Pancreatitis (pathologic inflammation of the pancreas)


Pancreatitis is that inflammation within the tissues of the pancreas. It is worth noting that the pancreas is a gland located behind the stomach in the upper part of the abdomen, among its functions, is the digestion of fats and carbohydrates that we eat using pancreatic juice.

This substance contains digestive enzymes; in addition to that, the pancreas is responsible for the production of insulin and glucagon hormones; insulin is responsible for lowering blood sugar levels. In contrast, glucagon has the opposite effect, and thus the pancreas works as two devices in one system, and one can face pancreatitis in different ways.

What is pancreatitis?

In public, the pancreas is usually associated with diabetes, and diabetes is definitely the most common disease. Its significance is damage to the pancreas, but it is not the only disease that affects the pancreas, and perhaps not the most serious, there is so-called pancreatitis.

Pancreatitis consists of inflammation of the organ's tissues and completely affects the shape and function of the gland. The main mechanism that causes inflammation is the change in the mechanisms of secretion of enzymes from the pancreas so that it produces secretion within the gland itself instead of the duodenum, which causes digestion of the pancreas tissue and sometimes of the adjacent organs...

Pancreatitis can occur in two main forms: as an acute and rapid disease, chronic disease, treatment of both diseases is different, as well as their clinical symptoms, there are three types of pancreatitis:

  • Acute pancreatitis
  • Chronic pancreatitis
  • Necrotizing pancreatitis

The importance of the pancreas to the body

The pancreas located in the upper part of the abdomen is an organ that has a dual function. The secretory role of the pancreas involves the secretion of different enzymes in the duodenum and digestive system. It has many benefits that the body cannot do without it. Among the important functions of the pancreas are:

  1. Excretion of powerful digestive enzymes, such as lipase and amylase, in the small intestine, to help digest carbohydrates, proteins, and fats.
  2. The release of insulin and glucagon hormones into the bloodstream and these two hormones are responsible for treating sugars in the blood.
  3. Regulating the way food is stored in the body, which is then used to produce energy.

What a chronic pancreatitis

  • Chronic pancreatitis is a long-term process that consists of a change in the structure of the gland, mainly due to fibrosis, which develops over time. It ends with the destruction of the entire gland, and ultimately leads to a change in all the functions of this device, and thus the loss of the pancreas function, and may cause diabetes and indigestion in the Long term. However, it is a chronic process. In some cases, the appropriate treatment can be administered to control the disease, and in some cases, even an ideal effect on the disease can be achieved.
  • The disease often occurs due to excessive alcohol consumption for many years.
  • Repeated episodes of acute pancreatitis can lead to chronic pancreatitis.
  • Sometimes the cause is unknown.
  • Pancreatitis is caused by gallstones.
  • The inflammation may be caused by the immune attacking the body, which is called autoimmune diseases.
  • Channels containing the enzymes from the pancreas are clogged.
  • Severe fibrosis of the organ tissue.
  • High levels of fat called triglycerides in the blood.
  • Overactive parathyroid gland.
  • Use of some medicines (especially sulfa drugs and diuretics).
  • The presence of large amounts of calcium or fat in the blood.
  • Chronic pancreatitis is more common in men than in women.
  • The condition most often occurs in people between the ages of 30 and 40.
  • Genetics plays a big role in developing chronic pancreatitis.

What immune pancreatitis?

Autoimmune pancreatitis is seen as the result of our immune system, which not only fights foreign tissues in the body, but the body's tissues themselves are considered strange, and they begin to attack them. Thus immunity treats pancreas tissue as foreign cells and breaks it by opening war against the pancreas. It is a rare disease among different immune diseases, and autoimmune pancreatitis consists of two types:

The first type autoimmune pancreatitis

  • Pancreatitis is associated with IgG4 (immunoglobulin G4).
  • It isn't only related to the pancreas, but also to the liver, bile ducts, salivary glands, kidneys, and lymph nodes, affecting many organs in the body.
  • It usually affects men aged 60 years and over.
  • Type 1 pancreatitis may recur if left untreated.

The second type of immune pancreatitis

It affects only the pancreas, and more than half of patients with type II suffer from inflammatory bowel disease, and it can affect women, as well as men over the age of 40.

What is necrotizing pancreatitis?

  • It represents about a quarter of the incidence of acute pancreatitis, also called severe acute pancreatitis, in which the normal tissue of the pancreas is necrosis, and the tissue is lost with its function.
  • It develops with severe damage and death to the tissues of the pancreas, and even the surrounding tissues and the respiratory system, kidneys, and blood circulation can also be severely affected due to the severity of the event and the different mechanisms that occur.
  • Enzymes and fluid release from the pancreas into the abdominal cavity cause blood thinning, from which a severe drop in blood pressure, a shock to the body, and death occur.
  • It is a life-threatening condition, and it requires focused care, which may require a large number of surgical interventions, despite all types of support and treatment, 30% of cases are lost.
  • Even if there is an improvement, the pancreas may be affected differently and lose its job. Through this, the result is pancreas insufficiency.
  • The necrotizing pancreas may be a form of acute recurrent pancreatitis that has not treated properly, which has caused this.

