Pancreatitis

February 2, 2017

Pancreatitis is an uncommon disease characterized by inflammation of the pancreas.

The pancreas is located deep in the retroperitoneal space of the upper part of the abdomen. It is almost completely covered by the stomach and duodenum. This elongated gland (12–20 cm long in the adult) has a lobe-like structure. Variation in shape and exact body location is common. In most people, the larger part of the gland’s head is located to the right of the spine or directly over the spinal column and extends to the spleen. The gland has both exocrine and endocrine functions. In its exocrine capacity, the acinar cells produce digestive juices, which are secreted into the intestine and are essential in the breakdown and metabolism of proteins, fats, and carbohydrates. In its endocrine function capacity, the pancreas also produces insulin and glucagon, which are secreted into the blood to regulate glucose levels.

Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas.

There are two forms of pancreatitis – Acute and Chronic.

Acute pancreatitis generally develops suddenly, and it is usually a short-term (a few days to weeks) illness that typically resolves with appropriate medical management. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.

Chronic pancreatitis, which typically develops after multiple episodes of acute pancreatitis, is a long-term condition that can last for months or even several years. Heavy alcohol drinking is another big cause. Damage to the pancreas from heavy alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms.

Who is at Risk?

People with these conditions or characteristics have a higher risk for pancreatitis:

Biliary tract disease
Binge alcohol use and chronic alcoholism
Recent surgery
Family history of high triglycerides
Age (most common ages 35 to 64)
Smokers
African Americans are at higher risk than Caucasians and Native Americans.

Causes

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).

Gallstones – Gallstones are the most common cause of pancreatitis in the United States and other Western countries. Biliary tract disease accounts for 35–50% of all cases. Despite aggressive and intensive early management, the mortality rate is approximately 10%. Although the exact mechanism of pancreatitis due to gallstones is not completely understood, most investigators believe that obstruction of the major papilla by the stone causes reflux of bile into the pancreatic duct. The presence of bile in the pancreatic duct appears to initiate a complex cascade effect that results in pancreatitis.

Drugs – Drugs are a well-recognized cause of pancreatitis. These drugs may be divided into those that have a definite association, and those with probable association with the development of pancreatitis. These include azathioprine, sulfonamides, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics such as tetracycline.

Pancreas Divisum – The most common congenital anomaly of the pancreas, pancreas divisum, occurs in approximately 10% of the population, and results from incomplete or absent fusion of the dorsal and ventralducts during embryological development. Recent clinical trials have supported the concept that obstruction of the minor papilla may cause acute pancreatitis or chronic pancreatitis in a subgroup of patients with pancreas divisum.

Microlithiasis – Recent studies have shown that a significant number of patients with idiopathic acute pancreatitis will have microlithiasis.

Metabolic Causes – Hyperlipidemia and hypercalcemia may lead to acute pancreatitis. In patients with hyperlipidemia, triglyceride levels are usually greater than 2,000mg/dl. It is believed that lipase present in the pancreatic capillaries metabolizes the levels of triglyceride generating toxic free fatty acids.

Alcohol – Alcohol is the second leading cause of acute pancreatitis in Western countries. In many patients, however, chronic pancreatitis is already established. Alcohol is believed to cause acute pancreatitis by several mechanisms.

Other – There are multiple other causes of pancreatitis that include scorpion stings, poisoning with organophosphorus insecticides, ascaris worms in the pancreatic duct, and trauma

Symptoms

Most people who have acute or chronic pancreatitis experience upper abdominal pain as their primary symptom. Some of those who have chronic pancreatitis may show inflammation on imaging scans, but otherwise may show no symptoms.

Other symptoms of pancreatitis may include:

Pain that extends from your the side around to the back
Indigestion
Nausea or vomiting
Abdominal tenderness
Unintentional weight loss
Bloating with a distended (swollen) stomach
Hiccups

People who have chronic pancreatitis may also experience steatorrhea, or fatty stools that give off a foul odor. Steatorrhea can be a sign of malabsorption. This means that patients do not get all of the essential nutrients because the pancreas doesn’t secrete enough digestive enzymes to break down your food.

Pain associated with pancreatitis may last from a few minutes to several hours at a time. In severe cases, discomfort from chronic pancreatitis could become constant. The pain is likely to increase after eating or when lying down.

Treatment

Medications – Medical treatment is usually focused on relieving symptoms and preventing further aggravation to the pancreas. Certain complications of either acute pancreatitis or chronic pancreatitis may require surgery or a blood transfusion.

