Pancreatic Disorders Pancreatitis

Pancreatic enzymes play an important role in digestion. The enzymes travel to the small intestine, where they break down protein, fats and other nutrients. If pancreatic enzymes are unable to pass into the intestine, they begin to work on surrounding tissue, resulting in an inflamed pancreas and malabsorption. An inflamed pancreas, or pancreatitis, presents as both acute and chronic conditions.

Acute Pancreatitis

Diagram of the Pancreas AreaAcute pancreatitis affects over 80,000 people in the United States every year. Sixty to eighty percent of these cases can be traced to two causes: gallstones and alcohol damage. Gallstones can block central ducts, preventing digestive enzymes from leaving the pancreas. Over time, alcoholism damages the gland and hinders its ability to function.

Certain medications and infections can also trigger acute attacks of the disease. In up to fifteen percent of cases, however, the cause of the inflammation is unknown.

Acute Pancreatitis Symptoms and Diagnosis

One of the most common pancreatitis symptoms is upper abdominal pain. It often radiates to the back and may last for several days. Although upper abdominal pain is usually present, some people don’t experience pain at all. Other pancreatitis symptoms include fever, nausea and vomiting.

Hypoxia may occur as a result of pancreatitis. Hypoxia occurs when the body’s cells do not receive enough oxygen, and is usually treated by administering oxygen through a facemask. Although rare, complications from an inflamed pancreas can be fatal. Lung, kidney and heart failure may all occur in severe cases.

Blood tests that measure levels of lipase and amylase may indicate inflammation. Lipase and amylase are both pancreatic enzymes. If the pancreas function is affected due to inflammation, tests for the two enzymes may be as high as three times normal levels.

Ultrasound imaging is often used to detect duct-blocking gallstones. CT scans can help detect signs of infection or damage to glandular tissue.

Treatment Options

For most acute attacks, pain management with analgesics is all that is required. If infection causes the inflammation, treatment may include antibiotics. Surgery may be required to remove gallstones, drain obstructed bile ducts or remove fluid-filled cysts.

After treatment, alcohol abstinence is highly recommended. Heavy meals should also be avoided, as they place greater demands on the pancreas to produce digestive enzymes.

Chronic Pancreatitis

Chronic pancreatitis is a series of recurring inflammatory attacks that gradually causes irreversible damage to the pancreas and surrounding tissue. Alcoholism is the primary cause of chronic inflammation: between seventy to eighty percent of cases can be traced to excessive, habitual alcohol consumption. Damage caused by alcoholism takes years to develop: most chronic pancreatitis symptoms don’t appear until people are in their thirties or forties.

While alcoholism is the primary cause of chronic inflammation, the condition can be traced to other causes: cystic fibrosis, drugs, genetic disposition, elevated blood trygliceride levels, and radiation therapy may all trigger the disease. In some cases, no cause can be determined.

Without treatment, chronic inflammation gradually destroys the pancreas’ ability to function. Reduced digestive enzymes cause malabsorbtion of nutrients, leading to both weight loss and poor quality bowel movements. If insulin-producing islet cells are damaged, diabetes may develop. Chronic inflammation carries with it a heightened risk of pancreatic cancer.

Chronic Pancreatitis Symptoms and Diagnosis

Chronic pancreatitis symptoms resemble those of an acute inflammatory attack, but recur over time. Upper abdominal pain may become chronic, and may be aggravated by eating or drinking.

Pancreatic enzyme tests are used to assess how much inflammatory damage the gland has endured. Blood tests, urine analysis and stool samples can help monitor advanced chronic inflammation and the disease’s progress.

Ultrasound, CT scans and other diagnostic imaging tools can detect physical problems associated with chronic inflammation, including calcification of the pancreatic tissue (calcium deposits may build up in the gland, causing tissues to harden).

Treatment Options

When alcoholism is the cause of the inflammation, complete abstinence from alcohol is required. People suffering from alcoholism may need to seek therapy or support groups to stop drinking. A low fat, high carbohydrate diet, which requires fewer enzymes to digest, is recommended. If damage to the gland is severe, enzyme supplements to aid digestion can be taken with meals. Surgical options include draining blocked ducts, and in advanced cases, removal of a portion of the gland.

Hereditary Factors

Heredity accounts for approximately one percent of pancreatitis cases. If heredity is responsible for the disease, inflammation is likely to be chronic, and to strike at relatively early ages. Hereditary inflammation also appears to increase the likelihood of pancreatic cancer; by age seventy, forty percent of people suffering from hereditary pancreatitis display some symptoms of cancer.


Maisonneuve, P.