Digestive Diseases: Pancreatitis

The pancreas is a large gland located behind the stomach and next to the duodenum (the first section of the small intestine). The pancreas has two primary functions:

1. To secrete powerful digestive enzymes into the small intestine to aid the digestion of carbohydrates, proteins and fat.
2. To release the hormones insulin and glucagon into the bloodstream. These hormones are involved in blood glucosemetabolism, regulating how the body stores and uses food for energy.

Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage occurs when the digestive enzymes are activated before they are secreted into the duodenum and begin attacking the pancreas.

There are two forms of pancreatitis: acute and chronic.

Acute pancreatitis

Acute pancreatitis is a sudden inflammation that occurs over a short period of time. In the majority of cases, acute pancreatitis is caused by gallstones or heavy alcohol use. Other causes include medications, infections, trauma, metabolic disorders, and surgery. In about 10% to 15% of people with acute pancreatitis, the cause is unknown.

The severity of acute pancreatitis may range from mild abdominal discomfort to a severe, life-threatening illness. However, the majority of people with acute pancreatitis (more than 80%) recover completely after receiving the appropriate treatment.

In very severe cases, acute pancreatitis can result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also cause damage if enzymes and toxins are released into the bloodstream, which can harm other vital organs such as the heart, lungs, and kidneys.

Chronic pancreatitis

Chronic pancreatitis occurs most commonly after an episode of acute pancreatitis and is the result of ongoing inflammation of the pancreas. In more than 70% of the cases, chronic pancreatitis is caused by prolonged alcohol use. Other, less common causes include metabolic disorders. Very rarely, patients have chronic pancreatitis that tends to run in families (hereditary pancreatitis). Damage to the pancreas from excessive alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms, including severe pain and loss of pancreatic function, resulting in digestion and blood sugar abnormalities.

What Are the Symptoms of Pancreatitis?

Acute pancreatitis

• Upper abdominal pain that radiates (travels) to their back. Patients may describe this as a "boring sensation" that may be aggravated by eating, especially foods high in fat.
• Swollen and tender abdomen
• Nausea and vomiting
• Fever
• Increased heart rate.

Chronic pancreatitis

The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. Patients frequently experience constant pain in the upper abdomen that radiates to the back. In some patients, the pain may be disabling. Other symptoms may include weight loss caused by poor absorption (malabsorption) of food. This malabsorption occurs because the gland is not secreting enough enzymes to break down the food normally. Also, diabetes may develop if the insulin-producing cells of the pancreas become damaged.