pancreatitis: A chronic pancreatic infection generates similar symptoms as acute pancreatitis. Some of the symptoms include:

  • Constant and disabling back pain
  • Unexpected and significant weight loss
  • Diabetes, foamy diarrhoea

Pancreatitis Causes

When digestive enzymes irritate and inflame the pancreatic cells, it causes a pancreatic infection. Chronic pancreatitis develops from repeated acute bouts of pancreas inflammation. Loss of pancreatic function may result from the development of scar tissue. Poor pancreatic function causes digestion issues and diabetes.

Some of the causes of acute pancreatitis include:

  • Abdominal injury
  • Trauma
  • Obesity
  • Gallstones
  • Alcoholism
  • Medications
  • High blood triglyceride levels
  • High blood calcium levels
  • Pancreatic cancer
  • Abdominal surgery
  • Cystic fibrosis
  • Infection

 

Pancreas infection may also occur due to endoscopic retrograde cholangiopancreatography (ERCP). Sometimes, the causes of pancreatitis infection are unknown. Doctors call this idiopathic pancreatitis.

Pancreatitis Risk Factors

  • Excessive alcohol consumption: According to a study, heavy alcohol users have an increased risk of pancreas infections
  • Cigarette smoking: Smokers have three times more pancreas infection risk than nonsmokers
  • Obesity: You have more pancreas infection risk if you're obese
  • Family history increases your pancreas infection risk, particularly when associated with other risk factors.

Pancreatitis Complications

Kidney failure - Pancreatitis can cause inflammation of the blood vessels, which can lead to kidney failure. The symptoms of this condition include nausea, vomiting, and decreased urination.
Breathing problems - The inflammation of the pancreas affects the airway and lungs, causing breathing problems. Pancreatitis also blocks the blood supply to the lungs, leading to breathing difficulties.
Infection - Another complication of pancreatitis is infection. The inflammation of the pancreas weakens the immune system and makes it vulnerable to infections.
Malnutrition - Malnutrition occurs because the inflammation of the pancreas disrupts the digestive system, which can make it difficult to eat and absorb food properly.
Diabetes - When chronic pancreatitis is not treated promptly and properly, it can lead to type 2 diabetes. This happens when the pancreas fails to produce adequate amounts of insulin. 
Pancreatic cancer - Due to the inflammation caused by chronic pancreatitis, cells in your pancreas can divide uncontrollably. This leads to the growth of cancerous tumours, which can be fatal if not treated in time.

    Diagnosis of Pancreatitis

    • Blood parameters for kidney function, liver enzymes, pancreatic enzymes, and white blood cells are evaluated
    • Ultrasound of the abdomen for the detection of gallstones and pancreatic inflammation
    • CT scans for gallstones and pancreas inflammation
    • MRI of gallbladder, pancreas, and ducts
    • Endoscopic ultrasound for pancreatic duct or bile duct inflammation and blockages
    • Chronic pancreatitis stool tests to measure fat levels, which are indicative of poor nutrient absorption

    Pancreatitis Treatment

    Acute Pancreatitis - With proper care and rest, mild cases of acute pancreatitis typically resolve within a few days. Pancreas infection treatment may also include the following if your pancreatitis is severe:

    Surgery - If gallstones induce pancreatitis, your doctor may recommend a cholecystectomy for pancreas infection treatment. Early surgery reduces complications. Doctors may postpone surgery for severe pancreatitis to manage some of the associated complications.

    If you have a large, painful, or bleeding pseudocyst, an abscess, or an infection, your doctor or specialist will drain the fluid in your abdomen for pancreas infection treatment. Your doctor may recommend removing damaged pancreatic tissue.

    Endoscopic Cholangiopancreatography (ERCP) - Doctors use ERCP for both acute and chronic pancreas infection treatment. ERCP combines endoscopy and x-rays to treat bile or pancreatic duct blockages and also removes gallstones from bile or pancreatic ducts.

    Chronic pancreatitis infection treatment may relieve pain, improve pancreas function, and reduce complications. Your doctor may prescribe the following:

    Vitamins and Medicines - Your doctor may prescribe enzyme tablets or vitamins A, D, E, and K for malabsorption. If needed, you may be given vitamin B12 shots.

