Pancreatitis: Types, Symptoms, Causes, Prevention and Treatment

The pancreas is an organ located between your stomach and spine. The primary capabilities of your pancreas are:

• Releasing strong digestive enzymes into your small intestine
• It causes your blood to release glucagon and insulin. Your body employs these hormones to regulate how it uses food as fuel.

Digestion enzymes that begin to function earlier than your pancreas releases them might cause damage to your pancreas. When this organ gets inflamed, it doesn't work right. This leads to many health problems.

Pancreatitis refers to the medical condition leading to the swelling of the pancreas. It can develop from a minor sore to a severe, even fatal ailment. You may experience back pain in addition to stomach pain if you have pancreatitis.

Types of Pancreatitis

There are two types of pancreatitis: Acute and Chronic.

• Acute Pancreatitis: Acute pancreatitis is marked by an abrupt onset of swelling. It can be caused by your gall bladder stones, drinking too much alcohol, some drugs, sickness or trauma. The signs like extreme stomach discomfort, feeling sick and throwing up can show quickly and strongly. Quick medical help is very important to manage acute pancreatitis and avoid complications. When given the right care, most people who have it get cured. In really bad cases of acute pancreatitis, it can lead to bleeding, excessive damage to the body's tissue, infection, and cysts. Severe pancreatitis can also harm the heart, lungs, and kidneys, besides affecting the pancreas.
• Chronic Pancreatitis: In contrast, chronic pancreatitis is a long-term condition marked by ongoing inflammation that damages the pancreas. This form of pancreatitis often develops gradually and is linked to long-term alcohol abuse, cystic fibrosis, certain genetic factors, or repeated episodes of acute pancreatitis. Chronic pancreatitis leads to irreversible damage to the pancreas, affecting its ability to function properly over time. The pancreas' tissues become scarred (fibrosis) as a result of ongoing inflammation, preventing the organ from producing hormones and enzymes.

Symptoms of Pancreatitis

The most common symptom of either acute or chronic pancreatitis is discomfort in the middle left upper abdomen. On diagnostic imaging scans, some patients with chronic pancreatitis may show signs of inflammation; nevertheless, they may not exhibit any other symptoms.

• Acute Pancreatitis Symptoms:
  • Abrupt, intense upper abdominal pain that might radiate to the back
  • Nausea, vomiting, and abdominal tenderness
  • Rapid pulse and fever
  • Swollen or tender abdomen
• Chronic Pancreatitis Symptoms:
  • Constant, dull stomach discomfort
  • Weight loss and malnutrition due to poor digestion and nutrient absorption
  • Oily, smelly stools resulting from the body's inability to properly digest fats
  • Diabetes due to damage to insulin-producing cells in the pancreas

When to See a Doctor?

Seek emergency medical assistance if you experience chronic stomach discomfort, particularly if it's severe or accompanied by other symptoms like nausea, vomiting, or fever. Early identification and treatment are essential to avoid complications and properly manage the illness.

What Causes Pancreatitis?

Many of the causes of acute and chronic pancreatitis are similar. Among them are:

• The most frequent reason for acute pancreatitis is gallstones. Bile, a fluid that helps in digestion, can solidify into tiny lumps known as gallstones.
• Excessive alcohol intake over time can lead to chronic pancreatitis.
• Tobacco use.
• Certain genetic conditions or family history.
• Elevated blood levels of triglycerides or fat particles.
• Infections like salmonella, hepatitis A or B, or the mumps.
• The pancreas' congenital anomalies.
• Some medications, such as certain antibiotics or immunosuppressants, may trigger pancreatitis. 

Pancreatitis Risk Factors

There are several risk factors that raise the probability of developing pancreatitis:

• An individual's susceptibility to pancreatitis can be genetic.
• Obesity and excess weight increase the chances of pancreatitis.
• Pancreatitis is more likely in those who have diabetes.
• Medical pancreatitis predisposition may be extended with the aid of conditions such as cystic fibrosis or excessive triglyceride ranges.
• Smokers are about three times more likely than nonsmokers to develop chronic pancreatitis. Quitting smoking might also reduce the risk.
• Excessive alcohol intake can also result in persistent pancreatitis, a disorder that has been connected to an increased risk of pancreatic cancer.
• Chronic pancreatitis has been related to many genes, particularly when paired with other risk factors. A family history of the infection is associated with a higher risk.

Complications of Pancreatitis

If left untreated or poorly managed, pancreatitis can result in severe complications:

• Kidney failure: Acute pancreatitis may compromise the kidneys' ability to filter waste from the blood.
• Breathing problems: Acute pancreatitis can alter lung function, leading to dangerously low blood oxygen levels.
• Pancreatic Pseudocysts: A pseudocyst is a "pocket" within the pancreas where fluid and particles can accumulate due to both acute and chronic pancreatitis. Ruptures of large pseudocysts can result in complications, such as infection and internal bleeding.
• Infections: Acute pancreatitis may increase the pancreas's susceptibility to infections. Serious pancreatic infections require aggressive treatments, including surgery or other methods to remove infected tissue.
• Diabetes: Diabetic conditions can arise from damage to the cells that produce insulin.
• Malnutrition: Impaired digestion and nutrient absorption can lead to malnutrition.
• Pancreatic cancer: Pancreatic cancer is a risk factor for persistent pancreas infection.

