Early Symptoms and Causes of Pancreatitis

Pancreas is a gland situated behind the stomach, and secretes digestive enzymes and hormones to the duodenum (upper part of small intestine), through the pancreatic duct. This gland secretes enzymes like amylase, carboxypeptidase, chymotrypsinogen, elastase, pancreatic lipase and trypsinogen, which act upon the proteins and fats in the small intestine, facilitating the absorption of nutrients. Insulin and glucagon are the hormones produced by pancreas. These hormones which are released into the bloodstream, help in controlling the levels of blood sugar.

The digestive enzymes produced by the pancreas, move through the pancreatic duct and reaches the small intestine in inactivated form. On reaching the small intestine, the enzymes get activated, and aids in digestion. Due to various causes, the enzymes get stuck in the pancreas itself, and get activated within the gland. The action of these enzymes in the pancreas cause inflammation of the gland. Repeated episodes of such attacks can cause scarring of the pancreas tissues and affect the functioning of the gland, leading to serious complications.

Pancreatitis or inflammation of pancreas can be of two types - acute pancreatitis and chronic pancreatitis. Acute pancreatitis is a sudden episode of inflammation of pancreas, whereas chronic pancreatitis is a long-term condition. The latter may be characterized by recurrent episodes of acute pancreatitis or long term damage (without symptoms) to the gland that lead to scarring and serious damage to the gland. Both can be severe and can create severe complications including death. Let us go through the causes and symptoms of the two types of pancreatiits.

Causes of Pancreatitis
The occurrence of pancreatitis can be due to various reasons. The main causes are gallstones and alcohol abuse. Almost 70% of chronic pancreatitis are caused by long-term (seven to twelve years) consumption of alcohol. According to some studies, alcohol causes a toxic effect on the pancreatic cells, which produce enzymes (acinar cells). Another theory is that alcohol creates protein plugs in the pancreas and blocks the pancreatic duct.

Gallstones, (crystalline bodies formed by the abnormal components in the bile) may sometimes travel through the common bile duct and settle in the pancreatic duct, blocking the enzymes in the pancreas itself, causing pancreatitis. This type of pancreatitis is commonly seen in women above the age of 50. Apart from these two reasons, there are other factors, which cause pancreatitis. They are as follows:

• Some medications like steroids and diuretics.
• Trauma or injury caused by accident or any such incident.
• Duodenal ulcers and cystic fibrosis.
• Autoimmune diseases (due to overactive immune response of the body against substances and tissues, normally present in the body).
• Smoking and family history of pancreatitis.
• Infections like mumps.
• High fat and calcium levels in the blood.
• Snake bites and scorpion stings.
• Some medical procedures like Endoscopic Retrograde Cholangio-Pancreatography (ERCP).
• Pancreatic cancer and abnormalities of pancreas and intestine.
• High levels of parathyroid hormone and triglycerides in the blood.

The causes, for about 15% of acute pancreatitis cases and almost 30% of chronic pancreatitis cases, are unknown.

Symptoms of Acute Pancreatitis
Symptoms vary with the type of pancreatitis. The most common symptom in acute pancreatitis is pain, whereas the patient may or may not experience pain in chronic pancreatitis. In case of acute pancreatitis the pain may occur suddenly or in a gradual manner. Sometimes the pain may start from the upper abdomen and radiates through the back. The pain may get worse after consuming food or when the patient lies on his back. Besides pain, nausea, vomiting, fever, tender abdomen, diarrhea, loss of appetite, rapid heartbeat and smelly stools may also occur. In severe cases, the patient may also experience dehydration, low blood pressure, weakness, etc. Bleeding of the pancreas may also take place, which may result in failure of other organs and subsequent death.

Symptoms of Chronic Pancreatitis
One of the symptoms of chronic pancreatitis is abdominal pain. But in the long run, some patients may not experience pain, as the pancreas may stop the production of enzymes. This can result in non-absorption of nutrients from food and assimilation of fats and proteins, as such, through the stools. Hence, the patient experiences oily and smelly stools, weight loss, severe nausea, bleeding, liver problems, etc. As the pancreas stop producing insulin, the patient is also likely to develop diabetes.

The treatment for acute pancreatitis include intravenous fluids, oxygen, antibiotics, or sometimes surgery. Chronic pancreatitis is treated with analgesics, therapeutic endoscopy, enzyme supplements and surgery. Studies show that in United States, around 80, 000 cases of acute pancreatitis occur each year. Men are more susceptible to this diseases than women and children. Hence, it is important to rule out the possibility of pancreatitis, if you experience frequent and severe abdominal pain.