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Pancreatitis Complications

Pancreatitis Symptoms:

The most common symptom of acute pancreatitis is nausea and vomiting. These are followed by abdominal pain, diarrhea, weakness and fatigue.

Other symptoms include chills, fever, headache, muscle aches and backache.

Acute pancreatitis may cause death due to heart failure or kidney failure. Acute pancreatitis may lead to permanent damage of pancreas, liver and other organs.

Causes of Acute Pancreatitis:

There are several causes of acute pancreatitis. These include:

Alcoholism or drug abuse are important causes of pancreatitis.

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Pancreatitis may occur in people infected with HIV.

Some people develop pancreatitis after a gallstone attack.

Infection of pancreatic ducts with gallstones or a blockage of the ducts with stool may also lead to pancreatitis.

Less common causes of acute pancreatitis include:

Autoimmune disease, in which body’s immune system attacks pancreas

Bile duct obstruction or cystic fibrosis

Dislodged blood clots from the lungs or heart

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Severe physical trauma or injuries such as car accidents, major falls or sports injuries

Risk Factors of Acute Pancreatitis:

The risk factors of acute pancreatitis include:

Alcoholism

Injury or trauma

Recent surgery in abdomen or organs nearby pancreas

Diabetes

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Obesity

Smoking

Increasing age

Symptoms of Acute Pancreatitis:

The symptoms of acute pancreatitis vary depending on the severity of the disease and the organs involved.

The main symptoms of acute pancreatitis are:

Severe, constant pain in the upper abdomen, spreading to the back

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Feeling nauseous and vomitting

Pain worsened by bending over, coughing, moving or breathing deeply

Pain worsened by eating, drinking alcohol and sometimes walking

Other symptoms of acute pancreatitis may include fever, chills, diarrhea and itching.

Chronic Pancreatitis Complications:

Chronic pancreatitis is associated with several serious complications, some of which are:

In rare instances, acute pancreatitis may lead to blood clots or abscess formation, which can cause death.

People with pancreatitis have a much higher risk of developing certain types of cancer, such as pancreatic cancer, gastric cancer, colon cancer and leukemia.

Chronic pancreatitis may also lead to problems with the gallbladder due to bile duct damage.

Chronic pancreatitis may also lead to diabetes because the pancreas normally produces the hormone insulin, which helps the body turn sugar, starches and food into energy. The disease may also cause hormonal imbalances and malnutrition.

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Chronic pancreatitis may also cause an enlarged liver, which is known as hepatomegaly.

Pancreatitis Symptoms:

The symptoms of pancreatitis include:

Upper abdominal pain (usually severe) and pain in the back that worsens when you move, cough or sneeze

Nausea

Vomiting

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Diarrhea (in some cases)

Feeling sick (nausea) and sometimes feeling hungry (even when you have no appetite)

Bloating

Upper abdominal distension

Sometimes fever, which may be mild or high

A swollen or tender abdomen.

Pancreatitis Complications:

The complications of pancreatitis may include the following:

In some cases, pancreatitis may lead to a pancreatic pseudocyst, in which a sac filled with fluid develops that surrounds the pancreas. If this occurs, you may experience severe pain.

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Pancreatitis can cause a blockage of the ducts that release pancreatic juice into your gastrointestinal tract. This can lead to a back up (stasis) of pancreatic juice that can cause infection and inflammation.

Pancreatitis may sometimes cause gallstones.

Pancreatitis may also lead to a malnutrition due to a lessened ability to absorb nutrients from food.

Treatment of Acute Pancreatitis:

Acute pancreatitis is treated by relieving the pain with analgesics and intravenous fluids. Antibiotics may be also given to prevent infections.

In severe cases, the person may require transfer to an intensive care unit.

The treatment for pancreatitis may also include:

Narcotics to relieve pain

Antibiotics to prevent infection

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Fluids given through a vein to prevent dehydration

Nutrition given through a vein to prevent malnutrition

Surgery to remove dead tissue and infected parts of the pancreas

In some cases, a temporary or permanent tube (stomach or jejunum) may be placed to bypass the area of the pancreas that is causing problems and allow the body to continue to absorb vital nutrients.

Laser therapy has also been used to try to heal pancreatitis.

Surgery may be done if there is an infected gallstone blocking the bile ducts of the liver or pancreas.

