Pancreatitis or inflammation of the pancreas can occur as an acute or chronic form. It involves inflammation of the bile ducts, as can occur with gallstones. Often, however, pathological or excessive alcohol consumption is also responsible for pancreatitis. Since life-threatening complications can occur with this condition, a doctor should be consulted as soon as possible if suspected.
What is pancreatitis?
Schmatic diagram showing the anatomy of pancreatitis (acute pancreatitis).
The pancreas is an organ about 15 centimeters long in the upper abdomen that produces hormones and digestive juices and enzymes. If this organ is inflamed by certain factors, it is called pancreatitis. Pancreatitis, also known as inflammation of the pancreas in medical terminology, is a relatively rare disease that can either appear suddenly or become chronic. In the latter form of this disease, it is not uncommon for alcohol to play a role. Pancreatitis manifests itself through various symptoms. Most patients complain of pain in the upper abdomen, and nausea and vomiting are not uncommon side effects of pancreatitis. The abdominal pain may radiate to the back or chest. Patients may often be found to have a curved back when lying down, as this relieves the pain somewhat. A soft abdomen, the so-called “rubber belly”, is also typical of pancreatitis. In turn, the abdomen is very sensitive to pressure. If the disease becomes chronic, other symptoms may be added, such as weight loss and digestive problems. Jaundice, flatulence, and also fever are also symptoms that can occur as part of pancreatitis.
Causes
Diseases of the bile ducts, such as gallstones, are often a cause of pancreatitis. However, alcohol is also not infrequently among the triggers of this disease. According to statistics, alcohol abuse is the main trigger of pancreatitis in men between 30 and 50 years of age, while gallstones are more common as a cause in women. About 1 in 100 patients with gallstones also develop pancreatitis. This happens when a gallstone lodges in front of the outlet of the pancreas and blocks it. Now the digestive juices can no longer exit the pancreas into the intestine – pancreatitis is the result. However, in addition to alcohol and gallstones as the main triggers of this disease, other factors can also cause pancreatitis. A high-fat diet is one of these triggers, as are elevated calcium levels in the blood or the use of certain medications. In the rarest cases, pancreatic cancer is to blame for inflammation of the pancreas. If the disease is genetic, it is also called hereditary pancreatitis.
Symptoms, complaints, and signs
Inflammation of the pancreas can be accompanied by a variety of symptoms. The symptoms that appear depend on whether the patient is suffering from acute or chronic pancreatitis. A typical sign of acute pancreatitis is an abrupt pain in the upper abdomen that takes the form of a belt. Not infrequently, the pain extends to the chest and back, persisting for a long time. In addition, the abdomen shows excessive tenderness and inflates to such an extent that it looks like an elastic rubber belly. If pancreatitis is caused by gallstone disease, colicky symptoms are also possible. In many cases, pancreatitis is associated with other symptoms. These are primarily nausea and vomiting. Due to the irritated gastrointestinal tract, feelings of pressure and flatulence also occur in the upper abdomen. The entire body is affected by the inflamed pancreas. Many patients experience fever and a general feeling of weakness. The patient feels tired and listless. Furthermore, blood pressure often drops. The symptoms of pancreatitis also include increased permeability of the vascular walls. This causes fluid to leak into the adjacent tissue.In extreme cases, this process leads to circulatory collapse. If chronic pancreatitis is present, there is also fatty stools, weight loss, jaundice and disturbances in sugar metabolism.
Course
In nine out of ten patients, acute pancreatitis progresses smoothly and without further complications – of course, it is important that it is treated properly. However, if one repeatedly suffers from pancreatitis within a short period of time, further diseases such as diabetes can be the unsightly consequence. Chronic pancreatitis, in turn, can cause pancreatic cancer. After surviving pancreatitis, patients must pay close attention to their diet: especially alcohol, coffee and fat are strictly prohibited.
When should you go to the doctor?
Acute pancreatitis requires prompt treatment by a physician. Initial examinations to narrow down the suspicion can already be performed by the family doctor. Serious signals are sudden abdominal pain that spreads in a circle around the upper abdomen and radiates to the back. If these symptoms persist for no apparent reason, there is sufficient reason to consult a physician. If the inflammation is particularly pronounced, fevers and profuse sweating are also prominent features. Nausea and vomiting plague the affected people. In addition, the onset of dizziness and falling blood pressure pose a concrete threat to life and limb. In this situation, immediate action is required and no valuable time must be allowed to elapse before help arrives. Therefore, the emergency call is the best choice in case of severe suffering. A rapid rise and combination of symptoms indicate an acute pancreatic problem. In general, because of the frequent severity of the pain and accompanying symptoms, there is little risk of the condition going unnoticed for too long. The chronic form usually manifests itself less dominantly and develops more slowly, but stresses the body at recurring intervals. If regular alcohol and nicotine consumption exists at the same time, it is also advisable to have the pancreas checked. In addition to quick help in case of severe pain, the general practitioner usually refers the patient to a specialist for an exact clarification of the causes. The gastroenterologist as well as internist then perform additional examinations to pinpoint the exact location, type and severity of the case.
