Pancreas - inflammation of
Common signs and symptoms of pancreatitis include the following:
There are several possible causes of pancreatitis. The most common are gallstones, which block the duct of the pancreas (for acute pancreatitis), and excessive alcohol consumption (for chronic pancreatitis).
People with these conditions or characteristics have a higher risk for pancreatitis:
African Americans are at higher risk than Caucasians and Native Americans.
Your health care provider will examine you for signs and symptoms of pancreatitis. Your provider may also perform blood tests, take x-rays, and use ultrasound, computed tomography (CT) scans, and other diagnostic tests to determine the severity of your condition and decide which treatment options are most appropriate.
In the case of chronic pancreatitis, your doctor may test your stool for excess fat (which your body, lacking the enzymes produced by the pancreas, is not able to absorb) and may order pancreatic function tests to check whether your pancreas can secrete the necessary enzymes.
Acute pancreatitis may require hospitalization, where you will receive medication for pain. You will also fast to allow the pancreas to rest and stabilize. You will receive intravenous fluids and nutrition (parenteral nutrition). If you have gallstones, your doctor may recommend surgery or other procedures to remove them.
People with chronic pancreatitis may require treatment for alcohol addiction, if that is the cause. Treatment also includes pain management, enzyme supplements, and dietary changes. Treatment for patients who have pancreatitis due to high triglyceride levels includes weight loss, exercise, eating a low-fat diet, controlling blood sugar (if you have diabetes), and avoiding alcohol and medications that can raise triglycerides, such as thiazide diuretics and beta-blockers.
Your doctor may prescribe painkillers. You may also receive antibiotics to treat or prevent infection in some cases. Your doctor may also prescribe enzyme supplements, such as pancrelipase (Lipram, Pancrease, Viokase), to help your body absorb food. In some cases, doctors may prescribe steroids to treat autoimmune pancreatitis.
Different types of surgical procedures may be necessary depending on the cause of the pancreatitis. People who have pancreatic necrosis (tissue death) almost always require surgery to remove damaged and infected tissue. Surgery may also be required to drain an abscess. For chronic pancreatitis with pain that will not respond to treatment, doctors may need to remove a section of the pancreas. If the pancreatitis is a result of gallstones, a procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be necessary. In ERCP, a specialist inserts a tube-like instrument through the mouth and down into the duodenum to access the pancreatic and biliary ducts.
It is important to get conventional medical treatment for pancreatitis as soon as possible. A severe attack can be life threatening if left untreated. Most alternative therapies have not yet been studied for use specifically in pancreatitis, although some evidence indicates that antioxidants may have beneficial effects. Several therapies, though, may reduce the risk of developing pancreatitis or ease some of the symptoms when used in conjunction with conventional care. You should never treat pancreatitis without your doctor's supervision.
Numerous studies have explored the role of antioxidants to help rid the body of harmful cells called free radicals. Low antioxidant levels in the blood (including reduced amounts of vitamins A, C, and E, selenium, and carotenoids) may lead to chronic pancreatitis due to the destructive effects of increased free radicals. Antioxidant deficiency and the risk of developing pancreatitis may be particularly linked in areas of the world with low dietary intake of antioxidants. In addition, the cooking and processing of foods may destroy antioxidants. Alcohol-induced pancreatitis is linked to low levels of antioxidants as well. There is also some evidence that antioxidant supplements may eliminate or minimize oxidative stress and help alleviate pain from chronic pancreatitis.
People who are susceptible to pancreatitis should avoid alcohol consumption.
Some evidence suggests that increasing your intake of antioxidants (found in fruits and green vegetables) may help protect against pancreatitis or alleviate symptoms of the condition. Health care providers may recommend increasing your intake of antioxidants to help rid the body of free radicals. Low levels of antioxidants in the blood may make someone more likely to develop pancreatitis. Alcohol-induced pancreatitis is linked to low levels of antioxidants as well.
Following these nutritional tips may help reduce risks and symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs are generally available as standardized, dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1 to 2 heaping tsp/cup water steeped for 10 to 15 minutes (roots need longer). Although herbs should never be used alone to treat pancreatitis, some herbs may be helpful along with conventional medical treatment. Tell your physician about any herb or complementary therapy you may be considering. Many herbs can interfere with certain medications. Speak with your physician.
Individual case reports suggest that Traditional Chinese Medicine (TCM) can be effective for preventing and treating pancreatitis. To determine the right regimen, consult a skilled herbalist or licensed and certified practitioner of TCM, and keep all of your health care providers informed of any supplements, herbs, and medications you are taking.
You may be given:
Studies evaluating acupuncture as a treatment for pancreatitis show mixed results. Some case reports say that acupuncture helped relieve pain from pancreatitis and pancreatic cancer. But a review of several studies was inconclusive.
Possible complications of pancreatitis include:Infection of the pancreasCyst-like pockets that can become infected, bleed, or ruptureThe failure of several organs (heart, kidney, lungs) and shock due to toxins in the bloodType II diabetes In mild cases of pancreatitis, where only the pancreas is inflamed, the prognosis is excellent. In chronic pancreatitis, recurring attacks tend to become more severe. Overall, 10-year survival approximates 70%, and 20-year survival is about 45%. Death is not usually due to pancreatitis itself, but rather to malignancy, postoperative complications, and complications of alcohol or tobacco.
People with chronic pancreatitis should eat a low-fat diet, abstain from alcohol, and avoid abdominal trauma to prevent acute attacks and further damage. About 70% of pancreatitis cases are considered to be induced by alcohol, and half of those who had alcohol-induced acute pancreatitis will have relapses. Continued drinking is a dose-responsive risk factor for relapse.
Those with high triglyceride levels should lose weight, exercise, and avoid medications, such as thiazide diuretics and beta-blockers, that increase triglyceride levels. Given reports suggesting that oxidative stress may contribute to the development of pancreatitis, and that antioxidant supplementation may be of some benefit, health care providers may begin recommending antioxidants to people with pancreatitis.
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