How is Pancreatitis Diagnosed?

Diagnosing pancreatitis involves a series of tests and examinations to confirm this condition and determine its severity. The doctor treating you will review your medical history. A physical checkup will be conducted to assess abdominal tenderness, swelling, or jaundice. Several imaging and blood tests may also be performed, including:

• Blood Tests: Analysing blood samples for elevated levels of pancreatic enzymes, such as amylase and lipase, whose increased levels indicate pancreatic inflammation.
• Imaging Studies
  • Ultrasound: A non-invasive imaging technique that helps visualise the pancreas and surrounding areas, detecting inflammation or blockages.
  • EUS (endoscopic ultrasound): This internal ultrasonography is performed while you are asleep, using a flexible tube called an endoscope.
  • CT Scan: A detailed imaging method that provides clearer images of the pancreas, aiding in identifying inflammation or complications.
  • MRCP (Magnetic Resonance Cholangiopancreatography): This creates detailed pictures of your pancreas, gallbladder, and pancreatic and bile ducts using magnetic resonance imaging (MRI). To enhance the clarity of the photographs, a dye is injected into your vein.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): In this procedure, a flexible tube with a camera is passed through the mouth to examine the pancreas, bile ducts, and surrounding areas. It can identify blockages or structural abnormalities.
• Stool Tests: Assessing stool samples for fat content helps determine if the pancreas is functioning properly in digesting fats.
• Biopsy: Occasionally, a tissue sample from the pancreas may be collected for examination to confirm the diagnosis or rule out other conditions.

How is Pancreatitis Treated?

Treatment for pancreatitis focuses on alleviating symptoms, addressing the underlying cause, and preventing complications. Depending on the severity of the condition, treatment methods may vary:

• Pain Management: Severe, persistent pain is a common side effect of chronic pancreatitis. Your doctor will not only provide medication but also investigate the underlying causes or painful consequences of chronic pancreatitis. Injections to stop nerve impulses from the pancreas to the brain or surgeries to increase pancreatic outflow are possible forms of treatment. A pain expert could be recommended to you.
• Fluid and Nutritional Support: Patients may require intravenous fluids to prevent dehydration and maintain electrolyte balance. In severe cases where eating is problematic, a feeding tube or nutritional supplements may be necessary.
• Gallstones: It could be advised to have the gallbladder surgically removed if pancreatitis was brought on by gallstones. Cholecystectomy is the term for this operation.
• Alcohol Dependency: An alcohol addiction treatment program is advised if pancreatitis is due to excessive alcohol consumption. Drinking alcohol continuously makes pancreatitis worse and can have major consequences.
• Alterations to medications: Your medical practitioner will collaborate with you to explore other choices if a medication is the likely cause of acute pancreatitis.
• Percutaneous Drainage or Surgery: In cases of fluid collection or severe complications, drainage procedures or surgery might be necessary to remove the fluid or treat damaged pancreatic tissue.
• Enzymes to facilitate better digestion: You may use pancreatic enzyme supplements if diarrhoea or weight loss are symptoms of chronic pancreatitis. These enzyme supplements, when taken with each meal, assist your body in utilising and breaking down the nutrients in food.
• Lifestyle Changes: Adopting a low-fat diet, quitting smoking, and maintaining a healthy weight are crucial for managing pancreatitis and preventing recurrences.

Prevention of Pancreatitis

Preventing pancreatitis involves adopting a healthy way of lifestyle and managing underlying risk factors to lessen the probability of infection within the pancreas:

• Moderate Alcohol Consumption: You can also reduce your chance of developing pancreatitis and defend your pancreas from the dangerous consequences of alcohol by consuming less or not at all.
• Healthy Diet: Maintain a balanced diet that is low in fats, refined sugars, and processed ingredients to support pancreas health.
• Lose Excess Weight by Engaging in Regular Exercise: Gallstones may be prevented from developing by losing excess weight and retaining it by ingesting a balanced food regimen and getting regular exercise.
• Avoid Smoking: Quitting smoking decreases the chances of developing pancreatitis and various related problems.
• Medication Use: Follow prescribed medications cautiously and regularly.

Pancreatitis, whether acute or chronic, necessitates prompt medical attention. Seeking timely medical care and adopting a healthy lifestyle can significantly reduce the risk and impact of pancreatitis. By prioritising these lifestyle adjustments and managing underlying health conditions, individuals can significantly lower the risk of developing pancreatitis.