    Treatment for Diabetes - Due to insufficient insulin production by the pancreatic beta cells, or if your body is unable to use the insulin produced, this may result in diabetes. Your doctor and healthcare team will create a medication routine eating plan and checkup for diabetes.

    Surgery - Your doctor may recommend surgery to relieve pancreatic duct pressure or remove damaged or infected pancreatic tissue.

    In individuals who don't respond to other treatments, surgeons may remove the pancreas and transplant islets. Islets produce insulin in the pancreas. Doctors implant pancreatic islets into the liver, and these islets release hormones into the bloodstream.

    Other Procedures - Your doctor may recommend a nerve block, an injection of numbing drugs into nerves that convey pancreatic pain messages. In cases of pancreatic duct stones, your doctor may break them and remove them.

    Also Read About Pancreatic Pseudocyst Treatment

    Pancreatitis Diet

    Good health and nutrition need a healthy diet. It prevents pancreatic infection, heart disease, diabetes, and cancer. A healthy diet includes a diverse range of foods and less salt, sugar, saturated, and trans fats.

    Focus on protein-rich, low-animal-fat, antioxidant-rich foods to help your pancreas. Beans, clear soups, lean meats, and dairy substitutes are good. These won't strain your pancreas.

    According to research, some persons with pancreatitis may tolerate 30 to 40% of calories from whole-food plant fats or medium-chain triglycerides. Some do well with 50 gms or less of fat per day.

    Pancreatitis patients are at risk for diabetes; hence, include cherry tomatoes, hummus, cucumbers, and fruit instead of sweets in your diet. Your pancreas will thank you.

    Pancreatitis Prevention

    Limit Alcohol Consumption: You may lower your risk for pancreatitis by drinking less (or not at all)

    Eat a Heart-Healthy Diet: Gallstones induce acute pancreatitis when too much cholesterol builds in bile, a fat-breaking fluid. Eat heart-healthy whole grains, fruits, and vegetables to lower gallstone risk. Avoid greasy, fried, and full-fat meals to prevent pancreatitis. High triglycerides increase pancreatitis risk.

    Exercise and Lose Some Weight: Obese people are prone to acute pancreatitis. Weight loss, a good diet, and regular exercise will help you lead a better life

    Avoid Crash Diets: Weight loss should be gradual. When you crash-diet, your liver boosts cholesterol production, increasing your risk of gallstones

    Quit Smoking: A study published in December 2019 in Pancreatology found that smokers are 1.5 times more likely to develop pancreatitis than nonsmokers. Pancreatitis may escalate to EPI (Exocrine Pancreatic Insufficiency) if untreated. Change your lifestyle if you have pancreatitis risk factors.

    Recovery

    Most persons with acute pancreatitis recover within a week and may leave the hospital 5-10 days later. In severe cases, problems that need additional treatment can delay recovery.

    Also Read About Pancreas Stone Treatment

    Frequently Asked Questions

    1. When does a pancreas infection heal?

    Acute pancreatitis usually improves within one or two weeks. People tend to avoid solid foods to ease the burden on their pancreas for a while. Medications may prevent complications and relieve symptoms.

    2. How serious is an infection in the pancreas?

    Infections of the pancreas are extremely dangerous and often necessitate extensive treatment, including surgical removal of the affected tissue. Fluid and debris can accumulate in cyst-like pockets in the pancreas due to acute pancreatitis. Internal bleeding and infection are two complications that can result from the rupture of a large pseudocyst.

    3. Can the pancreas repair itself?

    It is medically necessary to treat chronic pancreatitis because it destroys pancreatic function. Although there is no cure for chronic pancreatitis, it is possible to improve the quality of life for the patient and prevent further complications through medical management.

    4. Can you live without a pancreas?

    It's possible to live without a pancreas. It will, however, require some lifestyle changes on your part. Your pancreas produces hormones and digestive enzymes that regulate blood sugar and help in food digestion. Some medications can help with these needs after surgery.

    5. Can you live with a damaged pancreas for a long?

    Up to 10% of individuals who obtain an early diagnosis become disease-free following treatment. The average survival time for patients with pancreatic cancer is 3.5 years if doctors diagnose early enough before the tumour has grown or spread.


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