Pancreatitis

The inflammation of the pancreas is a condition known as pancreatitis. This disorder occurs when the enzymes that are involved in digesting food are no longer activated in the small intestine but in the pancreas instead. The condition comes in two forms: chronic and acute. Chronic pancreatitis may occur over several years with painful, multiple symptoms. Acute pancreatitis comes on suddenly, with symptoms lasting up to a few days. Chronic pancreatitis may develop from a single instance of pancreatitis in its acute form. Overuse of alcohol is one of the most common causes of both forms of the condition.

Symptoms

Symptoms of pancreatitis may include:

* Acute upper abdominal pain that may spread to the upper back
* Vomiting
* Jaundice
* High or low blood pressure (depending on the level of pain and whether dehydration or internal bleeding have occurred)
* Fever
* Abdominal tenderness
* Weight loss
* Nausea

Causes

Causes of pancreatitis may include:

* Idiopathic
* Gallstones
* Ethanol
* Trauma
* Steroids
* Mumps
* Autoimmune pancreatitis
* Scorpion sting
* Hypothermia, hypercalcaemia, or hypertriglyceridaemia
* Endoscopic Retrograde Cholangiopancreatography (ERCP)
* Various drugs

Among the most widespread causes of pancreatitis are high alcohol intake and gallstones. Gallstones are pebble-like stones that form from hardened bile. They can cause the pancreas to become inflamed when traveling via the common bile duct. Overconsumption of alcohol can be a cause of chronic or acute pancreatitis.

Less widespread causes of pancreatitis include: vasculitis (when the small blood vessels in the pancreas become inflamed), pancreatic cancer, pancreas divisum (congenital malformation of the pancreas), pregnancy, porphyrias, and calculi. A number of medications are associated with pancreatitis including: diuretics, AIDS drugs, anticonvulsants, estrogen, viruses, chemotherapeutic agents, and statins.

Genetic abnormality may be a factor in hereditary pancreatitis, with most pancreatic diseases complex conditions resulting from multiple environmental, genetic, and metabolic causes.

Diagnosing Pancreatitis

For someone to be diagnosed with pancreatitis, they must display two of the below three indicators:

* Abdominal pain typical of pancreatitis
* CT scan results in line with pancreatitis
* Lipase or serum amylase three times the normal limit

Treating Pancreatitis

Pancreatitis is curable in both its acute and chronic forms. Initially, pain relief may be provided with morphine. Fasting is typically required for a couple of days or even weeks to allow for the healing of the pancreas. The avoidance of fat is particularly important. Those fasting can be given fluids and salts intravenously to protect against malnutrition. In severe cases, surgery may be needed to drain or remove the pancreas. In all cases, a change in lifestyle is recommended. Enzymes to help in the digestion of food may be recommended to people with chronic forms of the disease. Antibiotics may need to be administered to prevent or treat infection.

Prognosis

Pancreatitis is rated in severity using various scoring systems including the Apache II, the Glasgow, and the Ranson criteria systems. The former system can be used on a person upon admission to hospital while the latter two may only be used 48 hours after admission.

Complications

Early complications of pancreatitis may include:

* Shock
* Hypocalcemia (low blood calcium)
* Dehydration
* High blood glucose
* Respiratory complications
* Pleural effusion
* Kidney failure
* Pneumonitis
* Infection of the inflamed pancreatic bed
* Pancreatic acitis
* Systemic inflammatory response syndrome (SIRS)

Late complications of pancreatitis may include:

* Recurrent pancreatitis
* Pancreatic pseudocysts
* Pancreatic abscess

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