The pancreas, which measures only 15x5x3cm, is the only organ in the body that performs a dual function. It produces the hormones insulin and glucagon, which regulate blood glucose levels. If this function of the pancreas is disturbed, this can lead to diabetes mellitus. Independently of this, the pancreas produces enzymes without which we cannot digest fats, proteins and carbohydrates from our food. If enzyme production is inadequate because the pancreas is inflamed or a tumor is present, problems can arise, especially with fat digestion.
Causes of pancreatitis.
“Chronic pancreatitis is the most common disease of the pancreas. In our country, it affects approximately 50,000 to 70,000 people. Although increased alcohol consumption is often the cause, there are people for whom even small amounts are sufficient to trigger the disease,” explains Prof. Dr. Joachim Mössner, Vice Chairman of the Gastro-Liga and head of the Pancreas Action Day.
Another important cause is genetic defects (mutations). They can also trigger chronic pancreatitis or promote its development. This is the case in every 4th to 5th patient. But gallstones can also cause pancreatitis.
Progressive pancreatitis leads to increasing destruction of the organ. Less or no insulin or digestive enzymes are produced. Severe pain in the upper abdomen, diarrhea/fatty stools, weight loss, and diabetes mellitus are important signs of the disease.
Therapy of pancreatitis.
Professor Mössner cautions, “The following applies to treatment: alcohol and smoking are taboo! In addition, the therapy depends primarily on the symptoms.” By taking digestive enzymes, an attempt is made to restore adequate digestion of food. If the upper abdominal symptoms are not relieved despite abstaining from alcohol, nicotine and taking digestive enzymes, more or less strong painkillers can help. Insulin injections may lower elevated blood sugar levels.
If even the strongest painkillers are no longer effective or if the pancreas, which has been altered by the chronic inflammation, affects surrounding organs, partial removal of the pancreas (pancreatectomy) is often the only option. However, endoscopic measures can sometimes also be used to control the complications. Therefore, the therapy of pancreatitis is an interdisciplinary approach: cooperation between gastrointestinal specialist (gastroenterologist) and abdominal (visceral) surgeon.
Pancreatic cancer – smoking as a risk factor.
Pancreatic cancer is one of the cancers whose early symptoms are rare and uncharacteristic. “Unfortunately, girdling back pain is often attributed to other causes,” Professor Mössner explains. “Pancreatic tumors are often not diagnosed until advanced stages, when bile can no longer drain and then the patient notices jaundice, dark urine and light-colored stools, or the patient loses significant weight.”
For the vast majority of those with pancreatic cancer, there is still little chance of a cure. The earlier malignant pancreatic tumors are operated on, the better the chances. Together with the possibilities of chemotherapy, survival rates of usually only a few years can now be achieved.
The molecular genetic alterations in the development of pancreatic tumors have been relatively well researched in the meantime. Nevertheless, there is still no possibility of early diagnosis, as is the case, for example, with colorectal cancer. Smoking increases the risk of developing pancreatic cancer. People who consume a lot of meat and animal fats are also more likely to develop the disease.
