Your pancreas is an organ in your gastrointestinal system that lies just behind your stomach. Day in and day out, it produces enzymes to help break down and digest the food you eat. It also produces hormones - insulin and glucagon - to keep your blood sugar level steady. Most of us never think about our pancreas, unless something goes wrong.
"Pancreatitis" is the general term for inflammation of the pancreas, a painful problem that begins when digestive enzymes cannot flow out of the pancreatic duct normally. Instead, they back up into the pancreas and cause inflammation. About 80,000 adults in the United States are diagnosed with pancreatitis each year.
There are two major types of pancreatitis: acute and chronic. Acute means that the inflammation comes on suddenly, causing uncomfortable and sometimes very painful symptoms. The chronic form can cause constant pain, with pain that gets worse with eating or drinking.
An attack of acute pancreatitis often starts with upper abdominal pain, which gets worse with eating. Nausea, vomiting, a tender and swollen abdomen, fever and rapid pulse are other common symptoms. The person looks and feels very ill. Some patients develop jaundice (yellowing of the skin and whites of the eyes).
Acute pancreatitis is diagnosed by a medical history, physical exam and blood tests to look at the levels of digestive enzymes - amylase and lipase - and blood levels of glucose, calcium and other electrolytes. Sometimes an ultrasound or CT scan is done.
The most common causes of acute pancreatitis are gallstones and alcohol abuse, but there are a few less common causes as well.
Gallstones may form in the gallbladder, located above the pancreas. If gallstones cause a blockage in the common bile duct, digestive enzymes back up in the pancreatic duct and inflame the pancreas. A procedure called ERCP (endoscopic retrograde cholangiopancreatography) may be done to remove gallstones from the common bile duct or to enlarge a duct that is too narrow. In some cases, the gallbladder may need to be removed surgically to prevent a recurrence.
Surgery on the pancreas itself is rarely done, because of the risk of further damaging the organ.
The usual treatment for acute pancreatitis is to give the patient nothing by mouth so that fewer digestive enzymes will be produced. Fluids and pain medication are given intravenously, and sometimes antibiotics are needed to prevent or treat infection. Hospitalization is often necessary.
About 75 percent of patients with acute pancreatitis recover without future problems. Of the other 25 percent, some may develop a "pseudocyst" in the pancreas, in which fluid and enzymes build up, and may become infected. Some of the pancreatic tissue can become infected and die. Heart, lung and kidney problems can develop as a result of pancreatitis.
Heavy alcohol drinkers are most likely to develop chronic pancreatitis, as the pancreas is constantly inflamed. They may need medications for pain and to reduce digestive enzymes and stomach acid. Often, those with chronic pancreatitis lose weight because the body is unable to digest food properly.
Some chronic pancreatitis patients must take pancreatic enzyme supplements and insulin, if the pancreas is so damaged that it cannot make these important substances any longer.
Anyone with chronic pancreatitis should stop drinking alcohol entirely, because even small amounts can further damage the pancreas and increase pain. Smoking, obesity and a high-fat diet may also make chronic pancreatitis worse.
The best way to reduce your risk of pancreatitis is to drink little or no alcohol. Also, eating a balanced diet and getting exercise will help you maintain a healthy weight, lowering your risk of gallstones.
Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send ideas to firstname.lastname@example.org. You can find more local health news and information in the Health section at www.bluemountaineagle.info.