Pancreatitis is the term used to describe a condition which results in the inflammation of the pancreas. The pancreas is a fish-shaped greyish pink gland that is located in the upper abdomen. It is 13cm long and secretes various substances, including digestive enzymes, insulin and the hormone glucagon.
Acute Pancreatitis is the term used to describe the sudden and severe inflammation of the pancreas that resolves with treatment. Chronic Pancreatitis, however, is the term used to describe Pancreatitis which persists regardless of treatment and indicates irreversible pancreatic damage. Biliary tract disease and alcoholism account for more than 80% of hospital admissions for acute Pancreatitis. The remaining 20% is caused by drugs e.g., azathioprine, sulphasalazine, frusemide etc; infections such as mumps, high blood cholesterol levels; structural abnormalities of the pancreas itself; surgery; injury; or a family history. Alcoholism is the most common cause of chronic Pancreatitis.
The biliary tract is the pathway leading from the liver to the small intestine. This pathway allows bile released from the liver to flow into the small intestine where it helps to break down dietary fats for digestion and absorption. Biliary tract disease occurs when a gallstone becomes lodged in the biliary tract. This causes Pancreatitis by blocking the flow of bile and forcing it to reflux into the pancreatic duct system.
An alcohol intake of more than 100 g per day (equal to 10 standard drinks) for several years is thought to result in blockages or plugs forming in the ducts of the pancreas which causes it to become inflamed. After approximately 3 to 5 years of continual, excessive drinking, the first episode of acute Pancreatitis usually occurs.
Pancreatitis involves fluid retention within the pancreas, damage of pancreatic tissue and haemorrhage. If the inflammation is confined to the pancreas the recovery rate is very high, however, Pancreatitis which is associated with severe tissue damage and haemorrhage is potentially fatal. Toxins and enzymes released into the blood stream from the diseased pancreas can cause heart, kidney and breathing failure, which are believed to be the most common causes of death from Pancreatitis.
SIGNS AND SYMPTOMS
The onset of acute Pancreatitis is usually sudden with the patient experiencing intense upper abdominal pain which radiates through to the back in approximately 50% of cases. The pain often occurs within 12 to 24 hours following a large meal and alcohol. Nausea and vomiting are common. In severe cases the patient may experience an increased and/or irregular heart rate; low blood pressure; shallow, rapid breathing; sweating; and kidney failure. Between 2 to 5 weeks after the onset of acute Pancreatitis, the patient may develop a pancreatic abscess. This will cause further abdominal pain, tenderness, fever and weight loss.
Chronic Pancreatitis usually causes similar symptoms with intense upper abdominal pain that may last for many hours or several days. Occasionally this ailment causes no pain. As the pancreas is progressively damaged by disease the production and flow of pancreatic enzymes is disrupted. These enzymes help to break down and digest fats from the diet. If these fats are not digested and absorbed normally, the patient begins to pass fatty, greasy stools or even oil droplets from the bowel. As chronic Pancreatitis worsens, the cells which produce insulin in the pancreas are also damaged. This reduces the amount of insulin in the body which causes the patient to develop glucose intolerance.
As with all conditions, your Doctor should be consulted to diagnose and treat this ailment. Ask your Doctor for the latest advice regarding Acute Pancreatitis. The patient with Acute Pancreatitis is usually hospitalised and in mild cases the patient fasts until the inflammation subsides. In severe cases medication may be required to stabilise breathing, kidney function and heart rate. If a pancreatic abscess has developed or there is severe damage to the pancreatic tissue, surgery may be required.
Ask your Pharmacist for advice. 1) Follow the Diet Hints. 2) Your Pharmacist can answer any queries you may have regarding your medication for Pancreatitis. 3) If the symptoms persist or return at any stage after treatment for Pancreatitis, see your Doctor immediately. 4) Drinking alcohol excessively every day puts you at greater risk of developing Pancreatitis. Talk to your Pharmacist about the options and services which are available to help stop drinking. 5) Your Doctor or Dietitian may recommend supplementing with pancreatic enzymes which will aid digestion and help to relieve the pain of Pancreatitis. 6) If pain is severe take aspirin to a maximum daily dose of 3.6 g by mouth or paracetamol to a maximum daily dose of 4 g by mouth. Ask your Pharmacist for advice before choosing medication to relieve pain. Stronger pain relief products should only be recommended by a Doctor.
Aspirin should not be given to children under 16 years of age unless specified by a Doctor.
DIET HINTS- It is advisable for a person with Pancreatitis to follow the dietary advice of his/her Doctor or Dietitian. In severe cases, fasting may be necessary for a period of time until inflammation of the pancreas resolves. - Pancreatic enzymes (produced by the pancreas) are necessary for proper digestion of food, especially fats and proteins. In cases of Pancreatitis the normal production and flow of enzymes from the pancreas into the small intestine is disrupted. These enzymes can accumulate and form cysts or enter into the circulation as toxins. In order to reduce the number of enzymes produced in the pancreas, a low fat and low protein diet is recommended. - A low fat diet is also recommended as Pancreatitis results in poor digestion of fats. This often causes flatulence, fatty stools and inadequate nutrition. - Small, regular meals are easier for the body to digest than less frequent large meals. Try to eat plenty of steamed vegetables and fresh fruits as these are highly nutritious and very low in fat. - Avoid drinking alcohol altogether as this chemical, if consumed regularly in excessive amounts can cause Acute Pancreatitis and even small amounts of alcohol can then aggravate an existing condition.