PANCREATITIS
What is Pancreatitis?
Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it derives from food for energy.
Acute Pancreatitis
Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Cysts, which are fluid-filled sacs of tissue, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.
Acute pancreatitis is usually caused by drinking too much alcohol or by gallstones. A gallstone can block the pancreatic duct, trapping digestive enzymes in the pancreas and causing pancreatitis. Some prescription drugs, pancreatic or intestinal abnormalities, abdominal trauma, or surgery can also cause pancreatitis. In some cases, recurrent pancreatitis is hereditary and caused by mutations in genes. In rare cases, the disease may result from infections, such as mumps, and in about 15 percent of the cases, the cause is unknown.
Symptoms
Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days. The pain may be severe and may become constant--just in the abdomen--or it may reach to the back and other areas. It may be sudden and intense or begin as a mild pain that gets worse when food is eaten. Someone with acute pancreatitis often looks and feels very sick.
Other symptoms may include:
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swollen and tender abdomen
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nausea
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vomiting
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fever
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rapid pulse
Severe cases may cause dehydration and low blood pressure. The heart, lungs, or kidneys may fail. If bleeding occurs in the pancreas, shock and sometimes even death follow.
Chronic Pancreatitis
If injury to the pancreas continues, from drinking alcohol, for example, chronic pancreatitis may develop. Chronic pancreatitis occurs when digestive enzymes attack and destroy the pancreas and nearby tissues, causing scarring and pain. The usual cause of chronic pancreatitis is many years of alcohol abuse, but the chronic form may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged. The damaged ducts cause the pancreas to become inflamed, tissue to be destroyed, and scar tissue to develop.
Chronic pancreatitis may also occur when the pancreatic duct is blocked or narrowed because of trauma or because pseudocysts have formed. Pseudocysts are cyst-like buildups of pancreatic fluid in the duct.
Some drugs can cause chronic pancreatitis too. In many cases, however, the cause is unknown. People with chronic pancreatitis may have one or even all three of the following problems: pain, diabetes, or malabsorption of food leading to weight loss.
In some cases, chronic pancreatitis is inherited. Hereditary pancreatitis usually begins in childhood but may not be diagnosed for several years. A person with hereditary pancreatitis usually has the typical symptoms that come and go over time. Episodes last from 2 days to 2 weeks.
Symptoms
Some people have no pain, but most do. Pain in the back and abdomen may be constant and disabling. In certain cases, abdominal pain goes away as the condition advances, probably because the pancreas is no longer making digestive enzymes.
People with chronic disease often lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to break down food, so nutrients are not absorbed normally. Poor digestion leads to excretion of fat, protein, and sugar into the stool. If the insulin-producing cells of the pancreas (islet cells) have been damaged, diabetes may also develop at this stage.
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