- What are the main symptoms of acute pancreatitis? Upper abdominal pain, abdominal pain that radiates to the back, abdominal pain that gets worse after eating, fever, rapid pulse, nausea, vomiting, tenderness when touching the abdomen are important symptoms.
- What are the symptoms of chronic pancreatitis? Upper abdominal pain, losing weight without trying and oily smelly stools are a few features.
- What are the conditions that can lead to pancreatitis? Alcoholism, gallstones, abdominal surgery, certain medications, cigarette smoking, family history of pancreatitis, high calcium levels in the blood, high triglycerides in the blood, injuries to the abdomen and pancreatic cancer. A procedure is known as ERCP that is endoscopic retrograde cholangiopancreatography also can lead to pancreatitis. Sometimes a cause is never found.
- What are the complications of pancreatitis? Cyst-like pockets with fluid can collect in the pancreas. This is known as pseudocyst. If this ruptures it may cause bleeding or infection. Acute pancreatitis can cause kidney failure which may require dialysis. Acute pancreatitis makes the pancreas vulnerable to infections. It may cause breathing problems due to acute lung injury. Diabetes, malnutrition and pancreatic cancer due to long-standing inflammation are other complications.
- What will help with pancreatitis? Procedures to remove bile duct obstructions, gallbladder surgery, pancreas surgery and treatment for alcohol dependence are a few options. Treatment of the cause that results in pancreatitis has to be identified by relevant investigations.
- What are the investigations necessary to diagnose pancreatitis? Routine blood tests that include blood counts, amylase and lipase levels in the blood, kidney function tests and ultrasound examination of the abdomen are mandatory. Most of these patients would require CT scan of the abdomen to identify the degree of necrosis of the pancreas as well as the associated complications if any. CT may also help to diagnose the etiology of pancreatitis.
- How long does it take to get over pancreatitis? An acute attack lasts a few days or a week. In a few, it may take a few weeks. These individuals may require intravenous nutrition for a few weeks. This is known as total parenteral nutrition.
- How serious is pancreatitis? Acute pancreatitis can at times be serious. The seriousness depends on the amount of land affected. The necrotizing type is more serious than the oedematous type. Acute pancreatitis can lead to multi-organ failure in a few individuals.
- What is the blood test done to diagnose pancreatic cancer? Blood levels of two tumor markers, carcinoembryonic antigen CEA and CA 19-9 are the most commonly used blood tests.
- What is the treatment of greasy stools and digestive problems in chronic pancreatitis? Restricting fat in the diet to about 20 grams per day is mandatory. Dietary supplements that contain the enzyme lipase helps to balance the deficiency. Medium chain triglycerides a form of dietary fat are more easily digested and absorbed than the long chain triglycerides found in most foods. These are oils and can be mixed in most juices. They are a good source of calories in individuals who have lost weight due to chronic pancreatitis.
Author: Dr Jay Deshmukh
M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD
(Internal Medicine – Bombay and New Delhi)
Chief Physician and Director, Sunflower Hospital, Nagpur