Treatment of Chronic Pancreatitis:

The treatment for chronic pancreatitis includes:

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Antibiotics to prevent infection

Nutrition given through a vein to prevent malnutrition

Surgery to remove damaged parts of the pancreas

Drugs that activate pancreatic cells to replace the natural secretions of the pancreas

Nutritional supplements and vitamins to prevent malnutrition and anemia (a reduction in the normal number of red blood cells)

In some cases, a temporary or permanent tube (jejunum or stomach) may be placed to bypass the area of the pancreas that is causing problems and allow the body to continue to absorb vital nutrients.

In severe cases, some patients may require a temporary or permanent feeding tube (G-tube) placed directly into the stomach to ensure adequate nutrition.

Even if you have no symptoms, you should let your doctor know if you have gallstones or have had pancreatitis in the past.

What is the long term outlook for someone with pancreatitis?

The outlook for someone with pancreatitis depends on the type of pancreatitis they have.

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The outlook for acute pancreatitis is usually very good, with most people making a complete recovery. Most people who have chronic pancreatitis usually have a good outlook especially if they are detected early and treated.

Most people with pancreatic cancer tend to have a poor outlook, but this is less common.

Genetic testing and mapping for people with a family history of pancreatitis is relatively new, but this may increase the chance of detecting it at an early stage.

What are the rates of death from pancreatitis?

The reported rate of death due to pancreatitis in Australia is 0.9 per 100,000 people. It is the 10th highest cause of death.

The rate of death from pancreatitis is around 1.3 per 100,000 people in the US.

The rate of death from pancreatic cancer is slightly lower at around 0.7 per 100,000 people in the US (around 23,200 deaths).

Can pancreatitis be prevented?

The most important way to prevent pancreatitis is to make sure you don’t drink too much alcohol. If you do experience symptoms, don’t assume they will go away, but seek medical help immediately. The quicker you seek treatment for acute pancreatitis, the better your chance of a full recovery.

There is currently no known way of preventing chronic pancreatitis.

How can pancreatitis be diagnosed?

Acute pancreatitis is usually relatively easy to diagnose based on your medical history and a physical examination. The doctor may suggest one or more of the following tests:

Blood tests to measure the levels of various chemicals and hormones in your blood

to measure the levels of various chemicals and hormones in your blood Ultrasound or CT scan to measure the size of the pancreas and any fluid around it

to measure the size of the pancreas and any fluid around it Needle Biopsy to obtain a sample of pancreatic tissue to be tested in a laboratory

to obtain a sample of pancreatic tissue to be tested in a laboratory Abdominal CT scan with contrast – an X-ray type scan that uses a contrast dye to better see certain structures or organs

What is the treatment for pancreatitis?

The aim of treatment for pancreatitis is to relieve the pain and monitor the extent of the damage. Treatment may also be required for complications such as infection.

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The type of treatment will depend on the severity and cause of the pancreatitis.

Blood transfusions may be necessary to treat or prevent complications such as from blood loss or a lowered blood-cell count.

How is pancreatitis treated?

Acute pancreatitis is usually treated by a gastroenterologist with medication to relieve the pain and decrease inflammation. A feeding tube may be needed if you are not able to eat or drink. Antibiotics may be needed to treat or prevent infection. In severe cases, surgery may be required to drain any necrotic (dead) tissue or remove the entire pancreas.

Chronic pancreatitis is treated in a number of ways. Your treatment plan may include surgery, medicines, changes to your diet, changes to your lifestyle and emotional support or counselling.

What is the prognosis (outlook) for pancreatitis?

The outlook for pancreatitis depends on the cause and the severity. In general, the mortality rate is low if treated promptly. The outlook for chronic pancreatitis is worse as the disease tends to progress and can lead to diabetes and premature death.

What is the Prognosis (Outlook) for pancreatitis?

Acute pancreatitis

Most people with acute pancreatitis make a full recovery. The pancreas usually returns to normal within a few weeks, depending on the severity of the attack.

About 1 in 5 people have some ongoing symptoms. These may include recurring attacks of pain, ongoing or permanent problems with Digestion and diabetes. In severe cases, surgery may be required.

Chronic pancreatitis

If you have had a number of attacks of acute pancreatitis, the chances are that you will develop chronic pancreatitis.

