Pancreatitis is the inflammation of the pancreas, an organ of the digestive and endocrine systems. The pancreas secretes juices that contain digestive enzymes and produces hormones including insulin. Acute pancreatitis develops suddenly while chronic pancreatitis progresses over many years. The inflammation happens because the digestive enzymes become active while still in the pancreas and irritate the pancreatic cells.
Causes
Heavy alcohol intake is a primary cause of pancreatitis. According to MedicineNet.com, an estimated 70 percent of all cases in the United States result from a history of alcohol abuse. Chronic alcoholism damages the pancreatic duct which eventually leads to destruction of the pancreas. The presence of gallstones commonly triggers acute pancreatitis. Gallstones are small formations of hardened bile that irritate the pancreas as they are passed through the common bile duct. Genetic abnormalities of the pancreas and a family history of pancreatitis predispose an individual to this disease. The National Digestive Diseases Information Clearinghouse lists cystic fibrosis, high levels of calcium and high levels of fat in the blood as causes for inflammation of the pancreas.
Abdominal Pain
Abdominal pain is a common symptom of acute pancreatitis, according to the Merck Manuals. Acute pancreatitis is triggered by biliary tract disease or chronic heavy alcohol intake. Pain is initially felt in the lower abdomen. Upper abdominal pain radiates through to the back in about half of all patients. The pain is severe, lasts for several days and is accentuate by coughing. A person will experience nausea and vomiting. Patients with chronic pancreatitis experience episodic abdominal pain. Chronic pancreatitis is persistent inflammation with permanent structural damage to the pancreas. A person with chronic pancreatitis experiences severe epigastric pain that lasts for many hours or several days.
Fever
A person with acute pancreatitis appears seriously ill with a elevated temperature gradually rising to 100 to 101 degrees F within a few hours. In addition, the person’s skin is clammy, breathing is shallow and rapid, pulse rate is 100 to 140 beats per minute and blood pressure drops with a change in position. A person has chills, a decrease in mental status to the point of semi-coma and respiratory difficulties indicative of a collapsed lung.
Upper Abdominal Distention
Inflammation of the pancreas causes distention or swelling and displacement of the stomach. The Merck Manual says that upper abdominal distention occurs in 20 percent of all cases of acute pancreatitis. Moderate tenderness is noted in the upper abdomen and mild tenderness is present in the lower abdomen.
Malabsorption
In the presence of chronic pancreatitis, the production of digestive enzymes is reduced and results in malabsorption. A person with chronic pancreatitis experiences weight loss without dieting. Signs of malabsorption include the development of oily stools and the presence of undigested muscle fibers in the feces. Symptoms of glucose intolerance such as frequent urination and excessive hunger.
Diagnosis
A physician suspects pancreatitis in a patient complaining of severe abdominal pain and who also has with a history of heavy alcohol consumption or gallstones. Diagnostic tools include a thorough range of blood tests to check complete blood cell counts, amylase and lipase levels. Advanced radiological imaging, such as a CT scan, is performed following diagnosis by laboratory test. The imaging identifies areas of necrosis or tissue death.
Treatment
Hospitalization is necessary to treat the symptoms of pancreatitis. The aim of treatment is to relieve the inflammation. A patient will be on a restricted diet beginning with no oral food intake, advancing to clear liquids and introducing bland foods before resuming a regular diet. Intravenous fluids are administered to provide hydration. A physician can prescribe analgesics or pain medications to relieve the symptom of abdominal pain. Pancreatic enzyme supplements are used to treat the symptom of malabsorption.
