pancreatitis
The pancreas is a long, thin organ located in the abdomen behind the Stomach, near the Duodenum (first portion of the small intestine).
The pancreas has two main functions:
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Secrete digestive enzymes into the small intestine to aid in the digestion of carbohydrates, proteins, and fats.
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Release hormones such as insulin and glucagon into the blood. These hormones are involved in glucose and energy metabolism in the body.
What is pancreatitis?
Pancreatitis is a disease in which the pancreas becomes inflamed and occurs when digestive enzymes are activated before being secreted into the intestine, causing inflammation and destruction of pancreatic tissue.
In severe cases, pancreatitis can result in bleeding from the pancreas, severe damage to pancreatic tissue, infection, and pseudocyst formation. Severe pancreatitis can also cause problems if enzymes and toxins are released into the bloodstream which can damage other vital organs such as the heart, lungs and kidneys.
There are two types of pancreatitis: Acute and chronic.
Acute pancreatitis is a sudden inflammation of the pancreas that occurs over a short period of time. In more than 70% of cases, acute pancreatitis is caused by obstruction of the pancreatic duct by bile stones or by alcohol abuse. Other causes may be the use of medications, infections, trauma, or metabolic disorders.
About 10% of cases of acute pancreatitis do not identify a cause. The severity of acute pancreatitis is variable, ranging from mild to severe. Most patients with acute pancreatitis (more than 80%) make a full recovery after receiving adequate treatment.
Chronic pancreatitis mainly occurs after multiple episodes of acute pancreatitis. In most cases, chronic pancreatitis is caused by excessive and repeated use of alcohol or by gallstones originating in the gallbladder. Chronic pancreatitis almost never has a hereditary factor.
What are the symptoms?
Most patients with acute pancreatitis have severe pain in the upper abdomen that radiates to the back. Patients describe a burning sensation in this area that is aggravated by eating food and gradually worsens. The abdomen may be swollen and painful. Patients may present with nausea, vomiting, fever, and increased heart rate.
Symptoms of chronic pancreatitis can be:
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Constant pain in the upper abdomen that radiates to the back, such pain can be disabling at times.
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Diarrhea and weight loss caused by poor digestion and absorption of food due to inadequate production of pancreatic enzymes.
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Diabetes Mellitus due to the fact that the pancreas loses its function of secreting insulin, a hormone that carries out the use of sugars.
How is it diagnosed?
Acute pancreatitis is diagnosed by the characteristic clinical picture and a history of alcohol intake or gallstones. Confirmation of acute pancreatitis is done by measuring enzymes produced by the organ (amylase and lipase) which are elevated in the bloodstream and urine. As the disease progresses, this elevation of enzymes tends to normalize.
Chronic pancreatitis is diagnosed by the above symptoms together with the patient's history. Diagnosis can be difficult, requiring the use of complex laboratory tests or imaging studies.
These diagnostic tests include:
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computed axial tomography
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Pancreatic function tests
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endoscopic ultrasound
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Nuclear magnetic resonance
How is pancreatitis treated?
In the event of any symptom suggestive of pancreatitis, it is necessary to seek medical help. There are different degrees of acute pancreatitis, from mild to severe, and in general it always requires hospitalization of the patient for close monitoring to avoid, as far as possible, complications.
Chronic pancreatitis is difficult to treat and often requires long-term, even lifelong, management.
The goals of treating chronic pancreatitis are mainly to reduce discomfort such as pain and/or diarrhea.