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Pancreatitis Disease Introduction |
The pancreas is an
organ located behind the
stomach, between the upper part of
the small intestine (duodenum) and
the spleen. Its primary
responsibility lies within the manufacturing of insulin and
specialized digestive enzymes. The digestive
enzymes flow into the small
intestine to help break down food.
Insulin is then released to help
control the levels of sugar
(glucose) released into the blood.
When a specific trigger causes the
pancreas or pancreas duct to fail in
protecting the pancreas from the
aforementioned digestive enzymes,
inflammation of the pancreas occurs.
This inflammation is referenced as
pancreatitis.
Pancreatitis is a condition that can be acute or
chronic. Acute pancreatitis
causes few complications besides the
immediate pain, however, chronic
pancreatitis can damage the
pancreas to an extent that is can no
longer function normally.
Acute
pancreatitis in adults can
be caused by a variety of conditions.
It is considered a mild disease in
nearly 80% of all patients. [1] The most common conditions that lead
to acute pancreatitis are gallstone
migration (cholelithiasis) and
alcohol abuse. The majority of
patients (some 65-90%) suffer from chronic
alcoholism and are between the ages
of 30-40 years. Among patients who consume large
amounts of alcohol, only 5-10%
develop acute pancreatitis,
suggesting that other risk factors
such as smoking and a high fat diet
may make a person more susceptible
to the disease. [2]
Other conditions that may cause acute pancreatitis,
include; viral
infections like mumps, coxsackie B,
mycoplasma, pneumonia, blunt trauma, and medications such as estrogen,
corticosteroids, and thiazide
diuretics. It
also may be due to abnormal anatomy,
genetic factors, high lipid levels,
or complications resulting from cystic
fibrosis. There is also strong evidence
suggesting that individuals living
in urban areas are twice as likely
to have incidences of acute pancreatitis than rural
populations (20 cases/ 100,000
persons). [3] Having an elevated serum
triglyceride level over 1000 mg/dl
is also strongly associated with an
increase of onset, with an
approximate 38% chance
of developing an acute episode. [4]
Children may develop
acute pancreatitis from other
predisposing illnesses such as
cystic fibrosis, Kawasaki disease
(an inflammation of the blood
vessels), or from Reye's syndrome
(brain damage from aspirin use in
viral infections). The mechanism of
action in children is often one of auto digestion, whereby the
pancreas secretes digestive enzymes
prematurely and begins to digest
itself.
Alcohol, drugs, and
infectious agents also damage the cells
of the pancreas and result in an
early activation that stays
localized in the organ instead of in
the small intestine. Acute pancreatitis is becoming a much more
common illness today, than when it
was initially diagnosed. [5]
Chronic
pancreatitis is an illness that
is seen primarily in the Western
world. This is, largely, due
to the Western diet
and lifestyle; both of which
influence an individual's chance of developing the disease. [6] Alcohol abuse,
common in Western societies, can cause
digestive enzymes
to precipitate into the ducts of the
pancreas, resulting in onset of
fibrosis. In general, any condition that can
causes repeated episodes of acute pancreatitis may result in chronic
pancreatitis. The pancreas has over
ten times the amount of cells
necessary for normal functioning, or
in other words, over 90% of the
organ would have to be damaged before
illness manifests. [6]
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Pancreatitis Signs & Symptoms |
Acute
Pancreatitis
Abdominal pain in the
upper left quadrant and upper middle
section of the abdomen is the
common presenting pain pattern in
acute pancreatitis.
Episodes of pain may
worsen when lying on the back, an may
radiate to the left shoulder blade.
Pain can also rise with both eating and
drinking. Pain may be worse with
alcohol consumption and movement. [7] The pain
is usually sudden, and may cause nausea, vomiting, and a
deep, gnawing discomfort. The patient may
also exhibit fever, lowered blood
pressure, and rapid heart rate.
Chronic
Pancreatitis
Chronic
pancreatitis presents as dull,
constant pain that gets worse with
eating food or drink. This
pain may lessen
with a change in body position, such as
sitting up and leaning forward. Attacks may last a few hours or as
long as a few weeks. As the pancreas
becomes damaged, it produces fewer
digestive enzymes, inhibiting the
absorption of foods. Bowel movements
become more frequent and are
extremely foul smelling, due to the problems
of fat
absorption. In addition, if insulin levels become
erratic due to the damage, diabetes
may develop and cause symptoms of
increased hunger, increased thirst, and increased urination. The patient
may also develop anorexia, nausea, and vomiting.
Diagnosis
For both conditions
the blood is measured for increased
levels of serum amylase and lipase,
enzymes secreted by the pancreas. Abdominal ultrasound, CT scans, and endoscopic retrograde
cholangiopancreatography
(visualizing the pancreas area with
an endoscope tube inserted) are also
used to make a definitive diagnosis.
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Learn More About Pancreatitis
Disease |
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