Complications
An acute inflammation of the pancreas can lead to serious complications if it is not treated promptly. One of the most common problems observed in the course of this disease is the tryptic accumulation of neighbouring organs and structures. The formation of so-called “pseudocysts” and the formation of blood clots within the portal vein are also among the most common complications of acute pancreatic inflammation.
Besides possible damage to organs, acute pancreatitis can also lead to impairment of the cardiovascular system. Affected patients often develop dehydration, a steep drop in blood pressure or life-threatening shock as the disease progresses. In addition, inadequately treated acute inflammation of the pancreas can lead to heart, lung or kidney failure.
Therapy
The most common cause of chronic inflammation of the pancreas is long-term alcohol abuse (about 80% of known cases). The alcohol consumption necessary to trigger inflammatory processes in the pancreas is on average more than 80g over a period of six to twelve years. However, regular consumption of alcoholic beverages alone does not represent a risk factor for the development of chronic pancreatitis.
Rather, it is a decisive co-factor, as only ten percent of heavy alcoholics develop chronic inflammation of the pancreas during their lifetime. In addition, the regular consumption of nicotine is considered a risk factor for the development of chronic inflammation of the pancreas. If an affected patient is a child, it may be a so-called “hereditary autosomal dominant pancreatitis”.
This form of inflammation of the pancreas leads to a chronic form of the disease through repeated attacks (acute inflammation of the pancreas) with self-digesting necroses. The direct cause in these cases is a mutation in the gene coding for the synthesis of the pancreatic enzyme trypsinogen (PRSS1) or in the gene of the serine protease inhibitor SPINK1. Triggered by these two decisive mutations, an autoactivation of trypsinogen to trypsin occurs within the pancreas and an associated autodigestion of pancreatic tissue.
The so-called “autoimmune chronic inflammation of the pancreas” is also triggered by a genetic malfunction. Other causes for the development of chronic inflammation of the pancreas
- Idiopathic (without known cause)
- Drug-associated (diuretics, beta-blockers, ACE inhibitors, cytostatics, antibiotics, antiepileptics etc. )
- Persistent hypercalcaemia in overactive parathyroid gland
- Hyperlipidemia
- Chronic renal insufficiency
- Tumors
- Narrowing of the pancreas and bile ducts
- Genetic factors
Constantly recurring pain that is not colicky and can last for hours or even days is considered a leading symptom of chronic inflammation of the pancreas.
Typically, the pain is localized to the upper abdomen in affected patients. Even in chronic inflammation of the pancreas, the pain perceived by the patient can radiate into the flanks and lower back. While the pain can be very strong at the beginning of the disease, the pain often decreases later on.
Many patients with advanced chronic inflammation of the pancreas are even completely pain-free. In addition, a pronounced food intolerance can often be observed in those affected. Whether this food intolerance is caused by the inflammatory processes themselves or merely by the fear of pain after eating is not yet clear.
In addition, the chronic inflammation of the pancreas often causes nausea and vomiting. The affected patients lose weight increasingly during the course of the disease. Due to the limited function of the pancreas, fewer digestive enzymes are released into the small intestine.
As a result, various food components can no longer be digested. Fat stools, diarrhea and flatulence develop. In addition, secondary diabetes mellitus can develop due to the limited release of insulin.
