PANCREATITIS
What is it?
Pancreatitis an the inflammation of the pancreas.
The pancreas is an organ situated in the upper part of the abdomen, roughfly behind the stomach.
It is an organ with various functions, being responsible part for insuline production and part for the production of the required substances for the digestion of foods.
Pancreatitis can be acute or chronic.
How it is acquired?
There are two causes responsible for the great majority of pancreatitis cases: calculi in the biliary tract abusive use of alcohol.
The bile produced in the liver and the substances produced in the pancreas are taken to the intestine by small ducts, and at its end by only one duct for both organs.
When a calculus (colloquially called gallstone), formed in the gallbladder or in any other part of these canals, obstructs the flow towards the intestine, a pancreatitis condition can occur.
Another major cause of pancreatitis is alcohol abuse. The chronic use of large amounts of alcohol can lead to either acute episodes of pancreatitis or to chronic pancreatitis itself.
Other causes of pancreatitis, far less common, are the produced by:
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certain medicines |
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viral infections as the mumps |
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abdominal traumas (e.g., serious car accidents) |
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overactivity of the parathyroid glands |
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high levels of triglycerides in the blood |
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pancreas malformations |
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exams using contrast agents in the biliary and pancreatic ducts |
What does one feel?
In acute pancreatitis the main symptom is abdominal pain. Generally, it is located next to the stomach entrance and may spread sideways and backwards. Nauseas and vomits, associated with pain, typically occur.
Onset is typically abrupt and becomes progressively stronger and continuous.
In chronic pancreatitis, in addition to pain, diarrhea is likely to occur with elimination of fat through the feces.
This occurs because, from a certain point, the pancreas becomes deficient in the digestive enzyme production required for the digestion and absorption of the fat contained in foods. Therefore, diarrhea of variable intensity, and even very intense, with a rancid smell and containing fat, occurs, looking like 'oil drops on the water'.
Pain in chronic pancreatitis can be permanent, requiring powerful painkillers, or it may be manifested by crises, generally caused by alcohol consumption.
How the doctor makes the diagnosis?
The symptoms reported by the patient and the clinical examination, associated with the history of alcohol consumption or gallbladder calculi, make the doctor arrive at a diagnosis.
Blood tests, abdominal ultrasound (sonography) and abdominal X-ray are used in order to confirm the disease.
Which is the treatment?
In the acute phase of pain, the most important procedure is absolute fasting, associated with hydration with intravenous serum (in the vein). For pain relief powerful painkillers are used.
In the case of pancreatitis being caused by calculi, it may be required that the patient undergo an upper digestive endoscopy with cholangiography and removal of the calculi that might be obstructing the flow of bile and of substances from the pancreas to the duodenum (. It is the first part of the intestine ).
In this procedure, through an endoscope inserted by the mouth, a catheter is introduced in the obstructed biliary way, then the calculi are found and their removal is possibly performed by pulling them inside the duodenum. This procedure is carried away with a mild sedation and is available only at some specialized centers.
The pancreatitis has different degrees of severity. From mild cases, in which a few days without receiving food orally are sufficient for the relief of the crisis, to extremely severe cases, requiring surgery and admission to an Intensive Care Unit (ICU).
How is it prevented?
Chronic pancreatitis caused by alcohol can be prevented by drinking moderately.
Individuals that have already had pancreatitis due to alcohol abuse must totally avoid its use in order to not exacerbate new crises and prevent the progression of pancreatic failure.
Individuals with calculi in the gallbladder having symptoms already manifested should talk to their doctor as to the indication of surgery for removal of the gallbladder in order to prevent future complications.
Individuals who have already had pancreatitis due to calculi in the biliary way must, in the absence of contraindications, have the gallbladder removed surgically. Currently, where there are no contraindications, the video-assisted surgery (video-assisted laparoscopic cholecystectomy) is chosen.