Treatment and therapy
The treating physician will first perform a so-called anamnesis, i.e., a detailed examination of the patient’s previous medical history. Several examinations, such as ultrasound, endoscopic examinations and blood tests, will find out whether it is indeed pancreatitis. The level of the enzyme lipase is often significantly elevated in pancreatitis – an analysis of the blood will quickly determine this. Acute pancreatitis usually requires hospital treatment. This therapy is usually carried out in the intensive care unit, but conservatively – that is, without surgical intervention. The affected patient is usually not allowed to eat anything until the pain has completely disappeared. Fluids and nutrients are supplied to the body via infusions during this time. This is followed by a slow build-up of food. If gallstones are the cause of pancreatitis, they are usually removed during an endoscopy.
Outlook and prognosis
The prognosis of pancreatitis depends primarily on whether it is acute or chronic. Acute pancreatitis usually heals without late damage, although the disease is often severe. However, in the course of acute pancreatitis, complications can occur that may even be fatal. This is the case, among other things, when the pancreas is almost completely dissolved by the digestive juices. In a few cases, sepsis (blood poisoning) can occur, which also worsens the short-term prognosis. Other complications, some of them fatal, include circulatory shock, hemorrhage in the pancreas, or multiple organ failure. After overcoming acute pancreatitis and its complications, complete recovery usually occurs. Unfortunately, the long-term prognosis of chronic pancreatitis is not as good. While it does not necessarily lead to death.However, chronic complaints may develop. In chronic pancreatitis, inflammatory processes are constantly taking place in the pancreas. This results in irreversible remodeling processes in the pancreas, which can lead to so-called pseudocysts. Pseudocysts are fluid-filled chambers. They often become inflamed and sometimes bleed in. Furthermore, calcifications develop in the course of chronic pancreatitis. This often results in the formation of so-called pancreatic stones, which in turn disrupt the outflow of digestive juices. Pancreatic cancer can also develop as a late consequence of chronic pancreatitis.
Follow-up
Pancreatitis is a serious condition that absolutely belongs in the hands of physicians. After treatment, consistent follow-up care is important, and the patient is involved in this. The patient’s cooperation is crucial, as a number of causes of pancreatitis are linked to the patient’s behavior. A classic example of this is alcohol, the frequent consumption of which is considered a typical trigger of pancreatitis. If this is the case with the patient in question, abstaining from alcohol during follow-up care is an essential factor in preventing the disease from flaring up again. The pancreas and its functions must be consistently spared. The general practitioner or the internist in charge of the patient will give precise instructions on how to proceed. The pancreatitis requires a conscious diet in the aftercare. The patient can support regeneration by avoiding foods that are difficult to digest and opting for a balanced diet. Foods to avoid include flatulent foods such as legumes, fatty foods and cold foods. In addition, there is the aforementioned abstention from alcohol, which must be followed consistently. Nicotine is also a factor that can have an unfavorable effect on regeneration and is better abandoned in the spirit of changing one’s lifestyle to a healthy level. Elevated blood lipid levels favor pancreatitis. They can be reduced in the long term by exercise and dietary changes. Regular monitoring is important.
What you can do yourself
If you do not want to go directly to a specialist, you will find a good alternative in homeopathy. In the early stages, pancreatitis can be treated well with Phosphorus C5 together with Iodum C5. Take three globules three times alternately until the condition improves satisfactorily. However, in case of pancreatitis, despite the offer of homeopathic preparations and self-help remedies, it is advisable to consult a doctor. The most important commandment is: Do not drink alcohol. Even in chocolates or as a flavoring in sauces, etc., it must not be consumed. Likewise, those affected must refrain from nicotine. Coffee consumption must at least be reduced from a health point of view. The diet should be extremely rich in carbohydrates. However, overly large portions of salad, whole-grain products, and fruits and vegetables should be avoided, because otherwise the digestive system will be overly burdened. Rather eat several small meals spread throughout the day. These also guarantee an energy intake that is well distributed throughout the day. Taking pancreatic powder, which is available in pharmacies as granules or capsules, normalizes the frequency of bowel movements and the consistency of the stool. In addition, fluid intake should be at least 2.5 liters per day. Still water should be fortified with electrolytes. Fortification is important to prevent the consequences of electrolyte deficiency from the beginning.
