What is the pancreas and what does it do?
The pancreas is an elongated organ located behind the stomach. The primary function of the pancreas is to aid in and regulate digestion by producing hormones and enzymes. In a normally functioning pancreas the digestive enzymes are not activated until reaching the small intestine. The pancreas also normally produces a hormone called insulin to regulate the level of sugar in the blood.
What are the signs and symptoms of pancreatitis?
Pain in the upper abdomen is the most common symptom in both acute and chronic pancreatitis. The pain will often radiate to the chest or back. The pain can range from mild to severe and last for hours to days. Alcohol and eating tend to worsen the pain.
- Mild to severe pain in the upper abdomen
- Abdominal pain that radiates to the back or chest
- Increased heart rate
- Increased breathing
- Steatorrhea; Oily, foul-smelly stools (chronic pancreatitis)
- Weight loss
What tests will be carried out to see if I have pancreatitis?
Tests are important for two reasons. First to determine if the patient has pancreatitis and second to diagnose what is causing it. Along with symptoms, personal and family history doctors can conduct tests to diagnose pancreatitis. Blood tests can reveal high levels of digestive enzymes produced by the pancreas. Blood tests also reveal changes that occur to blood sugar and trace minerals contained in the blood. Doctors can also identify gallstones using an ultrasound and inflammation and damage to the pancreas with a CAT (computerized axial tomography) scan. Another procedure that is used is known as an ERCP. This involves inserting a tube with a tiny camera at the end down the throat and through the stomach lining, through the small intestine and to the pancreas.
- Family/personal history
- Blood tests
- Urine/stool sample
- CAT scan
- MRCP procedure
- ERCP procedure
What kind of doctor do I see if I suspect I have pancreatitis?
Your general practitioner is typically the best place to start. He can help you determine if your symptoms could indicate pancreatitis and can refer you to a specialist. If you are still in doubt and want to consult a specialist, or if you are referred to a specialist, your first visit will probably be to a gastroenterologist.
A gastroenterologist specializes in the digestive system and can help identify the causes of your pancreatitis and recommend treatment. If surgery is required you may be recommended to either a general surgeon or a gastrointestinal surgeon.
What causes pancreatitis?
There are a number of factors that can lead to the development of pancreatitis:
- Chronic Alcoholism and binge drinking
- Bilary disorders (like gallstones)
- Medications (including azathioprine, 6-mercaptopurine, dideoxyinosine, estrogens, furosemide, pentamidine, sulfonamides, tetracycline, thiazide diuretics, and valproic acid)
- Cystic fibrosis
- Autoimmune disorders (where the body does not recognize its own immune system and attacks itself)
- Genetics – family history of pancreatitis
- High calcium levels in the blood (hypercalcemia)
- High levels of parathyroid hormone in the blood (hyperparathyroidism)
- High triglyceride levels in the blood (hypertriglyceridemia)
- Pancreatic cancer
- Abdominal injuries
- Abdominal surgery
How curable is pancreatitis?
Currently there is no complete cure available for pancreatitis. Unfortunately, in the majority of cases, the pancreas is not able to repair itself and return to normal functional capacity after damage has occurred. The level to which a patient can recover depends on a number of factors such as when the diagnosis is made, the extent of damage done when diagnosis is made, the success of surgery if it is performed and how well the patient commits to new dietary and lifestyle regimes. It also depends on the cause of the pancreatic attack.
How important is the pancreas? Can it be removed surgically?
The pancreas is one of the most important organs in the body, but it can be removed by surgery and its functions replaced in various ways. The pancreas supplies the body with insulin, so when it is removed, diabetes mellitus must be considered. This is solved by the patient receiving regular insulin injections. Because the pancreas also plays a very important role in the digestion of food, when it is removed the patient is usually treated with an extract of pancreatic digestive enzymes from animal sources. These are added to the patient’s food. The drug cimetdine is used to stop the stomach from producing acids, thus preventing the breakdown of pancreatic enzymes by acid. (Source: Encyclopedia of Family Health, 3rd Edn, 2005)
Does a person who has a diseased pancreas always get diabetes?
No; many pancreatic problems do not cause diabetes. However, if there is inflammation of the entire pancreas as there is in pancreatitis, the insulin-producing cells in the islets are almost bound to be involved, leading to a diabetic tendency that is often less marked than might be expected from the extent of the damage. (Source: Encyclopedia of Family Health, 3rd Edn, 2005)
Can the pancreas be injured in an accident?
Yes, injuries to the pancreas most commonly occur as a result of car accidents in which the upper part of the abdomen is struck with force during the crash. It can be difficult to tell if the pancreas is involved, and surgery is always performed if a pancreatic injury is suspected; if it is left untreated, the digestive juices of the pancreas leak into the abdomen. (Source: Encyclopedia of Family Health, 3rd Edn, 2005). Bicycle accidents can be quite common causes of pancreatitis in children. The bike’s handlebars are often the cause of trauma as they impact on the upper abdomen.