Pancreatitis

Pancreatitis (pan-kree-a-TY-tis) is a painful inflammation * of the pancreas.

The pancreas (PAN-kree-us) is part of the digestive system. It is a gland that is about six inches long and shaped like a flattened pear. It lies next to the stomach with its wider end near the duodenum (dew-eh-DEE-num), the first part of the small intestine. The pancreas produces insulin and glucagon (GLOO-ka-gon), which are chemical messengers called hormones * , which control the use of sugar in the body. The pancreas is also one of the organs in the digestive system that helps to break down food. The pancreas does this by secreting enzymes * that allow the body to digest proteins, sugars, and fats. These digestive juices from the pancreas travel into a tube, called the pancreatic duct. Other digestive juices, known as bile, also enter the pancreatic duct. Bile comes from the gallbladder, which is a small muscular sac that stores juices produced by another organ, the liver. Another tube, called the common bile duct, leads from the bladder to the pancreatic duct. From the pancreatic duct, this combination of digestive juices empties from the pancreatic duct into the small intestine, where it can then start digesting food.

Normally, the powerful digestive enzymes of the pancreas are inactive until they reach the small intestine. When the pancreas becomes inflamed, however, its enzymes leak out, become activated, and begin to digest the tissues they contact, so they begin to eat away at the pancreas and surrounding tissues. The resulting damage can cause swelling of tissues and blood vessels.

Insulin and glucagon work opposite to one another. Glucagon tells the liver to turn a chemical called glycogen into another, called glucose. Glucose is a form of sugar that the liver then releases into the bloodstream. Insulin, by contrast, tells the liver to turn the glucose into glycogen, and the glycogen is then stored in the liver. Together, these two hormones regulate blood sugar. This regulation is important because blood sugar levels that are too high or too low can cause numerous health problems, including death.

Because advanced chronic pancreatitis can affect both insulin and glucagon production, doctors must be very careful in treating this condition. For example, people who have diabetes usually have high blood sugar, and doctors may order an infusion of insulin to treat it. If a patient's glucagon production is low, however, the additional insulin can lead to an overly decreased blood-sugar level (called hypoglycemia), which can be fatal.

Pancreatitis has many causes, but most cases of acute pancreatitis result from alcohol abuse or gallstones * . A patient usually feels severe pain in the upper abdomen * that may last for hours or for a few days. The abdomen may be swollen and tender. Other symptoms may include nausea, vomiting, fever, and an increased pulse rate.

In addition to pain, patients with chronic pancreatitis usually show signs of long-term damage such as malabsorption or diabetes. Because acute pancreatitis causes an increase in certain levels of digestive enzymes in the blood, a blood test may confirm a diagnosis of the condition. Sometimes, a doctor may order x-rays or CT scans * to make the diagnosis.

Treatment for pancreatitis depends on the type, cause, and severity of the condition. Although acute pancreatitis usually gets better on its own, a patient may spend time in the hospital during the attack. If the patient has gallstones, surgery to remove them may be needed.

Patients with chronic pancreatitis will begin a strict diet that limits fat and protein, because the damaged pancreas can no longer digest these substances properly. Patients sometimes receive replacement enzymes to help digest their food, and a doctor may prescribe medication to relieve pain. Because alcohol is often the cause of both acute and chronic pancreatitis, the best way to prevent the disease is to avoid drinking alcohol.

With treatment, the outlook for chronic pancreatitis often is good, but patients must stop drinking alcohol. Other less common causes of pancreatitis, such as infections, cancer * , and reactions to medicines or chemicals, require a proper diagnosis in order to be treated in the best way possible.

See also Alcoholism • Diabetes • Gallstones

* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.

* hormones are chemical substances that are produced by various glands and sent into the bloodstream carrying messages that have certain effects on other parts of the body.

* enzymes (EN-zimes) are proteins that help speed up a chemical reaction in a cell or organism.

* diabetes (dye-uh-BEE-teez) is a condition in which the body's pancreas does not produce enough insulin or the body cannot use the insulin it makes effectively, resulting in increased levels of sugar in the blood. This can lead to increased urination, dehydration, weight loss, weakness, and a number of other symptoms and complications related to chemical imbalances within the body.

* gallstones (GAWL-stonz) are hard masses that form in the gallbladder or bile duct.

* abdomen (AB-do-men), commonly called the belly, is the portion of the body between the thorax (THOR-aks) and the pelvis.

* CT scans, or computed tomography (to-MOG-ra-fee) scans, use computers to view structures inside the body. Formerly called computerized axial tomography (CAT) scans.

* cancer is a condition characterized by abnormal overgrowth of certain cells, which may be fatal.