Inflammation Of The Pancreas - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms, treatment of inflammation of the pancreas

The pancreas is an internal organ that is necessary for the assimilation of glucose entering the human body with food. The gland secretes hormones such as glucagon and insulin, as well as enzymes needed to properly digest food. Inflammation of this organ is called pancreatitis. If enzymes stagnate in the pancreas itself and do not enter the intestines, they can irritate and swell the mucous membrane lining the inner surface of this important organ of the digestive system. The inflammation can develop suddenly, or it can take years. And over time, the pancreas gradually collapses.

Content:

• Causes of inflammation of the pancreas
• Pancreatic inflammation symptoms
• What happens when the pancreas is inflamed?
• Risk factors
• Diagnosis of inflammation of the pancreas
• Pancreatic inflammation treatment
• Prevention of inflammation of the pancreas
• Who is the doctor to contact?

Causes of inflammation of the pancreas

The most common provoking factors leading to pancreatitis are alcohol abuse and stones that form in the gallbladder. Also, this disease can develop as a result of injuries, infections and uncontrolled taking of certain medications. Sometimes it happens that the causes that led to the inflammatory processes in the pancreas remain idiopathic (unexplained). In a normal state, the pancreas and its ducts do not give enzymes the ability to corrode the cells of the mucous membrane. But sometimes the outflow of enzymes into the small intestine fails, and the digestive juices begin to have a destructive effect on the tissues of the gland itself.

Acute pancreatitis

Most often, an acute attack of pain is caused by blockage of the pancreatic ducts by gallstones or excessive alcohol intake. A sudden attack of pancreatitis is also caused by prolonged binges.

Other reasons include:

• Injuries;
• Infections;
• Increased blood triglyceride levels;
• Certain medicines (steroids, antibiotics, drugs for the treatment of arterial hypertension).

Chronic pancreatitis

Experts believe that the development of chronic pancreatitis leads to excessive enthusiasm for fatty foods, tobacco smoking and alcohol abuse. It is not clear exactly how alcohol affects the functioning of the pancreas. Presumably, it can impede the release of digestive juices from the pancreas or greatly alter their chemical composition, so they begin to cause an inflammatory process.

Pancreatic inflammation symptoms

The most obvious symptom of pancreatic inflammation is a rather severe pain in the left hypochondrium or upper abdomen. Sometimes the pain radiates to the lower back and is girdle in nature. When taking a sitting position or leaning slightly forward, the pain gradually subsides and becomes insignificant.

Symptoms also include:

• Tachycardia (heart palpitations);
• Nausea and vomiting;
• Increased sweating;
• State of shock;
• Yellowing of the whites of the eyes and skin;
• Back pain, however, this symptom is sometimes provoked by diseases such as peptic ulcer, appendicitis, cholecystitis, intestinal obstruction, diverticulosis.

What happens when the pancreas is inflamed?

Acute pancreatitis

Pancreatitis can be mild or severe. Acute mild pancreatitis is most often diagnosed. This disease does not affect nearby organs and heals quickly enough. With the appointment of the correct therapy, the symptoms of the disease disappear a week after the start of treatment.

The therapy is carried out directly in the hospital under the supervision of a doctor, who, depending on the individual characteristics of the human body, prescribes pain relievers and anti-inflammatory drugs and develops a system for their intake. As soon as the inflammation is eliminated, the patient will immediately recover.

But sometimes pancreatic tissue necrosis or severe damage to its cells can occur. In this case, there is a danger of complete organ failure. In an advanced case, inflammatory processes in the pancreas can be fatal.

Chronic pancreatitis

Usually, the disease becomes chronic after a series of attacks of acute pancreatitis and in the absence of adequate treatment. The most likely cause of chronic inflammation, experts say, is the constant abuse of alcoholic beverages.

This form of the disease proceeds in different ways. Chronic pancreatitis is often accompanied by regular pain and associated complications. These include recurring symptoms of all pancreatitis symptoms, blockages of blood vessels, small intestine, bile ducts, and accumulation of air and fluid.

