Pancreatitis

Information

Pancreatitis is an inflammation of the pancreas. The pancreas, also known as the pancreatic gland, is located behind the stomach, close to the liver. It produces enzymes that are necessary for digestion, as well as hormones that help regulate blood sugar levels.

Pancreatitis is a relatively rare disease. In general, it represents an inflammation of the pancreas in which its enzymes become activated and damage it. As a result, the function of the gland is impaired, which can manifest with various symptoms - pain, organ failure affecting the lungs, heart, and kidneys - and in later stages, pancreatic necrosis, the formation of cysts that may subsequently become infected, or the development of pancreatic exocrine insufficiency, which represents the inability of the pancreas to provide an adequate amount of digestive enzymes, or endocrine insufficiency - diabetes mellitus. In some cases, due to its anatomical proximity to the bile ducts, jaundice may be observed as a result of compression by the swollen and inflamed pancreas.

Types:

Pancreatitis can be acute or chronic. Acute pancreatitis is most commonly caused by gallstones entering the common bile duct or alcohol consumption, less frequently by trauma, certain viral diseases such as mumps, or tumors. Chronic pancreatitis can result from a wide range of causes - most commonly excessive alcohol consumption, autoimmune diseases, cystic fibrosis, certain genetic mutations, hypercalcaemia, and hypertriglyceridaemia.

Symptoms:

Acute pancreatitis can range from a relatively mild course to severe with a fully developed clinical picture and subsequent multi-organ failure. The most common symptoms are pain in the upper abdomen radiating to the back, nausea, vomiting, inability to eat, and yellowing of the skin and visible mucous membranes.

Chronic pancreatitis may be accompanied only by pain in the upper abdomen, weight loss, diarrhoea, and "fatty" stools due to the already developed pancreatic exocrine insufficiency.

This disease is important to monitor with a gastroenterologist, as it can often progress over time to pancreatic cancer.

Treatment:

Treatment of pancreatitis depends on whether it is acute or chronic and how severe the clinical picture is. In most cases, treatment of acute pancreatitis is conservative - infusions of various intravenous solutions, placement of a nasogastric tube, parenteral nutrition, analgesics, and in cases of infection - antibiotics, etc.

Depending on the cause, highly specialised endoscopic procedures may sometimes be necessary - endoscopic retrograde cholangiopancreatography if the cause of the acute pancreatitis episode is a stone in the common bile duct, or endoscopic drainage of cysts formed as a consequence of acute pancreatitis if there is clinical and imaging evidence of their infection. In severe cases, surgical treatment is also a method of choice, although this is increasingly rarely resorted to nowadays.

In chronic pancreatitis, treatment is primarily symptomatic - analgesics, enzyme replacement therapy, diet. In some cases, when imaging shows dilation of the pancreatic duct or the formation of stones within it as a consequence of inflammation, stenting or lithotripsy of these stones may be performed.