Symptoms of pancreatitis

The symptoms of acute and chronic pancreatitis are somewhat similar, or by another definition, the symptoms of inflammation for both types are similar. Still, one of them lasts for a short period, and the other has become a disease associated with humans throughout life.

Symptoms of acute pancreatitis

people with acute pancreatitis suffer from:

  • The most prominent signs of acute pancreatitis are abdominal pain. Pain can appear in varying degrees of severity, usually appears in the abdominal cavity, can back on the back and navel, and other common complaints are nausea, vomiting, and a swollen stomach. The patient may experience a rise in temperature Fast heart rate (tachycardia), and sometimes high blood pressure.
  • A more severe case of acute inflammation can occur with bleeding in the abdomen and signs of bleeding in the body, especially in the umbilical area and in the waist.
  • In the case of acute pancreatitis, a person may experience swelling in the upper abdomen. This swelling can occur because the intestine contents have stopped moving, causing intestinal edema.

Symptoms of chronic pancreatitis

people with chronic pancreatitis suffer from :

  • chronic pain, which is found in more than 80% of patients. It is often persistent pain of moderate intensity in the upper abdomen and bounces back toward the back.
  • Pain worsens after meals. Or after drinking alcohol, and improves when the torso is bent forward, or when lying on the stomach.
  • The pain is usually persistent, or in the form of seizures, without sometimes disappearing completely from one case to another.
  • With the development of pancreatitis and the deterioration of the pancreas, the pain tends to disappear. A fact that can occur 5 to 10 years after the onset of the disease.
The most common symptoms are:
  • Stomach ache.
  • Vomiting and nausea.
  • Seborrheic nausea.
  • Abdominal distension.
  • Heart rate acceleration.
  • High temperature.

Other symptoms that the disease can manifest associated with the gradual deterioration of the function of the pancreas, and they usually appear in times of disease progression, including:

  • Diarrhea and weight loss can appear due to insufficient food digestion and the body's inability to absorb it, leading to progressive malnutrition.
  • Diabetes can also appear because insulin is not produced properly from the pancreas.

Diagnosis of pancreatitis

Diagnosis of pancreatitis is easy, and when clinical symptoms are typical and complete in the patient, the experienced doctor makes the diagnosis while listening to the signs. Sometimes many blood tests, and x-rays, and even endoscopic examinations required, and for the diagnosis of chronic pancreatitis must have at least one of the following data:

The patient's history contains some important data, such as: (chronic alcohol consumption, chronic or occasional abdominal pain, weight loss, diarrhea, and diabetes).

Morphological change of the pancreas, shown through an endoscopic study of the pathway of the pancreas.

Pancreatitis diagnostic tests include:

  • Fecal fat test.
  • High level of amylase in the blood.
  • High level of lipase in the blood.
  • Blood trypsinogen.
  • IgG4 (for the diagnosis of autoimmune pancreatitis).
  • Genetic testing takes place in most cases when there are no other common causes, or when there is a family history of this disease.

The clinical examination that may show inflammation, scars, or other changes in the pancreas can be:

  • Abdominal CT scan.
  • Abdominal ultrasound.
  • Endoscopic examination.
  • Magnetic resonance imaging of the pancreas.
  • Endoscopic imaging of the pancreas and bile ducts.

Causes of pancreatitis

Acute pancreatitis can divided into direct and indirect causes. The direct causes are directly related to the pancreas and the tissues and channels of the pancreas. The indirect causes are diseases and conditions that involve other organs related to the pancreas, and the most common causes of pancreatitis are:

  • Toxic metabolism: it results from the digestion of some toxic substances in the pancreas, the most important of which are alcohol and tobacco.
  • Due to disorders, or metabolic diseases, such as hypercalcemia (increased calcium in the blood), or chronic kidney failure, which leads to an increase in toxic substances in the pancreas, as they cannot be sufficiently filtered by the kidneys.
  • Genetic: it results in mutations in the genes that increase the risk of developing this disease. This results in a type of inherited chronic pancreatitis.
  • Autoimmunity: In this case, pathologic inflammation of the pancreass is caused by a defect in the immune system that "attacks" the pancreas, resulting in chronic inflammation.
  • Recurrent occurs as a result of acute pancreatitis, that is, a sudden inflammation of the pancreas (either due to any toxic substance such as alcohol, gallstones, and autoimmune diseases) can also happen after one episode of severe acute pancreatitis.
  • Obstruction: When the secretory duct of the pancreas is blocked for any reason (stones such as gallstones, tumors, malformations ...).
  • The use of aspirin in children and individuals under the age of 19 without a doctor's recommendation, like aspirin, can lead to acute pancreatitis.
  • Idiopathic: When we don't know the underlying cause that causes pancreatitis, pancreatitis may be due to a psychological condition.

