Pancreatic Disease

The pancreas is located deep in the abdomen behind the stomach. About six to eight inches long, it is a solid organ which makes enzymes as well as hormones. The pancreas opens in the intestine called duodenum beyond stomach via pancreatic duct exactly where bile duct from liver also opens.

The pancreas produces juices and enzymes that digest fat, protein, and carbohydrates so they can be absorbed by the intestine. The pancreas also produces insulin, a hormone which helps in regulation of blood sugar and prevents diabetes.

A number of problems can occur in the pancreas: Acute and chronic pancreatitis, pancreatic cancer and other tumors, diabetes also occur due to pancreatic problem it is hormonal disorder. The symptoms of pancreatic disease depends on the types of disease.

Acute Pancreatitis

This condition occurs when the pancreas becomes quickly and severely inflamed. There are two major causes of acute pancreatitis in USA: heavy alcohol ingestion & gallstones. Other causes include trauma, drugs, high triglycerides in blood, autoimmune pancreatitis and unknown factors. Binge alcohol drinking is a common cause of acute pancreatitis. Gallbladder disease, especially where a gallstone becomes lodged in the main bile duct next to the pancreas, also causes this condition. In pancreatitis, the digestive enzymes of the pancreas break out into the tissues of the organ causing sever damage to the pancreas itself.

The main symptoms of pancreatitis are acute, severe pain in the upper abdomen which radiates to the back, frequently accompanied by nausea and vomiting and sometimes fever. The abdomen is tender, and the patient feels and looks ill. The diagnosis is made by measuring the blood pancreas enzymes which are elevated. An ultrasound or sonogram and abdominal CT exam often shows an enlarged pancreas. The condition is treated by resting the pancreas while the tissues heal. This is accomplished through bowel rest, hospitalization, intravenous feeding and, pain medications.

Treatment

When pancreatitis is caused by gallstones, it is necessary to remove the gallbladder. This is usually done after the acute pancreatitis has resolved. At times, an ERCP (Endoscopic Retrograde CholangioPancreatography) test is recommended at start of pancreatic treatment. This involves passing a flexible tube through the mouth and down to the small intestine. A small catheter is then inserted into the bile duct to see if any stones are present. If so, they are then removed with the scope. Most patients with this condition recover well, although a few, especially those who have alcohol-induced pancreatitis, may become very sick causing prolonged hospital stay and even require surgery.

Chronic Pancreatitis

This condition occurs mostly in alcoholics or people who repeatedly binge drink alcohol. The main symptoms are recurrent, dull, or moderate pain in abdomen and back but acute attacks also do occur with alcohol relapses. Chronic diarrhea and diabetes also develop with this condition. Treatment consists of rest, medication, and certain food restrictions. Alcohol consumption is absolutely prohibited. However, in cases where damage is extensive, pain can occur even when alcohol consumption has stopped.

Diagnosis of this condition is made by measuring blood enzymes and by performing abdominal CT, x-rays, and ultrasound exams. An ERCP, which is an endoscopic test, is helpful in diagnosis and treatment of chronic pancreatitis. Many times these patients are on narcotic pain medications and may even become addicted. In some cases, surgery is recommended to provide relief of pain.

Pancreatic enzyme insufficiency develops in chronic pancreatitis, leading to undigested food especially fatty foods and lead to diarrhea and malabsorption which leads to weight loss. Diabetes also develops which usually requires insulin for treatment and is not easy to control many times. Chronic pancreatitis is also considered precancerous condition which can lead to cancer.

Pancreatic cancer and other tumors

Cancer of the pancreas is a serious malignancy which is difficult to diagnose in early stage as there is no symptoms in early pancreatic cancer. Abdominal pain that radiates to back, weight loss, depression and jaundice due to blockage of main bile duct draining liver are main symptoms of this cancer. The disorder occurs in middle- or older-aged people. Causes of this include chronic alcohol ingestion and pancreatitis, smoking and heredity. Surgery is the only effective form of treatment for pancreas cancer if diagnosed in early stage. Palliative drainage of blocked bile duct coming from liver, with ERCP is an important endoscopic treatment gastroenterologists do.

The pancreas can also develop benign tumors and cause no problems. However, some benign tumors can secrete hormones which, when present in high levels, have a detrimental effect. For example, insulin can be secreted in excessive amounts and result in dangerously low blood sugar levels (insulinoma). Another hormone, gastrin, can stimulate the stomach to secrete its strong hydrochloric acid causing recurrent stomach and peptic ulcers, with many complications (gastrinoma). Fortunately, there is much that can be done about these tumors.

For more information about different types of pancreatic disease, visit our clinic in Riverdale NJ.