Pancreatitis occurs when the pancreas (a gland in the abdomen) becomes inflamed. It's extremely painful and is usually accompanied by vomiting. Apart from powerful painkilling drugs, the only other thing that sometimes brings relief is sitting forwards.
The pancreas is a special gland that helps with digestion and guards blood sugar levels. It's attached to the duodenum (the part of the gut just below the stomach) and lies crosswise behind the stomach. It's a thin gland about 15cm long and is often described as being two glands in one, as it performs two vital functions:
It secretes many enzymes that play a key role in digestion. These include lipase, which helps to digest fat, and amylase that helps to digest starchy foods. It also releases 'bicarbonate of soda' to neutralise any stomach acid that may otherwise damage the lining of the gut.
The control of blood sugar levels is regulated by the hormones insulin and glucagon. These are both produced and secreted from the pancreas. When necessary insulin lowers the level of glucose in the blood, and glucagon raises it.
Causes Of Pancreatitis
There are many causes of acute pancreatitis, but gallstones and excess alcohol are the most common.
Some people who have never touched a drop of alcohol, or who drink sensible amounts may develop pancreatitis as a result of other causes, which include:
Injury to the pancreas, Viral infections, for example mumps, Medication side-effects, High blood fat or calcium levels, Pancreatic cancer, Auto-immune disease of the pancreas.
Some people develop a hereditary form of the disease, while for others the cause remains unknown.
Treatments For Pancreatitis
Acute pancreatitis is treated in hospital as a medical emergency with intravenous fluids and medications to control the pain. Antibiotics may be needed especially if there is concurrent inflammation of the gall bladder.
The disease can be very severe with a significant mortality - severe acute pancreatitis occurs in about 20 per cent of cases, and about 30 per cent of these will not survive the episode.
Although some people are never troubled again after their first attack, for others it causes long-term ill health. Recurrent attacks, which are referred to as chronic pancreatitis, can repeatedly cause problems for people and put them back into hospital needing further treatment.
Avoiding triggers such as alcohol, or removing gall stones, can reduce the risk of chronic pancreatitis.
As the pancreas works less effectively, insufficient amounts of the digestive enzymes and the hormones insulin and glucagon are produced and need to be supplemented.
Excessive fatigue, weight loss and malabsorption may occur since there is an inadequate supply of the necessary digestive enzymes to aid absorption of the nutrients everyone needs for the body to function properly.
To overcome this, pancreatic extracts and daily vitamin supplements are taken by mouth with every meal.
Since the pancreas plays a vital role in blood sugar control it's not uncommon for those who have had severe or chronic pancreatitis to develop diabetes and need treatment, either with medication or insulin injections.
Doctors sometimes recommend that the pancreas is surgically removed if people are getting regular, severe attacks, but this is not common.