Ask The Doctor

Prompt Diagnosis Is Key with Pancreatitis

Dear Dr. Garner,

I was wondering if you could tell us a little about pancreatitis. Both my husband and I have experienced the pains and were diagnosed with pancreatitis. Our favorite uncle also has pancreatitis, but we believe it is due to his love of Mr. Johnny Walker.

Could you please tell us some more about this disease?

Pancreatic Problems and Relatives in Prospect Park West

 

Dear Pancreatic Problems,

While not the most exciting of diseases, pancreatitis causes hospitalizations of about 200,000 people a year in the U.S. About 80,000 Americans suffer from the disease.

When someone comes to the office complaining of upper abdominal pain, pancreatitis should be considered. We look for hints, such as heavy alcohol intake and gall bladder disease as these are found to cause the majority of cases.

The name makes a lot of sense – pancreas referring to the large gland that is located just behind the stomach and “itis” referring to swelling or inflammation of the gland.

Two Main Purposes

The pancreas serves two main purposes: First, it helps to regulate sugar levels in the body as it makes and releases insulin into the blood stream.

Second, it helps in the digestion of food. In this role, it makes very strong chemicals to help dissolve food. The problem in pancreatitis occurs when the chemicals back up in the pancreas itself instead of being released into the intestines. The chemicals actually destroy the pancreas.

There are many factors that can cause the pancreas to malfunction. In addition to alcohol intake and gall bladder disease, certain medications such as antibiotics, injuries (car accidents, for example), infections and tumors may bring on the disease.

The symptoms that would cause one to seek medical attention include tender abdomen, nausea, vomiting, fever and a rapid pulse.

Severe pancreatitis can cause dehydration and low blood pressure. The heart, lungs or kidney can fail. If bleeding occurs in the pancreas, shock and even death may occur.

The condition is diagnosed by medical history and a physical exam as well as blood tests, X-rays and sonograms.

Treatment for acute pancreatitis requires a few days stay in the hospital for IV fluids, antibiotics and medication to relieve pain. The person cannot eat or drink, so the pancreas can rest and recover. Unless there are complications, acute pancreatitis usually resolves in a few days. The pancreas and gall bladder are closely related, and gallstones and pancreatitis may exist at the same time.

Actually the gallstones can cause pancreatitis by blocking the tubes carrying the chemicals that the pancreas uses to help in digestion.

Chronic Concerns

Sometimes the inflammation of the pancreas may become chronic. In this situation, the disease gets worse over time and leads to permanent damage. The most common cause of chronic pancreatitis is heavy alcohol use. Chronic pancreatitis can be triggered by one acute attack that damages the pancreas and its tubes or by multiple attacks.

Treatment of chronic pancreatitis may require hospitalization and IV fluids, and fasting may be necessary. It is critical that people who develop chronic pancreatitis stop drinking. Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea and oily stools.

The bottom line is that while not as common as other causes of stomach pains, pancreatitis may be a very serious condition and can lead to death if not appropriately treated.

Prompt diagnosis and treatment are critical in providing a good outcome.

I hope this helps you better understand your condition.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.

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