Acute pancreatitis occurs most often as a result of gallstone disease or excessive alcohol consumption. This disease, in its acute form, can even lead to death. What are the other causes of pancreatitis? Check what are the symptoms of this disease and how it is treated.

It is estimated that in a yearacute pancreatitisaffects 10-45 people per 100,000 residents. The pancreas is a small and very universal factory of our body. Thanks to its intensive work, it is possible, among other things, to efficiently digest the main components of food, as well as to regulate the level of glucose in the blood. Sometimes, however, due to various external factors, its functioning is disturbed and an acute inflammatory process occurs. What can lead to acute pancreatitis and what are the risks of it?

Why is the proper functioning of the pancreas so important?

The pancreas belongs to one of the most important secretory organs in humans. It is located on the left side of the abdomen, just behind the stomach. It consists of two types of tissue: alveolar and insular, which enable simultaneous performance of different functions.

Thanks to the follicular cells, the pancreas plays an exocrine role, i.e. it can produce substances necessary for the digestion of nutrients - proteins, fats and carbohydrates. They are produced in the form of still inactive proenzymes, thanks to which physiologically there is no situation where the intestinal wall could be etched and damaged.

Active enzymes contained in the so-called pancreatic juice are delivered through the tubules to the duodenum, which is the initial part of the small intestine.

The main enzymes synthesized by the pancreas are:

  • trypsin
  • chymotrypsin
  • elastase
  • carboxypeptidases
  • pancreatic lipase
  • phospholipase
  • esterases
  • pancreatic amylase
  • nuclease

The secretion of pancreatic juice is a complex mechanism regulated, inter alia, by by the nervous system, hormones and chewing food.

The second, no less important function of the pancreas is the endocrine function - stimulated by cells accumulated in the so-called pancreatic islets or the islets of Langerhans. It consists of:

  • synthesis of glucagon (which, in turn, can initiate the breakdown of glycogen in the liver and the release ofblood glucose),
  • Insulin production (which enables, among other things, the storage of glucose from food in the form of glycogen),
  • Somatostatin secretion (inhibiting the synthesis of glucagon and insulin),
  • Production of pancreatic polypeptide (inhibiting e.g. the secretion of digestive enzymes).

As you can see, although the pancreas is a relatively small organ, its functions are very complex, and the compounds it produces become essential for the balance of many systems.

What is acute pancreatitis?

Sometimes the mechanisms that protect the pancreas from self-digesting stop working. A progressive inflammatory process begins to develop, i.e.acute pancreatitis (pancreatitis) .

Active pancreatic enzymes destroy not only the flesh of the organ, but also the walls of the digestive tract and the blood vessels lining them.

In an advanced inflammatory process, a part of the pancreas may die, and may even lead to a perforation of the intestine. The general inflammatory process will affect the whole organism and may lead to dangerous multi-organ failure.

The frequency of diagnosis of acute pancreatitis is between 10 and about 40 cases per 100,000 people per year. However, without extensive testing, this disease can be difficult to diagnose.

Symptoms of acute pancreatitis

Pancreatitisgives characteristic symptoms. One of the first, most sudden, is the most severe pain (sometimes compared to a "stabbed" pain) in the upper abdomen, mostly on the left or in the center. Patients may feel its build-up or even radiation to the back or chest.

Intense vomiting and nausea are common, as well as abdominal distension and decreased intestinal peristalsis.

Fever, shortness of breath, rapid breathing, elevated heart rate and significantly lowered blood pressure appear.

In acute conditions, patients may experience impaired consciousness and lose consciousness. In addition, in some cases of acute pancreatitis, yellowing of the skin may also occur, which is a symptom of impaired bile drainage from the bile ducts.

It is very important to refrain from food and only drink water if symptoms are even less severe. Thanks to this, the stressed pancreas will have a chance to regenerate.

Causes of acute pancreatitis

In adults, the most common causes of acute pancreatitis are:

  • excessive alcohol consumption,
  • gallstone disease,
  • injuries within the abdominal cavity (most often bicycle and motorcycle accidents resulting in hitting the handlebars),
  • viral infection (most often hepatitis, hepatitis, influenza or HIV),
  • parasitic diseases (human roundworm),
  • taking certain medications.

