What is Pancreatitis? Diagnosis & Treatment

What is Pancreatitis?

Pancreatitis is a sudden onset swelling or irritation of the pancreas. The pancreas is an organ within your belly that secretes hormones and digestive juices that help in the digestion of your food, the most important hormone secreted by the pancreas is insulin.

Pancreatitis occurs mainly due to two reasons number one is gallstone disease. Gallstone disease causes pancreatitis when a gallstone produced in the gallbladder slips into the bile duct and get stuck in the common tube that drains both the pancreas as well as the gallbladder.

As the stone is stuck in the common tube, there is a sudden build-up of fluid in both of these areas and this build-up of fluid in the pancreas is what causes pain, swelling and irritation of the pancreas that is also called pancreatitis.

The second most common cause of pancreatitis is because of alcohol. Alcohol can directly damage the pancreas. So try not to over drink too much very often.

It’s much better if you can quit alcohol altogether. But before that try identifying what’s making you drink so much and seek the help of a qualified psychologist or psychiatrist who is trained in alcohol dependence and alcohol de-addiction, there are also many support groups available for alcohol de-addiction.

How much alcohol are you allowed to have or what is the safe limit for alcohol consumption?

This is a tricky question because if you have had health problems due to alcohol use, for example, liver disease or cirrhosis. An attack of acute pancreatitis or heart problems or neurological problems due to alcohol is also a red flag. In this case, alcohol is poison to you and you need to stop alcohol consumption immediately and completely.

There is no “safe” limit for alcohol consumption for people with such underlying conditions.

For everyone else who is a normal individual, the recommended safe limit for alcohol consumption is 14 units of alcohol per week, provided that you have no more than 3 units a day and that you have at least two alcohol-free days in the week.

So what are 3 units of alcohol? It is one and half-pints of normal beer or one pint of strong beer or one glass of wine that is 250 ml of wine or two pegs i.e. 60 ml of hard liquor which includes whisky Vodka, gin, etc.

Can I stop drinking on my own?

A lot of people who identify that they have an alcohol addiction, do stop drinking on their own but if you are drinking every day for several weeks and this has been continuing for a few months then you’re a heavy drinker, it is best to stop drinking with the help of your doctor, the reason being is that the moment you stop drinking the physical withdrawal symptoms will be very severe.

Coming back to pancreatitis these are the two main causes of this disease gallstone disease and alcohol addiction.

Some alcoholics may have also experienced pancreatitis after a severe binge of alcohol that is if a moderately heavy drinker has too many drinks about 1 to 2 days later will have severe belly pain at the top of his belly and this goes like a band around the body to the back that is it radiates to the back and is often associated with nausea and vomiting.

Diagnosis:

Your doctor, after you come to him with the symptoms of belly pain and nausea or vomiting, will consider the possibility that you might have pancreatitis and will prescribe certain enzyme blood tests to check if your blood levels of these enzymes are more than three times normal then the diagnosis of pancreatitis is made.

In some cases, your doctor may also ask for a CT scan in which the pancreas is seen and the diagnosis is made.

How is pancreatitis treated?

Pancreatitis is usually treated in the hospital, even in cases of mild pancreatitis it usually is advisable to get hospitalized and when you are in the hospital your doctor will start on IV Fluids (saline) also start you on IV pain killers. If you are able to eat food that’s great but if you are not able to tolerate food that is if you start vomiting then to feed you a tube may be passed into your stomach and this tube is usually passed through the nose to provide additional nutrition.

In mild cases of pancreatitis when the patient becomes relatively better in 2 to 3 days, he might be discharged home after three days and then called for follow-up.

In severe cases of pancreatitis, however, and when I say severe I mean the patient has developed complications of pancreatitis that is has developed local complications by that I mean infection or fluid accumulation around the pancreas or a part of the pancreas has become rotten or necrotic or has developed general complications of pancreatitis in which there is generalized infection throughout the body and organ failure.

These severe cases of pancreatitis need to be managed by a team of doctors usually in an ICU setup or at least in a bigger hospital, the reason being in severe cases of pancreatitis, your whole body is affected, your kidneys start shutting down, so toxins are not expelled from your body is there might be fluid accumulation inside your lungs causing difficulty in breathing and all of this needs extensive supportive management in the form of maybe ventilatory support that is you may need a ventilator or may need dialysis.

So you need to be in a hospital that has an equipped ICU to manage these very sick patients and a lot of the time even in spite of best efforts these patients with severe pancreatitis sometimes do not survive and die from the illness. The second most important part of the treatment of pancreatitis is the treatment of the cause of the disease. If a stone is stuck in the common tube between the pancreas and the gallbladder the stone many need to be removed this procedure is called endoscopic retrograde cholangiography also the gallbladder may need to be removed because recurrent stones will keep getting passed from the gallbladder into this common tube and if you don’t remove the gallbladder you will, again and again, keep getting recurrent episodes of pancreatitis. A lot of the time your surgeon or your doctor will do this gallbladder surgery in the same admission as pancreatitis or some doctor will prefer to discharge you and call you for the surgery 6 weeks later.

The second cause of pancreatitis which is alcoholic pancreatitis requires the patient to stop alcohol completely and totally so this is usually done with the help of a qualified psychologist and psychiatrist who may prescribe some medicines and counsel you to join a support group.