Pancreatitis

The pancreas gland is positioned behind the stomach next to the gall bladder. It works in conjunction with the oesophagus, stomach, intestines, liver and gall bladder to digest food and disseminate nutrients throughout the body.  Abnormal pancreatic function results in pancreatitis, which is an inflammation of the pancreas gland.

What is Pancreatitis?

The role of the pancreas in the digestive process is to produce and deliver glucagon, insulin, hormones and other enzyme components, to aid the small intestine in breaking down food for the body's nutrition and to excrete the waste leftover as a by-product via the bowels and bladder. An imbalance in this production or delivery process may cause these enzyme components to become active within the pancreas, where they start to breakdown the pancreatic tissue resulting in inflammation and haemorrhaging known as ‘pancreatitis’.

Are there different types of Pancreatitis?

There are four types of pancreatitis, classified according to their severity and cause. These include Acute Pancreatitis and Chronic Pancreatitis, such as that caused by alcoholism, gallstones, Pancreatic Pseudocyst and Pancreatic Abscesses. Depending on the cause and length of time before diagnosis and treatment, pancreatitis can develop from acute to chronic inflammation. Pancreatic secretions that build-up in the pancreas causing scar tissue, which lead to obstructed bile ducts, are referred to as Pancreatic Pseudocysts. They can cause jaundice, internal bleeding and infection. Pancreatic abscesses result from development of pseudocysts and infection, accentuating symptoms.

How does Pancreatitis occur?

Pancreatitis may result from a number of causes, which include:

  • Viruses, such as cytomegalovirus, coxsackie, herpes simplex, hepatitis B, varicella-zoster and mumps.
  • Bacteria, such as salmonella, legionella, mycoplasma, leptospira.
  • Fungi, such as aspergillus.
  • Parasites, such as toxoplasma, cryptosporidium and ascaris.
  • Hereditary conditions, such as pancreatic divisum congenital malformation and the abnormal activation of trypsinogen.
  • Gallstones or pancreatic duct stones.
  • Alcohol.
  • Medications, such as diuretics, chemotherapeutics, anticonvulsants, cholesterol-reducing, steroids.
  • Diseases, such as diabetes type II, cancer, auto-immune.
  • Medical conditions, such as vasculitis, high blood calcium or triglycerides, endoscopic retrograde, hypothermia and porphyria.
  • Pregnancy, raising blood triglycerides.
  • Stings, such as those from scorpions.
  • Injury or trauma to the pancreas.

Is Pancreatitis contagious?

Pancreatitis itself as a condition is not contagious, but infection-causing agents such as viruses and bacteria can cause pancreatitis.

What diseases or medical conditions result from Pancreatitis?

Both diseases and medical conditions can arise due to Pancreatitis, affecting blood, auto-immune functions and metabolic and neural processes. Associated conditions include cystic fibrosis, hypertriglyceridemia and hyperparathyroidism. If left untreated early onset inflammation of the pancreas can lead to cancer, heart disease and shortened life expectancy. 

What are the symptoms of Pancreatitis?

Symptoms of pancreatitis may include any of the following: abdominal swelling, pain in the abdomen and back, nausea, vomiting, dehydration, fatigue, weight-loss, high or low temperatures resulting in fever, chills and clammy skin, high or low blood pressure, jaundice, fatty faeces, internal bleeding, heart palpitations and difficulty breathing. Each type of pancreatitis may present symptoms differently.

How is Pancreatitis diagnosed?

Physical examination, discussion of symptoms and discussion of medical history all form a part of the initial diagnostic procedure. These are generally followed by urine tests, blood tests, ultrasound and computer tomography (CT) scans. The blood tests will reveal abnormal levels of lipase or amylase. Imaging allows medical practitioners to identify the presence of gall and pancreatic duct stones, pancreatic inflammation and fatty liver.

How is Pancreatitis treated?

The method used to treat pancreatitis depends on the severity and type of pancreatitis. Usually the cause needs to be identified and treated to reduce and stop the inflammation; for example, gallstones may be treated through cholangiopancreatography (ERCP) and bacterial infections with antibiotics. Other medications and therapies may be used in combination to treat symptoms of dehydration, such as intravenous feeding with electrolytes and fluids, and morphine to reduce the pain.

What are the health implications of Pancreatitis?

When inflammation of the pancreas starts and symptoms develop, each person's body may respond differently, due to their unique make-up and medical condition. Infection may spread faster or to a lesser degree and each person's systematic response to inflammation may differ. Other organ functions, such as the kidney, can be affected. Pressure on the lungs due to difficulty breathing can also damage the lungs. The body can go into shock. It is therefore important to get symptoms checked by a medical practitioner and receive treatment for the cause as soon as possible.

How can Pancreatitis be prevented?

Understanding the cause of pancreatitis can help in practising prevention. Preventative measures may include:

  • Having medical checks and blood tests to monitor levels of calcium, lipase and amylase.
  • Monitoring medical conditions and treatment.
  • Discussing medication use and effects with your doctor.
  • Early medical intervention and treatment.
  • Practising good hygiene to prevent infection.
  • Reducing alcohol intake or abstaining from alcohol.
  • Avoiding injury to the abdomen or back, such as through physical work or contact sports.
  • Refraining from areas prevalent with scorpions, or having treatment with you for stings.
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