The outlook for chronic pancreatitis is poor. It can lead to diabetes and premature death.

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In some cases, removal of the pancreas may be necessary.

Complications of pancreatitis

Pancreatic Cancer – This is an uncommon complication of long-term pancreatitis. It is usually found in people with chronic pancreatitis.

About 1 in 10 people with chronic pancreatitis are likely to develop it.

Diabetes – This occurs due to the destruction of the cells in the pancreas that produce the hormone insulin.

Gallstones – These are lumps that form in the gall bladder, and are common in people with chronic pancreatitis. The risk of developing them is increased by the consumption of alcohol.

What is the Pancreas and what does it do?

The pancreas is a gland situated in the abdomen near the stomach. It produces several important chemicals including insulin and enzymes to help with digestion.

The pancreas also helps regulate the amount of sugar in the blood. It produces a hormone called insulin which enables the sugar to be taken up by body cells for use as energy.

Any sugar not needed immediately is stored in the form of glycogen and then converted to fat. If you eat a meal that contains sugar or starch, the levels of glucose (a type of sugar) in your blood rise. The pancreas immediately responds to this by releasing more insulin into the blood. This reduces the level of glucose in the blood so it falls back to its usual level.

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Acute Pancreatitis

This is inflammation in the pancreas that is severe enough to cause symptoms. It can be mild, moderate or severe.

Normally the enzymes and chemicals produced by the pancreas aren’t found in the blood. However, when the pancreas is inflamed, some of these can be found in the blood.

The most common enzyme found in the blood is known as amylase. The levels become elevated when there is inflammation in the pancreas.

Chronic Pancreatitis

In this condition, the inflammation in the pancreas is long lasting (continuous). The pancreas becomes thickened and gradually unable to work properly.

This can lead to Diabetes developing.

This can be a very slow process taking years. However, there may be periods where there is accelerated damage, such as after a heavy drinking session.

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There is no cure for chronic pancreatitis. Treatment is aimed at relieving the symptoms and preventing any complications, including diabetes.

Severely affected people may need to have their pancreas removed (a procedure known as a pancreatectomy).

This is where there is ongoing irritation and inflammation in the pancreas. The repeated swelling and healing process causes the pancreas to gradually become less able to produce the enzymes and chemicals it needs to work properly.

This can occur after a single severe attack of acute pancreatitis or a number of less severe attacks of acute pancreatitis.

This is where there is a build-up of gallstones in the gall bladder. The bile that normally flows freely out of the gall bladder becomes blocked and the bile becomes more concentrated.

This leads to further irritation, swelling and pancreatic damage.

The build-up of gallstones can occur after a single severe attack of acute pancreatitis or a number of less severe attacks of acute pancreatitis. The gallstones can only be identified by carrying out certain medical tests.

The stones can sometimes pass out of the gall bladder into the intestines during a bowel motion. If this happens they can be seen in the stool.

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This means the pancreas is working at only a small percentage of its normal capacity. In many cases, the only symptom is recurring bouts of vague abdominal pain.

There is no specific treatment for chronic pancreatitis apart from treating the individual symptoms. Painkillers, antibiotics and a low-fat diet may be recommended.

The long-term outlook depends on how much functioning pancreas is left and whether complications such as diabetes develop.

Pancreatitis is caused by the pancreas becoming inflamed. It can be acute or chronic.

One of the main risk factors is heavy drinking. There are also other factors that increase the risk of developing pancreatitis, especially if heavy drinking is also taking place.

The most common symptom of pancreatitis is persistent mid-upper abdominal pain that gradually spreads to the lower abdomen.

The main risk factor is heavy drinking. The mechanisms by which alcohol causes pancreatitis are not fully understood.

A number of possible mechanisms have been suggested, including:

Long-term heavy drinking also causes changes in the hormones and hormone-receptors that control the digestive system. Some of these changes make the digestive process slower.

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As a result, alcohol is fermented in the digestive tract rather than being absorbed into the blood stream. Other changes reduce the vomiting reflex and feelings of fullness. As a result, people with long-term alcohol problems often eat less and become malnourished.

Other factors that increase the risk of pancreatitis are:

Pain in the abdomen (usually the upper-middle part) that worsens when walking or moving around

Nausea

Vomiting

Passing only small amounts of urine.