Treating pathologic inflammation of the pancreas

Because changes in the body caused by pancreatitis are necessary, they usually require urgent intervention, and among the steps to treat pancreatitis are symptoms of the digestive system and reduce indigestion. Enzymes are provided to perform the digestive system's function again, and the pancreatic treatment protocol is as follows:

  • Patients with acute pancreatitis often hospitalized and treated.
  • The patient given the drug intravenously and supplied with sufficient fluid.
  • Besides, analgesics and medications that prevent possible infections  given.
  • In some cases, surgery required to remove damaged tissue, drain the accumulated bile, or open the blocked ducts. If gallstones are causing the problem, the gallbladder removed surgically.
  • If the doctor thinks that this caused by a medication the patient uses, he will ask the patient to leave the drug immediately.
  • The patient must strictly follow the advice of the doctor, take medications on time and not eat fatty food, and fully rest the patient.
  • pathologic inflammation of the pancreas can attributed to some of the psychological conditions experienced by the patient, and from here, the doctor advises psychological comfort and not to think of anything.
  • He should quit smoking completely, drink alcohol, and drink plenty of fluids.
  • Acute pancreatitis can sometimes linked to type 2 diabetes, type 2 diabetes is a disease that affects insulin production, and the consumption of protein-free of fats, green leafy vegetables, and grains helps the pancreas to restore regular insulin production again.
  • If the underlying cause is gallstones and persistent bile duct obstruction, and endoscopic intervention (ERCP) removed to remove the existing stone by widening the bile ducts, and the pressure in both the bile duct and the pancreatic duct reduced by providing the flow again.

Treatment of moderate acute pancreatitis

Treatment aims to maintain body functions and relieve symptoms, while the pancreas repairs itself, this will include:

  • Pain relievers: Moderate acute pancreatitis can cause moderate or severe pain.
  • Intestinal nasal tubes: The tube can remove excess fluid and air as a treatment for nausea, vomiting, and flatulence.
  • Intestinal rest: The digestive system needs a few days of rest, so a person does not take food or drink orally until his condition improves.
  • Prevention of dehydration: dehydration often accompanies pathologic inflammation of the pancreas, and it can aggravate symptoms and complications, and fluid usually given intravenously for the first 24-48 hours.
  • A person can usually return home after about 5 to 7 days.

Complications of pathologic inflammation of the pancreas

Pancreatitis is a very painful disease in the short term, and it known that pancreatitis becomes chronic in cases that neglected treatment, or in patients who do not make the necessary lifestyle changes. More serious complications from pancreatitis occur, and complications can include:

  • Ascites.
  • Blockage of the small intestine or bile ducts.
  • Blood clots in the spleen vein.
  • Fluid build-up in the pancreas (false pancreatic cysts) can become infected.
  • Diabetic.
  • Malabsorption of fats, nutrients, and vitamins (in most cases, fat-soluble vitamins A, D, E, and K).
  • Anemia due to iron deficiency.
  • Vitamin B12 deficiency.
  • Inflammation can cause the organ to exposed to a bacterial or fungal infection.
  • Necrosis of the pancreas tissue and fluid leakage into the abdominal cavity, leading to death.
  • Pancreatitis rarely develops pancreatic cancer.

Is pancreatitis contagious?

No type of pancreatitis can be infectious, whether the infection is acute or chronic, and this is because it does not occur as a result of any bacterial infection. Hence none of the family members can transmit the infection.

Prevention of pancreatitis

It is possible to avoid all these matters related to pancreatitis by working to prevent the causes that lead to it. And to constantly examine and monitor the digestive system specialist when feeling preliminary symptoms of this disease. The following methods can relied upon as a form of prevention:

  • Drink a lot of fluids.
  • Reduce fat intake in food.
  • Eat small, frequent meals (this helps reduce symptoms of the digestive system).
  • Get enough vitamins and calcium in the diet, or as additional supplements.
  • Reduce caffeine.
  • Your doctor may prescribe pancreatic enzymes. These medications should taken with every meal and even snacks because the enzymes help you digest food better, gain weight, and reduce diarrhea.
  • Avoid smoking and drinking alcoholic beverages, even if pancreatitis is mild.

The most common questions about pathologic inflammation of the pancreas

When and where do you go, and which doctor to find ?

Pancreatitis should diagnosed early, and treatment started, especially for acute pancreatitis. Treatment should begin immediately and prevented from switching to a necrotic, or chronic, pancreatitis form. And when patients see symptoms of pancreatitis in themselves, they should consult a specialist.

Besides, if the family has a history of pancreatitis, or has a chronic disease. The patient must consult a doctor with a periodic examination to avoid the disease or its progress. The specialist in the diagnosis and treatment of pathologic inflammation of the pancreasis a gastroenterologist.

Can pancreatitis become cancer?

Because of pancreatitis that appears for many years in patients with chronic pathologic inflammation of the pancreas and alcohol consumption for a long time. The damage caused by the pancreas will increase and may develop into cancer in the patient.

Since some symptoms of pancreatic cancer can confused with pancreatitis, advanced diagnostic methods used Rather than making an inappropriate decision.

Does the treatment take a long time?

The duration of treatment in acute pancreatitis varies depending on the severity of the disease. In contrast, moderate pancreatitis improves within a few days Treatment of acute pancreatitis with tissue loss in the pancreas organ is difficult, and it lasts longer. In such cases, an endoscopic intervention may needed or surgery to remove damaged tissue.

Seborrheic nausea

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