Drugs – Pancreatitis can cause severe pain. The doctor may prescribe painkillers in order to control that pain. The patient may also receive antibiotics to treat or prevent infection in some cases. The doctor may also prescribe enzyme supplements, such as pancrelipase (Lipram, Pancrease, Viokase), to help the body absorb food. In some cases, doctors may prescribe steroids to treat autoimmune pancreatitis.
Intravenous (IV) fluids – As the body devotes energy and fluids to repair the pancreas, the patient may become dehydrated. For this reason, the patient is given extra fluids through a vein in the arm during the hospital stay.

Surgery and Other procedures – 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.

Alternative Treatment

Nutritional Supplements

Grape Seed Extract – Grape seed extract is a very strong anti-inflammatory but it is also one of the most powerful antioxidants on earth and one of the few that will cross the blood-brain barrier. According to research grape seed extract causes cancer cells to die but more importantly grape seed extract helps relieve nausea and pain that are two rotten symptoms of pancreatitis

Curcumin puts out the fire of inflammation and so helps control pain. Curcumin is a powerful pain reliever and one of the best pancreatitis supplements. It fights pancreas inflammation,. Curcumin is also a very strong antioxidant which seems to inhibit cancer growth by actually causing cancer cells to die.

Vitamin C is another antioxidant, anti-inflammatory and essential nutrient. Vitamin C can do so many things, in combination with grape seed extract and curcumin. Those three pancreatitis supplements in combination are extremely powerful.

Vitamins, Minerals and Antioxidants are important pancreatitis supplements simply because with pancreatitis patients can often suffer from malabsorption which simply means they do not absorb the nutrients from food. Extra vitamins, minerals and antioxidants may be very helpful in providing more energy and all-around better health.

Digestive Enzymes are important pancreatitis supplements simply because the pancreas produces digestive enzymes and the less the pancreas has to work the better. If the pancreas has sustained a large amount of damage it may not produce enough enzymes to digest thefood and of course this makes an enzyme supplement mandatory.

Chromium picolinate mineral helps maintain stable blood sugar levels so the pancreas doesn’t have to work overtime secreting insulin to move sugar out of the blood into cells.

Calcium & Magnesium work hand in hand to promote the health of all glands.

Vitamin B Complex helps relieve stress on the pancreas, and vitamins B-3 and B-5 in particular are important for fat and carbohydrate metabolism.

Dandelion root is an herbal supplement that is commonly used to help treat pancreatitis. Studies suggest that dandelion root helps stimulate and strengthen your pancreas and may improve the function of other organs, too, including the kidneys, spleen and stomach.

Omega 3 fatty acids helps in treating High Triglycerides, inflammation, gallstones. It also reduce the chance of a recurrent episode if you have a history of pancreatitis.

Milk thistle is one of those cholagogue herbs, which have been trusted by herbalists for over thousands of years to treat a damaged, liver, pancreas and stomach. Silymarin, a type of flavonoid has given this herbaceous plant the power to deal with liver damages. Being used as a liver tonic, the extracts of milk thistle help to neutralize all sorts of liver damages, other than protecting the liver as a whole. Other than that, milk thistle is also a source of vitamin E, which helps to treat and regenerate the cells of the liver and pancreas, which get damaged as a result of pancreatitis.

Licorice root has been used as a traditional Chinese herb for treating an array of health disorders, which also includes pancreatitis. Deglycyrrhizinated licorice (DGL) is one of the major bioactive compounds found in licorice, which can be the major reason behind the herb’s effectiveness for treating pancreatitis.

Reference –

http://www.webmd.com/digestive-disorders/digestive-diseases-pancreatitis?page=3

http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/treatment/con-20028421

http://www.nhs.uk/Conditions/Pancreatitis/Pages/Treatment.aspx

http://www.emedicinehealth.com/pancreatitis/page7_em.htm#medical_treatment_for_pancreatitis

http://www.naturalnews.com/042349_pancreatitis_natural_treatments_digestive_health.html

http://www.medicinenet.com/pancreatitis/page3.htm#what_are_the_signs_and_symptoms_of_pancreatitis

http://www.healthline.com/health/pancreatitis#Types2

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60649-8.pdf

http://www.everydayhealth.com/pancreatitis/treatment/

https://www.pancan.org/section-facing-pancreatic-cancer/learn-about-pan-cancer/treatment/complementary-and-alternative-therapies/

http://pathology.jhu.edu/pancreas/TreatmentNutrition.php?area=tr#cam