The pancreas is a gland in the abdomen (belly), surrounded by the stomach, intestines, and other organs. It makes substances called pancreatic juices (containing digestive enzymes) and the hormones insulin and glucagon.
Pancreatitis is inflammation (swelling) of the pancreas. It occurs when these digestive enzymes begin attacking the pancreas. Pancreatitis can be acute (occurs suddenly). Continuing injury to the pancreas may lead to a long-lasting (chronic) form. Chronic pancreatitis is inflammation and scarring of the pancreas that occurs over a long period. The pancreas doesn’t make its enzymes, causing an inability to digest and absorb fat in the diet. Insulin production also decreases.
Chronic pancreatitis isn’t common. More men than women are affected. Pancreatitis cannot be caught.
Alcohol abuse is the major cause. Other causes are hemochromatosis (too much iron in the blood) and cystic fibrosis. Sometimes the cause is unknown.
The most common symptom is pain in the mid- and upper back and abdomen that varies in intensity. It may be a lowgrade, lasting pain with repeated acute attacks. The pain may be constant and severe.
Another symptom is weight loss, which occurs because the body cannot absorb fat properly (malabsorption). Large, foul, bulky bowel movements, or stools (called steatorrhea) occur because of this problem with fat absorption. People can also have a distended abdomen and jaundice (yellowing of skin) in severe cases.
The health care provider diagnoses chronic pancreatitis by reviewing the medical history and doing a physical examination. Samples of blood are studied for signs of this disease. A CT scan or ultrasound of the abdomen may also be done to exclude other causes of your symptoms.
The first treatment goal is to manage pain, usually by using nonnarcotic pain relievers. Referral to a pain specialist may help. In rare cases, if pain cannot be controlled, surgery is a possibility. Surgery involves draining the pancreatic duct (tube connecting the pancreas and bile duct). In advanced cases, all or part of the pancreas can be removed.
The second goal is replacing digestive enzymes and insulin that the pancreas normally makes. In severe cases, insulin replacement may also be necessary. Pancreatic enzymes, as tablets, are taken with meals and snacks. Insulin injections are used to control the high blood sugar (glucose) level if present. Supplements of vitamins A, D, and K may be needed because of poor absorption.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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