When most of the tissue in the pancreas dies, malnutrition occurs, as the organ stops producing enzymes necessary for digestion that help to digest proteins and fats. The body cannot absorb fats, and they are simply excreted in the stool. It becomes thin, pale and offensive due to the development of steatorrhea.

Damage to the cells responsible for the production of insulin (insulacytes) leads to the inability to assimilate carbohydrates and sugar from food, which threatens the development of diabetes. Chronic inflammation of the pancreas increases the risk of cancer. It occurs in about 4 cases out of 100 in people with chronic pancreatitis.

Find out more: Pancreatitis - Causes, Symptoms, Diet, and Modern and Traditional Treatment

Risk factors

The following factors significantly increase the risk of pancreatitis:

• Alcohol abuse. It all depends on the individual characteristics of the organism. The amount of alcohol that can lead to the destruction of cells in the pancreas varies from person to person. On average, medical experts suggest that men can drink no more than two glasses of strong alcohol a day, and for women this rate should not exceed one glass;
• Gallstones. Gallstone disease can lead to a blockage of the pancreatic duct, and as a result, the outflow of digestive juices will be impaired;
• Increased blood triglyceride levels;
• Deviation in the structure of the bile or pancreatic ducts, and congenital pathology, when the pancreas is divided and has two main channels.

It is important to know! It is worth resorting to medical help immediately in case of severe abdominal pain, if there is vomiting for several hours, or if there is little pain for several days. It is not necessary that such symptoms indicate a disease of the pancreas, but a number of tests must be performed to exclude the diagnosis. You should not endure for a long time and wait for the symptoms to pass by themselves. This is especially true for severe abdominal pain, as this condition can seriously threaten a person's life.

Diagnosis of inflammation of the pancreas

If pancreatic inflammation is suspected, the following medical specialists can participate in the diagnosis of this disease: therapist, surgeon, family doctor, gastroenterologist. A visual examination is carried out, and a blood test is prescribed, which may indicate the presence of a blockage of the ducts or their infection. Then, other studies are additionally prescribed, including ultrasound, which is the most common painless diagnostic procedure.

1. Initial examination. To begin with, the doctor performs a visual examination and asks about the symptoms. Also finds out all the diseases that preceded this health problem. If there is a suspicion of gallstone disease, then the doctor pays attention to the yellowish tint of the skin and whites of the eyes, conducts a finger examination of the abdomen. If there are attacks of nausea or vomiting, then it is necessary to find out their causes. To do this, you should describe your feelings at the doctor's appointment as accurately as possible. It is necessary to accurately indicate the number of attacks and their duration. For a more thorough study, detailed blood and urine tests, as well as an X-ray examination, may be prescribed.

2. Analyzes. To begin with, a study of the level of enzymes in the blood is prescribed. Based on the results of the data obtained, the doctor diagnoses the disease and decides on the appointment of a treatment for inflammation of the pancreas.

   To draw up a clearer picture, two main blood tests are prescribed:

   • Lipase level. An increase in its level in the blood may indicate an acute attack of pancreatitis;
   • Amylase level. High amylase levels are a sign of inflammation.

   Also, in addition to the above analyzes, the following may be additionally prescribed:

   • Analysis for bilirubin. An increase in the level of this protein occurs when the bile ducts are blocked;
   • Complete blood count. If the pancreas is inflamed, then a large number of leukocytes will be present in the blood;
   • Blood test for liver enzymes. In acute pancreatitis, which is caused by gallstones, there is an increase in the activity of alaninominotransferase and alkaline phosphatase.