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There is no method of preventing pancreatitis that can be recommended to everyone. In most cases, the cause is heavy drinking so the best way of reducing the risk is not to drink heavily.

If you have a diagnosed pancreatitis or a family history of the condition, you may be advised to reduce your consumption of fatty foods and avoid drinking alcohol. You may also be advised to take digestive enzymes together with meals and snacks if pancreatic enzyme output is reduced.

(These digestive enzymes are only obtainable on medical prescription in the UK).

Alcoholic pancreatitis is caused by long-term heavy drinking.

Non-alcoholic pancreatitis (also known as chronic pancreatitis, or pancreatic exocrine insufficiency) is caused by long-term alcohol abuse or malnutrition (often due to heavy drinking).

The cause can also be a combination of the two, or one drinker may display symptoms of both conditions. Long-term abuse of illegal drugs such as amphetamines can also cause pancreatitis.

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The pancreas is a vital organ that lies deep in the abdomen behind the stomach. It produces vital digestive juices that help break down food and absorb key nutrients such as glucose into the bloodstream.

The pancreas also produces a hormone called insulin that is necessary for controlling the level of glucose in the blood.

Any condition that causes the pancreas to become inflamed can interfere with the organ’s ability to produce these vital substances, causing a potentially life-threatening build up of digestive juices in the pancrease. If this is not treated immediately it can cause severe pain and shock and may even be fatal.

The pancreas has two main functions. It secretes digestive juices into the small intestine and also hormones into the blood stream.

The major digestive juice secreted is composed of water, enzymes and electrolytes. It contains enzymes that will start the digestive process of protein, polysaccharides (carbohydrates), and fats.

It is secreted into the small intestine and breaks down food so that it can be absorbed through the wall of the small intestine into the blood stream.

The pancreas also produces hormones that prevent the liver from over producing glucose and also regulates the absorption of fats into the blood stream.

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Pancreatitis can be acute or chronic.

In acute pancreatitis there is a sudden onset of symptoms and the pancreas becomes inflamed over a period of hours or days. With all the digestive juices flooding the pancreas, it starts to digest itself and cause severe pain.

The underlying cause is usually gallstones or excess alcohol intake.

The pancrease becomes starved of oxygen and the enzymes start digesting the pancreas.

The major symptoms of acute pancreatitis are:

Severe central upper abdominal pain.

Vomiting.

Weakness.

Low blood pressure.

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A fast heart rate.

Dehydration from the vomiting.

Severe complications can cause Death.

Gallstones are a common cause of acute pancreatitis.

The stones lodge in one of the ducts in the pancreas that drain the digestive enzymes into the duodenum.

The stones cause a blockage and the pancreatic juice starts to digest the pancrease.

The other common cause of pancreatitis is alcohol abuse.

The toxic acids start digesting the pancrease and also impair its function causing an overload on the liver.

Chronic pancreatitis is a condition that has been present for at least three months.

The pancreas becomes inflamed gradually over a period of months or years.

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The underlying cause is excessive alcohol intake or inherited conditions.

Acute pancreatitis may develop due to the initial damage caused by these factors.

Chronic pancreatitis can also sometimes be genetic.

The major symptoms of chronic pancreatitis are:

Blood or pus in the urine.

Jaundice (yellowing of the skin), caused by build up of bile salts in the liver.

Vitamin deficiencies.

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Stomach or abdominal distension.

Anaemia (lowered number of red blood cells) due to bleeding in the digestive tract.

Pain in the upper abdomen.

These symptoms can last for a long time or come and go depending on the underlying cause.

If the pancrease becomes completely damaged then diabetes may develop.

The pancreas may become so damaged that it can no longer produce digestive juices or hormones. This can result in a build up of fat in the liver and will cause severe pain, shock and death if untreated.

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Approximately 1 in 20 people who suffer from alcoholic hepatitis will develop pancreatic cancer.

There are several types of treatment for pancreatitis, depending on the nature and severity of the disease.

Pancreatitis is caused by the digestive enzymes building up in the pancreas, burning a hole in it. These digestive enzymes are made up of powerful proteins that digest fat.

Proteins are chemically very similar to the hemoglobin in the blood.