In childrenpancreatitismay be caused by:

  • childhood diseases (measles, mumps, rubella, chicken pox),
  • mechanical injuries,
  • anatomical defects,
  • metabolic diseases,
  • drug use.

In some casesacute pancreatitismay be caused by other medical conditions, including biliary disorders, such as:

  • anorexia and bulimia,
  • diabetes,
  • enteritis,
  • neoplastic diseases,
  • hypercholesterolemia
  • or kidney failure.

If there is no indication of the probable cause of the disease, then it is called idiopathic pancreatitis.

Diagnosis of acute pancreatitis

The diagnosis of acute pancreatitis takes place in the first stage during the medical interview, based on the described symptoms and the examination of the hardness of the abdominal wall of the patient.

Laboratory tests are performed:

  • determination of amylase activity in blood and urine,
  • lipase activity,
  • assessment of aminotransferase levels,
  • alkaline phosphatase
  • and bilirubin.

By testing the level of liver enzymes, it will be possible to determine if the problem is caused by, for example, gallstone disease.

Other tested parameters which may be:

  • assessment of lipid and calcium levels,
  • electrolyte concentration,
  • creatinine
  • and urea (characterizing, among others, kidney function).

An important indicator will also be the determination of the concentration of CRP protein, the concentration of which increases with the progression of the inflammatory process in the body.

Additionally, the doctor may order imaging tests:

  • USG,
  • computed tomography of the abdominal cavity,
  • Chest X-ray.

They are auxiliary research, allowing to determine, inter alia, whether the bowel wall has perforation or pulmonary complications, or whether the bile ducts are open.

Treatment of acute pancreatitis

Pancreatitisis treated depending on its course and complications, but in general, hospital care will be required. In the case of a mild diseaseit may be enough to introduce a few days of fasting, along with an intravenous irrigation system and administration of painkillers.

Only after the vomiting and abdominal pain are over, the patient will be able to start normal oral nutrition. If the tests performed indicate the presence of stones in the bile ducts, it may also be necessary to perform a gallbladder removal procedure (most often using the laparoscopic method).

In the acute course of pancreatitis, especially when life-threatening complications occur:

  • kidney,
  • pulmonary,
  • tissue necrosis infections,
  • and even peritoneal infection,

you will need to be in the intensive care unit or surgery unit. The patient will be nourished enterally or intravenously, and in the case of bacterial infections, he will also receive antibiotics.

Diet for acute pancreatitis

After the treatment is completed, it is very important to introduce an appropriate diet, and to eliminate factors that could lead to pancreatitis. They are mainly alcohol and fatty, difficult to digest dishes.

In the nutrition of convalescents, you should gradually increase the proportion of carbohydrates, and prepare small but regular meals (about 5 during the day).

Especially at the beginning, you should limit the consumption of fats and excess protein. The best form of processing is cooking, stewing or baking the food.

Products not recommendedin the diet after pancreatitis is for sure:

  • fatty meats (pork, lamb, goose),
  • fatty dairy products (milk, cheese, cream),
  • rye or wholemeal bread,
  • coarse-grained groats (e.g. buckwheat),
  • bloating fruits and vegetables (cherries, pears, plums, peas, cabbage, beans).

Sometimes patients, despite the disappearance of inflammation symptoms and the end of treatment, complain of recurring ailments from the digestive system. This may be due to a partial damage to the pancreatic function or its ongoing regeneration process.

In such cases, it is recommended to take preparations with pancreatic enzymes, as well as a set of fat-soluble vitamins:

  • vitamins from group A,
  • vitamin D,
  • vitamin E,
  • vitamin K.

Pancreatitisis a disease that, especially at the beginning, can be mild and associated with discomfort after too much feast.

However, it must not be underestimated, because it is subject to serious complications and relapses, which may even be life-threatening.

Win the prevention of pancreatic inflammation, it is beneficial to maintain a he althy body weight, an easily digestible diet and limit alcohol consumption.

Category:

Gastrology