Course of acute pancreatitis

The course of acute pancreatitis (inflammation of the pancreas) is divided into three phases:

Due to swelling and dying tissue of the pancreas, there is an increase in pancreatic enzymes, the inflammation parameter CRP and the white blood cells in the blood. These changes can be diagnosed on the basis of laboratory values. – The second phase consists of healing. – If the pancreas has partially transformed itself into dying (necrotic) tissue, an inflammation of these areas is possible. In serious cases, even blood poisoning (sepsis) is possible.

Chronic pancreatitis

This is a chronic inflammatory process that affects the area around the pancreas without much relief or healing. In almost all cases, the causes can be seen in chronic alcohol consumption. People with alcohol addiction have the greatest risk of this disease, also known as chronic pancreatitis.

In addition, some medications (blood pressure medication, antibiotics, anticonvulsants and chemotherapeutic drugs) can lead to chronic inflammation. In addition to an increase in the blood lipid level, hyperactivity of the parathyroid gland can also be considered a cause. Despite extensive medical research, in about 15% of cases no exact cause can be found.

The diagnosis of a chronic pancreatitis is made by means of ultrasound on the one hand, but also by blood tests on the other, in which pancreatic values are examined. If these are strongly elevated (lipase), this indicates an inflammatory process. In ultrasound, calcifying structures (whitish visible in ultrasound) or a cloudy suspension of the normal structure of the pancreas would indicate an inflammation.

Whether it is an acute process or a chronic process would only be determined by the duration and the number of episodes that have already occurred. If it is an initial disease, the process would be described as acute, whereas a course that is repeated or never completely interrupted would be counted as chronic pancreatitis. Once chronic inflammation has been diagnosed, all alcohol consumption should be stopped and a longer period of abstinence should be taken.

This is the only way to guarantee that the pancreatic cells can recover. Attempts at conservative treatment, such as sparing, painkillers and, if necessary, antibiotics, should be attempted under close supervision of the patient. However, if there is no improvement, a surgical procedure should also be considered.

The inflamed area is inspected endoscopically and surgically removed. This procedure should be chosen especially if cell areas that have already died off are present. An extensive inflammation must be treated additionally with sterile rinsing solutions. A chronic or severe course of pancreatitis can be fatal in some cases. Patients who do not refrain from drinking alcohol despite recurring episodes are particularly affected.

Symptoms

There are so-called leading symptoms in pancreatitis: Leading symptoms are complaints and characteristics that are typical for a certain disease and usually always occur. In the majority of patients (90%) with pancreatitis, an acute onset is characterised by severe abdominal pain that can radiate to the side. Often the pain wraps itself around the body like a belt.

Other symptoms of pancreatitis include nausea and vomiting, a bloated abdomen and paralysis of the intestine (ileus). Fever, low blood pressure and changes in the ECG are also observed. If the suffering is of a chronic nature, fatty stools often occur – this means excretion of fat, which could not be absorbed through the intestines due to a lack of pancreatic secretions, weight loss and diarrhoea.

In addition, food intolerance occurs. Fatty foods are therefore poorly tolerated and lead to nausea, vomiting and pain. The main symptom here is recurrent pain, which is not colicky but can last for hours and days. – Pain in the upper abdomen and

An increase in pancreatic enzymes in the blood and urine (e.g. trypsin)