Inflammation of the pancreatic gland, which is always serious.

 

Acute Pancreatitis

The condition is serious and can be life-threatening if left untreated. Acute pancreatitis almost exclusively affects adults and excessive alcohol consumption is a risk factor.

 

Causes of Pancreatitis

The pancreas lies behind the stomach at the back of the abdomen. It secretes insulin, which is of fundamental importance in the handling of glucose. It also secretes pancreatic enzymes into the small intestine which are important in digesting protein and fat. These are powerful juices; the seriousness of pancreatitis lies in the fact that the release of these juices leads to auto-digestion of whatever they come into contact with, for example the lining of the abdomen, the liver, the intestines and other internal organs. Pancreatitis is divided into acute and chronic.

Acute pancreatitis

Sudden inflammation of the pancreas is thought to be related to liver or gall bladder problems. This may be because the ducts through which pancreatic juices flow lie close to these structures and become blocked or irritated by bile. A few drugs can cause pancreatitis and it can be a rare consequence of viral infections including mumps.

  • gallstones
  • injury
  • gallbladder surgery
  • certain drugs (diuretics, sulphonamides)
  • long-term alcohol abuse
  • hyperlipidaemia.

Chronic pancreatitis

This is nearly always associated with alcoholic liver disease (see Liver problems), when the pancreatic gland becomes converted to fibrous tissue.

Symptoms of pancreatitis

In the case of acute pancreatitis the illness begins with upper abdominal pain, which appears to radiate into the back. It is impossible at this stage to distinguish it from the condition of severe indigestion without investigations. The pain may be mild but persistent or it may be excruciating, accompanied by collapse of blood pressure and nausea, and so severe that peritonitis is suspected.

The diagnosis is very difficult to make without measuring enzymes released by the inflamed pancreas into the blood stream. The most useful one is amylase, which should be measured in all cases of severe upper abdominal pain.

Acute pancreatitis

Acute pancreatitis causes a range of symptoms that occur suddenly and may be severe, including:

  • sudden and very severe upper abdominal pain, often spreading to the back and made worse by movement and relieved by sitting Up
  • nausea and vomiting
  • bruised appearance of the skin around the abdomen
  • fever

In severe cases, inflammation affects the whole abdomen, making it rigid and increasing pain. Acute pancreatitis may also lead to shock, a potentially fatal condition in which the blood pressure falls dangerously low. Blood tests, a computerized tomography.

(CT) scan or endoscopy of the pancreas may be used to confirm a diagnosis of acute pancreatitis.

Chronic pancreatitis

Characterized by recurrent upper abdominal pain in a heavy drinker (see Alcohol and alcoholism). As the gland deteriorates there is weight loss because the juices are no longer available to digest food. Diabetes develops through lack of insulin. The diagnosis is difficult to make without a CT scan.

Treatment of Pancreatitis

Acute pancreatitis

A very dangerous condition, with mortality at best 1%, and in severe cases 50% or higher. Treatment is with drip feeding to maintain blood pressure and energetic treatment of any internal infections, which are common. Sometimes fluid-filled cysts within the abdomen need be surgically drained. Recovery takes weeks or months.

  • Your stomach will be kept empty to prevent the pancreas from being stimulated to produce more enzymes. A tube will be passed through your nose into your stomach to remove its contents by suction.
  • You will be given fluids intravenously. If tests have detected a gallstone, ERCP may locate the stone more precisely and remove it.
  • Rarely, if damaged pancreatic tissue becomes infected, surgical drainage may be needed.
  • If the pancreatitis was caused by gallstones, it may be advisable to have your gallbladder removed once you have recovered.

Chronic pancreatitis

it is essential that the individual stops drinking alcohol to avoid further progression of the disease, although this will not reverse the damage done. Diabetes is treated with insulin, drugs or diet depending on how bad it is. Capsules are available containing the digestive enzymes no longer being produced by the pancreas. Painkillers are needed for persistent pain, which can also be helped by surgically removing diseased parts of the pancreas. The pain of chronic pancreatitis can be intense – a painkiller as strong as morphine may be required at times. The outlook is quite good as long as the individual gives up alcohol.

QUESTIONS

Is pancreatitis related to cancer of the pancreas?

There is no evidence for this; cancer of the pancreas is steadily increasing in frequency for unknown reasons, but there has been no such increase in the incidence of pancreatitis.

How risky are gallstones?

Considering how common gallstones are — affecting 20% of an adult population – very few actually cause pancreatitis. However, anyone with gallstones who has even mild pancreatitis would be well advised to have the gall bladder removed as soon as possible. Investigations for gallstones are routine in anyone presenting with pancreatitis.

Complementary Treatment

Acute pancreatitis is a medical emergency, and should be treated by a conventional practitioner. Chakra balancing helps reduce pain attacks and supports orthodox treatment; postoperatively it aids relaxation and promotes healing of wounds. Cymatics could help for chronic, long-term pancreatitis. You should use all means of support to give up alcohol, and hypnotherapy can have a role here, too. Other therapies to try: see Alcohol and alcoholism.

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