Pancreatitis

Sunday, December 21, 2008

Pancreatitis is inflammation of the pancreas. The pancreas produces and releases digestive enzymes into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile, which is produced in the liver and stored in the gallbladder, to digest food. Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them, causing then pancreatitis. Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.

Acute pancreatitis occurs suddenly and usually resolves in a few days with treatment. Without appropriate treatement, acute pancreatitis can be a life-threatening illness with severe complications. Each year, more than 200,000 people in the United States are admitted into hospitals with acute pancreatitis. The most common cause of acute pancreatitis is the presence of gallstones, which cause inflammation in the pancreas as they pass through the common bile duct. Chronic, heavy alcohol use is also a common cause. Acute pancreatitis can occur within hours or as long as 2 days after consuming alcohol. Abdominal trauma, medications, infections, tumors, and genetic abnormalities of the pancreas can also cause acute pancreatitis.

Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends through the back. The pain may be mild at first and feel worse after eating. But the pain is often severe and may become constant and last for several days. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symptoms may include a swollen and tender abdomen, nausea and vomiting, fever, and rapid pulse. Severe acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. If bleeding occurs in the pancreas, shock and even death may follow.

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve—it gets worse over time and leads to permanent damage. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain. Chronic pancreatitis often develops in people who are between the ages of 30 and 40.

The most common cause of chronic pancreatitis is many years of heavy alcohol use. The chronic form of pancreatitis can be triggered by one acute attack that damages the pancreatic duct. The damaged duct causes the pancreas to become inflamed. Scar tissue develops and the pancreas is slowly destroyed. Other causes of chronic pancreatitis are hereditary disorders of the pancreas, cystic fibrosis, and high levels of calcium in the blood.