3. Clinical researches

   The following hardware techniques are used:

   • Ultrasound examination of the abdominal cavity. With its help, you can find out how much the duct is blocked, and where the gallstones are located;
   • CT with contrast. Computed tomography with the addition of contrast agent eliminates other causes of abdominal pain. Also, this procedure helps to exclude intestinal obstruction, find complications, identify dead tissue (pancreatic necrosis), see the blockage of veins;
   • MRCT (magnetic resonance cholangiopancreatography). Is performed to identify gallstones in the common bile duct;
   • ERCP. Endoscopic retrograde cholangiopancreatography. Allows the specialist to see the structure of the main pancreatic duct. This is the only diagnostic test that can be used simultaneously to remove stones from the common bile duct and to treat narrowed bile ducts;
   • MRI. This procedure is used to detect inflammation and to supplement the information obtained by computed tomography;
   • Endoscopic ultrasound examination. This procedure is carried out using a specially designed endoscope, which is inserted through the esophagus directly into the stomach. With the help of this study, the presence of gallstones in the bile ducts is revealed;
   • Puncture. A similar procedure is prescribed in cases where the specialist is not sure whether there is a process of infection of the tissues of the pancreas. The puncture is taken from the inflamed area of the organ. The resulting tissue or fluid sample is then examined in a laboratory for the presence of pathogens that cause inflammation. If pancreatitis proceeds in a complex chronic form, then it is necessary to analyze the feces for the presence of fats in it. If they are present there, then this will indicate that fats are not digested and not absorbed by the body. This means that the pancreas does not secrete enough digestive enzymes.

Pancreatic inflammation treatment

Most often, treatment is carried out in a hospital setting. Pain medications are prescribed to the sick person, and a special drug regimen is developed to eliminate inflammation. With pancreatitis, air and fluid sometimes build up in the stomach, which can cause bouts of severe vomiting. To eliminate this symptom, a tube is inserted into the stomach through the nose, which brings fluid and air out.

The choice of therapy for pancreatitis will depend on the nature of the disease: an acute attack or a chronic course. Initial treatment for an acute attack of pancreatitis should be carried out in a hospital setting. The patient is prescribed intravenous fluids to replace fluid loss and normalize blood pressure. NSAIDs are prescribed to eliminate inflammation. A strict diet is followed during this period from three days to a week.

If you have gallstones that trigger pancreatic inflammation, ERCP (endoscopic retrograde cholangiopancreatography) is done to remove them from the bile duct. After eliminating the inflammatory processes, sometimes the gallbladder is surgically removed.

In the chronic course of the disease, when acute attacks of pancreatitis appear, a similar treatment is prescribed. If it is necessary to expand the pancreatic ducts, remove stones or cysts, it is necessary to resort to surgical intervention. After such a procedure, a person should be constantly monitored by the attending physician for about six months in order to avoid complications. At home, you should constantly adhere to an appropriate diet, avoid overeating and alcoholic beverages.

Medicines for the treatment of chronic inflammation of the pancreas

In the treatment of chronic pancreatitis, pain relievers, enzymes that improve food digestion, and, if necessary, insulin-containing drugs are prescribed.

The main types of drugs for the treatment of pancreatitis:

• Pain relievers. If the pain attacks are tolerable, then they can be stopped with ibuprofen or acetaminophen. For more intense and sharp pains, as prescribed by a doctor, stronger pain medications are used;
• Insulin. If the inflammation has led to the death of the cells of the pancreas responsible for the production of insulin, then the patient is prescribed insulin injections for life;
• Enzymes. In severe inflammatory processes in the pancreas, this organ can stop the production of digestive enzymes, which are vital for the digestion and proper absorption of fats, carbohydrates and proteins. In this case, the patient is prescribed enzymes. Entering the body, they help food to be fully absorbed.

Using enzymes to treat chronic pancreatitis can cause side effects. For example, soreness in the anus or mouth. Most enzymes are made from pork protein and should not be taken if you are allergic to pork.

With caution and under the direct supervision of a physician, enzymes should be taken in childhood, since a large amount of them can lead to intestinal obstruction.

Find out more: Medicines used in the treatment of the pancreas

When is surgery necessary?

The pancreas is a very delicate organ that can be easily damaged during surgery, doctors prefer not to prescribe interventions whenever possible. However, sometimes surgery is simply necessary because the risk of complications due to dead tissue in the pancreas is much higher than the risk of complications from surgery.

If pancreatitis is caused by the presence of gallstones, it is usually chosen from two types of operations:

• Laparoscopy;
• Open gallbladder surgery.

In the presence of stones in the gallbladder, endoscopic retrograde cholangiopancreatography is used. It is also used if it is necessary to expand or drain a narrow pancreatic duct.