The digestive enzymes require an alkaline environment to work best. The stomach churns and mixed with powerful acids to create this alkaline environment.

The duodenum, the top part of the small intestine, quickly absorbs the food and then dumps it into a tunnel called the jejunum.

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The jejunum passes the food into the next part of the small intestine, the ilium.The tunnel is called the ilium.

The exit of this tunnel opens up into another tunnel called the ileum.

The duodenum dumps the food into the jejunum. The jejunum passes the food into the ileum.

The ileum slowly moves the food through into the large intestine. The large intestine opens into the rectum. Feces are produced in the colon and stored in the rectum. When they reach a sufficient amount then they are expelled from the body through the rectum and out through the buttocks.

The liver plays a vital role in breaking down the fat in the intestines. It also helps the small intestine to absorb food, and controls cholesterol production in the body.

It is the only organ that can regenerate itself.

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The pancreas produces several vital substances. It produces digestive juices which contain powerful enzymes to break down food.

It also produces hormones such as insulin and glucagon to regulate the amount of sugar in the blood.

The small intestine is a vital part of the digestive system. It is divided into three sections.

The duodenum, the jejunum and ileum.

The small intestine is about 7 metres long in adults. The small intestine contains an elaborate network of tiny blood vessels called capillaries.

Nutrients are absorbed through these blood vessels. Other substances such as water, salts and vitamins are absorbed in the larger lymph vessels.

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The small intestine is divided into three sections. The start of the small intestine is called the duodenum.

The duodenum is a J-shaped bend and is about 20 inches long. The next section is called the jejunum. The jejunum is about 6 feet long. Finally there is the ileum. The ileum is also about 6 feet long.

There are three layers of tissue that protect the small intestines: the mucosa, submucosa and the muscularis.

The mucosa has three main functions: it absorbs nutrients, it prevents pathogens from entering the blood stream and it produces mucus.

The submucosa is a layer of dense connective tissue. It also contains blood vessels and nerves that enter the gut to supply it with nutrients and nerves.

It also contains Peyer’s patches.

The muscularis is a layer of muscles that continuously mix the food as it passes through the small intestines.

The small intestine is protected by the mesentery, a fold of peritoneum.

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The large intestine is much larger than the small intestine. It starts at the distal end of the ileum and continues for another 6 feet.

The entire large intestine is about 5 feet long.

The large intestine is concerned with the fermentation of carbohydrates and the absorption of water and a little more sodium.

The large intestine removes water from the remaining wastes. It contains a lot of bacteria that help break down the wastes into substances that can be removed from the body as feces.

The large intestine is made up of four parts: the cecum, the colon, the rectum and the urinary colon. The cecum is a pouch at the start of the large intestine.

It is about 3 inches long. It receives the contents of the small intestine through the ileum. It also secretes chemicals that encourage the contents in the intestines to ferment and putrefy.

The colon is further divided into the ascending colon, the transverse colon, the descending colon, the pelvic colon and the rectum.

The ascending colon is about 12 inches long. It ascends vertically after the cecum and ends in the transverse colon.

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The transverse colon is about 12 inches long. It is wider than the ascending colon and crosses the abdomen horizontally.

It ends in the descending colon.

The descending colon is about 9 inches long. It descends vertically after the transverse colon, ending in the pelvic colon.

The pelvic colon is about 5 inches long. It extends from the descending colon to the rectum where it widens.

It forms two sphincters. The internal sphincter is involuntary and surrounds the rectum. The external sphincter surrounds the opening of the rectum and is under voluntary control.

The large intestine absorbs water and some salts.

The large intestine is made of longitudinal and circular muscles to help it contract and push the feces out.

The rectum is around 12 inches long and leads to the opening of the urinary tract. This is called the Anus.

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The large intestine contains bacteria that produce fatty acids, vitamins and cholesterol. The bacteria are also important in the breaking down of some compounds such as lactose in our diet.

The large intestine absorbs most of the water from the feces. The feces are then stored in the rectum and eventually open out as in defecation.

The large intestine is susceptible to many disorders. The most serious of these are colorectal cancer and inflammatory bowel disease.

The process of removing solid waste from the body is called defecation. It involves storage of feces in the rectum and voluntary relaxation of sphincters leading to expulsion of feces out of the body.

Sources & references used in this article:

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