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It is an inflammatory condition of the pancreas characterised by the damage of the pancreatic cells by the digestive enzymes, secreted by the pancreas itself. This condition can be acute or chronic. Acute pancreatitis is sudden in onset and generally resolves in a few days. Frequent episodes of acute pancreatitis damage the pancreatic cells, leading to chronic pancreatitis.

Pancreas is a vital gland, located behind the stomach just below the liver. Pancreas is both an exocrine and an endocrine gland. The exocrine part produces enzymes that help in digestion and absorption of nutrients from food. The endocrine part of the pancreas secretes hormones involved in the metabolism of sugar and maintenance of blood sugar levels.

Causes

Any inflammation of the pancreas may temporarily block the bile and the pancreatic duct leading to reflux of the bile into the pancreatic duct. Some of the causes of acute pancreatitis include excessive consumption of alcohol, certain medications, viral infections such as mumps, hypothermia and scorpion sting. Alcohol consumption is one of the most common causes of chronic pancreatitis; the other causes of chronic pancreatitis include exposure to industrial toxins, congenital variation in pancreatic duct system and genetic factors.

Symptoms

The characteristic symptoms of pancreatitis include sharp, aching or burning pain over the upper and central portion of the abdomen associated with back pain (acute pancreatitis). Any enlargement or abnormality of the head of the pancreas may block the bile duct and lead to jaundice associated with dark urine, pale stools and itchy skin. Steatorrhoea is a condition characterised by loose, pale, fatty, floating, offensive bowel motions due to lack of secretion of the digestive juice from the pancreas that hampers the absorption of fats from the intestines. Pancreatic disorders interfere with digestion and sugar metabolism and the patient experiences weight loss and loss of appetite.

Diagnosis

The diagnosis of pancreatitis includes medical history and physical examination along with a few lab tests for the evaluation of the condition. Blood and stool tests evaluate the levels of the pancreatic enzymes in the blood and stools. A CT scan, MRI scan or abdominal ultrasound may be used to evaluate any associated abnormalities of the pancreas. Endoscopic ultrasound may also be used to look for any inflammation or blockage of the pancreatic duct.

Treatment

The treatment of pancreatitis requires hospitalisation to stabilise and monitor the patient’s condition. The treatment of acute pancreatitis includes pain medications to control pain and intravenous fluids to avoid dehydration. During this period patient is advised a liquid diet to allow the damaged pancreas to heal. The treatment of the chronic condition includes pain medications to control pain, pancreatic enzymes supplements to improve digestion and a low fat diet to avoid any complications. In case of bile duct obstruction or severe pancreatitis, surgery may be recommended.

Complications

Some of the complications associated with pancreatitis include breathing problems, diabetes mellitus, infections, malnutrition and pancreatic cancer.

Conditions

  • Medical Board of Australia
  • Royal Australasian College of Physicians
  • Gastroenterological Society of Australia
  • American Society for Gastrointestinal Endoscopy
  • American Gastroenterological Association
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