Various methods are used to eliminate dead tissue in the pancreas:

• Laparoscopic necrectomy, which is performed with limited tissue necrosis of the pancreas. Such an operation is important for saving the patient's life, although after it the volume of enzymes and hormones secreted by the body decreases;
• Open necrectomy. It is indicated for the extensive spread of necrotic processes in the tissues of the pancreas. Excision of necrotic cells is performed, followed by removal of inflammatory exudate, drainage of retroperitoneal tissue and lavage of purulent cavities.

Pancreatic necrectomy is an organ-conserving operation that removes all dead tissue.

What to do if complications of the inflammatory process begin?

Pancreatitis attacks do not go away without a trace and are often accompanied by complications. These include:

• Necrotization of pancreatic tissue;
• Infection;
• Cyst.

Sometimes surgery is required to remove stones from the gallbladder or resection of the damaged part of the pancreas. If the violations are critical, then the patient will most likely have to take insulin to regulate blood sugar levels. And for the normal digestion of proteins and fats, medications are prescribed, which contain digestive enzymes.

If the inflammation of the pancreas is chronic, then the sick person needs to follow a constant diet, which completely excludes the consumption of alcoholic beverages, including low-alcohol ones. You also need to constantly take pain relievers. The patient needs to develop a nutritional system in conjunction with the attending physician. Changing your eating habits is difficult, especially for people with a weak will, but with the right approach, good planning and with the support of the family, all this becomes possible.

Complications of chronic pancreatitis include:

1. Accumulation of excess fluid around the pancreas;
2. Blockage of blood vessels
3. Constant bouts of pain;
4. Stenosis of the bile ducts and small intestine;
5. Pancreatic cancer risk.

Treatment if the patient's condition worsens

The consequence of long chronic inflammation of the pancreas is a decrease in the amount of digestive enzymes secreted by it. Therefore, the body cannot fully digest fats. Decreased enzyme synthesis results in steatorrhea. This is the discharge of liquid, oily feces.

Since proteins and fats are not absorbed from food, a person begins to lose weight. They solve this problem with the help of medicines containing enzymes. If pancreatitis has led to the cessation of the secretion of the hormone insulin by the pancreas, then the sick person is prescribed appropriate injections.

During treatment, with the development of an infectious inflammatory process, the patient is prescribed antibiotics or the necrotic diseased tissue of the pancreas is surgically removed. However, doctors try to treat this organ without resorting to surgery, since the pancreas is very delicate and vulnerable.

Find out more: The most effective recipes for restoring the pancreas!

Prevention of inflammation of the pancreas

It is impossible to guarantee to prevent inflammation of the pancreas, like any other disease.

However, you can reduce your risk factors and thereby minimize the chance of new attacks:

• Since most often attacks of pancreatitis occur against the background of alcohol abuse, in the presence of such a disease, alcohol should be completely excluded from your life. Even a small amount of it can provoke an attack of pain or complications. Large doses of alcohol can be life-threatening for someone with pancreatitis;
• Since chronic pancreatitis is accompanied by bouts of pain, pain relievers are prescribed, as well as digestive enzymes;
• The intake of fatty, fried, smoked, spicy foods is limited, as they irritate the pancreas and cause pain;
• If pancreatitis is provoked by gallstones, then you should monitor your diet and lead a healthy, active lifestyle;
• Smoking also provokes the development of pancreatic diseases, so you should think about quitting this bad habit;
• You need to eat more fresh fruits and vegetables, lean meats, baked goods made from wholemeal flour, porridge cooked in water.

Only a timely visit to a doctor in the presence of the first symptoms of pancreatitis, adherence to all his recommendations for the treatment and prevention of the disease, will help to maintain the normal functions of such an irreplaceable digestive organ as the pancreas.

Who is the doctor to contact?

Pancreatic inflammation can be diagnosed and treated for:

• Family doctor;
• Local therapist;
• Gastroenterologist (specialist in diseases of the gastrointestinal tract);
• Abdominal surgeon.

The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist

Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.