Acute Pancreatitis

Acute Pancreatitis

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Overview

The pancreas is a 6-inch-long gland and lies between the stomach and the spine. The pancreas makes juices that help digest food and produce hormones like glucagon and insulin that help in controlling blood sugar levels. Acute pancreatitis is a medical condition where the pancreas becomes inflamed, and it is deadly sometimes. Most patients with acute pancreatitis start to feel better within a span of a week and report no further problem. However, some patients with severe acute pancreatitis may develop serious complications.

What are the symptoms of acute pancreatitis?

Sudden severe pain in the center of your abdomen

  • Being sick
  • Diarrhea
  • Having a temperature

What causes acute pancreatitis?

Common causes:

  • Gallstones
  • Alcohol consumption
  • High body fat level- hypertriglyceridemia

Rare causes

  • Viral infections like HIV, mumps, etc.
  • Side effects of the medicine
  • Injury or surgery around the pancreas
  • Infections with parasites that live within another organism.
  • High blood calcium levels.
  • Abnormal structure of the pancreas.
  • Hereditary causes
  • Autoimmune diseases like Sjogren's syndrome, etc.

How is acute pancreatitis diagnosed?

When you visit the doctor with symptoms, he will examine you to identify the problem.

  • Physical examination: The doctor will take your health history, including eating habits, past illness, etc. He will do a physical check-up and look for signs of the disease like abdominal sensitivity or anything unusual.

Based on the observations from the physical examination, he will suggest some tests that will help confirm the diagnosis.

  • Blood tests: The doctor may suggest a blood test to measure the amounts of certain substances like levels of lipase and amylase. A high level of these may be indicative of pancreatic abnormality. Your doctor may suggest tests furthermore in order to confirm the diagnosis.
  • Abdominal ultrasound: This procedure, with the help of sound waves, creates a picture of the internal organs like the pancreas, gallbladder, etc., to look for any signs of abnormality.
  • Endoscopic retrograde cholangiopancreatography (ERCP): This procedure is used to x-ray the ducts (tubes), which take bile from the liver to the gallbladder and from there to the small intestine. This procedure can help in determining the exact location of gallstones.
  • CECT (contrast-enhanced computed tomography) scan: This scan takes pictures of the same area from many angles and is then combined to produce a 3-D image. This helps in identifying the inflammation of the pancreas, fluid collection, and any changes in the density of the gland.
  • Chest X-ray: Your doctor may suggest a chest X-ray to look for accumulation of fluid in the chest cavity or areas of collapsed lung tissue.
  • CT scan: This test uses a special dye medium that helps with a clear image of the body parts from different angles. It can help in seeing detailed images of soft tissue and blood vessels.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields to produce detailed body images.

How is acute pancreatitis treated?

There are different treatment options listed below for treating acute pancreatitis:

  • Fluids: One of the primary treatments for acute pancreatitis is adequate early fluid resuscitation, especially within the first 24 hours of onset. As pancreatitis is associated with inflammation. Giving fluids intravenously prevents dehydration and ensures that the rest of the body organs have adequate blood flow to support the healing process.
  • Nutritional Support: For the first 24-48 hours, no nutrition is given to rest the pancreas and bowels. After 48 hours, a nutrition plan is implemented as it will support the healing process. In most cases, people can start taking food on their own by 48 hours, or else a feeding tube that is passed through the nose into the intestines can be used to provide nutrition.
  • Pain Control: Various pain control medications are given to the patient intravenously, which are effective in controlling pain associated with acute pancreatitis.
  • Treatment of Underlying Issues: It is important to treat the underlying cause of acute pancreatitis. Below of the following procedure that can be done:
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): This is a procedure where a specialist passes a thin, flexible tube with a camera attached at the end through your mouth and into the first part of the small intestine, where the pancreatic duct and bile duct exit. A small catheter can also be passed into the bile duct to remove gallstones that might have gotten stuck and are responsible for pancreatitis. Below are some procedures which can be performed with ERCP:
  • SPHINCTEROTOMY: During this procedure, your doctor uses a small wire on the endoscope and finds the muscle which surrounds the pancreatic duct or bile duct, and makes a tiny cut to enlarge the duct opening. If a pseudocyst is present, the duct is drained.
  • GALLSTONE REMOVAL: Removal of pancreatic or bile duct stones is sone endoscopically. Gallstone removal is sometimes done along with a sphincterotomy.
  • STENT PLACEMENT: In this procedure, your doctor uses an endoscope and places a tiny piece of plastic or metal which looks like a straw into a narrowed pancreatic or bile duct to keep it open.
  • BALLOON DILATATION: Sometimes doctor uses endoscopes which have a small balloon and uses them to stretch or dilate a narrowed pancreatic or bile duct. A temporary stent can be placed for some time (few months) to keep the duct open.

Tips for preventing Pancreatitis

Tips to protect the pancreas from pancreatitis

  • 1. Limit alcohol consumption: Limiting alcohol consumption helps in protecting the pancreas from the toxic effects of alcohol and reduces your risk for pancreatitis.
  • 2. Eat a low-fat diet: As gallstones are one of the leading causes of acute pancreatitis. It is recommended to eat a diet low in fat which includes whole grains and a variety of fresh fruits and vegetables. Avoid fried or fatty foods and full-fat dairy products. Having high levels of triglycerides increases your risk for acute pancreatitis. To avoid this, limit foods that are high in simple sugars, such as high-calorie beverages and sweets.
  • 3. Exercise regularly and lose excess weight: Overweight people are more likely to develop gallstones, which in turn increases the risk of developing acute pancreatitis. Losing extra weight gradually and maintaining a healthy weight by eating a balanced diet and involving in regular physical activity can help in preventing gallstones formation.
  • 4. Don't smoke: It is recommended to limit smoking as smokers are more likely to develop acute or chronic pancreatitis than non-smokers.

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