Pancreatitis is an inflammation of the pancreas, a large glandular organ that sits behind the stomach and near the first section of the small intestine (the duodenum).
The pancreas has two main functions in the body:
Pancreatitis occurs when the pancreas's enzymes, which normally activate after reaching the small intestine, activate early and start digesting pancreatic tissues. This can cause swelling, bleeding, and damage to the pancreas and its blood vessels.
There are two main types of pancreatitis: acute and chronic. "Pancreatitis" is often used synonymously with "acute pancreatitis," because this form of the disease which appears suddenly and is short-lived is the most common. (In this series, the term pancreatitis will refer to acute pancreatitis.)
In 2009, 275,000 people in the United States were hospitalized due to pancreatitis, according to a 2013 article in the journal Gastroenterology.
And each year across the globe, there are 13 to 45 cases of pancreatitis per every 100,000 people, the study notes (though a 2013 article in the American Journal of Gastroenterology reports a worldwide incidence rate of 4.9 to 73.4 cases per 100,000 people).
As a whole, pancreatitis affects men and women equally, but the risk of developing the condition increases with age.
Additionally, the prevalence of pancreatitis (both acute and chronic) is two to three times higher among black people than white people, though it's unclear why, according to the Gastroenterology report.
The most common cause of pancreatitis is gallstones, pebble-like deposits that forms in the gallbladder from the hardening of substances, such as cholesterol and pigments.
Research indicates that gallstones, especially small gallstones that are less than 5 millimeters, cause at least 40 percent of pancreatitis cases, according to the American Journal of Gastroenterology article.
The second most common cause of pancreatitis is alcohol consumption, which accounts for at least 25 percent of cases. Alcoholic pancreatitis is more common in men than women.
Other causes of pancreatitis include:
The initial symptom of pancreatitis is pain in the upper left side of the abdomen, as well as nausea and vomiting.
Other common symptoms include:
For some people, acute pancreatitis may be moderately severe and require extended (a week or more) hospital stays after causing issues such as dehydration, low blood pressure, and transient organ failure. These symptoms typically resolve within 48 hours.
About 15 to 20 percent of pancreatitis cases are classified as severe, according to the American Journal of Gastroenterologyreport. Severe pancreatitis doesn't revolve within 48 hours and can cause organ failure, gastrointestinal bleeding, and possibly death.
To diagnose pancreatitis, your doctor will begin by asking questions about your medical history and conducting a physical examination.
He or she will then likely order a blood test. People with pancreatitis have an elevated amount (about three times the normal amount) of the digestive enzymes amylase and lipase in their bloodstream. There are also sometimes changes in the levels of glucose, calcium, magnesium, sodium, potassium, and bicarbonate.
Other tests to diagnose pancreatitis include:
Acute pancreatitis usually resolves within a few days with hospital treatment, which may include IV fluids, antibiotics (if there's a bacterial infection), and pain-relieving medications.
During this time, eating and drinking may be restricted, to limit the activity of the pancreas.
Surgery may also be necessary to remove any gallstones or blockages that may have caused the illness, and to drain fluid around the pancreas.
Additionally, in the most severe cases, surgery may be necessary to remove damaged, infected, or dead pancreatic tissue.
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Your pancreas is an organ that's part of both the digestive system and the endocrine system.
The digestive system, which breaks down food into tiny components that are then absorbed into the body, is made up of numerous organs in addition to the pancreas, such as the mouth, esophagus, stomach, and small and large intestines.
The endocrine system is a collection of many different endocrine glands, such as the thyroid gland, testes, and pituitary gland, which secrete hormones directly into the bloodstream.
Your pancreas is located in the upper left area of your abdomen, behind your stomach and near your duodenum, the first section of your small intestine.
The organ measures 5.5 to 7.9 inches (14 to 20 centimeters) long and weighs about 100 grams (about one-fifth of a pound).
Looking somewhat like a sweet potato or yam, your pancreas is made up of a bulbous head and neck, a bulky body, and a narrow, pointy tail.
The pancreas contains a tube-like structure called the main pancreatic duct, which runs from the tail to the head of the organ.
The gallbladder's bile duct enters in from the top of the pancreas head to connect to the main pancreatic duct. The joined ducts exit from the pancreas head, where they connect to your duodenum.
(Some people also have an accessory pancreatic duct, sometimes known as the duct of Santorini, which connects to another part of the duodenum.)
Your pancreas has two main responsibilities: It helps the body digest food, and it helps regulate blood sugar levels.
More than 95 percent of the pancreas's mass is made up of cells and tissues that produce pancreatic juices containing digestive enzymes such as amylase, lipase, elastase, and nucleases.
Each of these enzymes break down specific types of substances for instance, amylase breaks down carbohydrates, lipase breaks down fats, and elastase breaks down proteins.
The pancreatic juices, along with bile from the gallbladder, empty into the small intestine at the duodenum, where they assist in digesting food.
So-called islets of Langerhans make up much of the rest of the pancreas (about 1 to 2 percent). These island-like cell clusters produce insulin, glucagon, and other hormones directly into the bloodstream, helping to control the body's blood sugar levels.
Pancreatitis is a common condition that develops when the pancreas becomes inflamed.
Small gallstones that get stuck in the pancreatic duct, and chronic, heavy alcohol use, are the two most common causes of pancreatitis.
In 2009, pancreatitis resulted in approximately 275,000 hospital visits in the United States, according to a 2013 article in the journal Gastroenterology.
Pancreatitis often causes symptoms such as abdominal pain, fever, weakness, and nausea, and generally resolves within a few days with hospital treatment.
Pancreatic cancer is another common health issue involving the pancreas.
Each year in the United States, about 46,000 people develop pancreatic cancer and 40,000 people die from the disease, according to the National Cancer Institute.
Pancreatic cancer causes a number of common symptoms, including:
Treatment options for pancreatic cancer include surgery, chemotherapy, targeted cancer therapy with drugs, and radiation therapy.
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The pancreas is a glandular organ that is located in the upper area of the abdomen. It plays an important role in food digestion (by excreting digestive enzymes) and the regulation of blood sugar levels (by releasing insulin, glucagon, and other hormones).
Certain issues most notably gallstones and chronic, heavy alcohol consumption can cause the pancreas to become inflamed, a condition called pancreatitis.
Pancreatitis is associated with pain and a handful of other symptoms, some of which can be severe.
The most common symptom of pancreatitis is pain in the upper abdominal area, immediately above the stomach. This pain:
The abdominal pain may also differ depending on the cause of the pancreatitis, according to a 2006 report in the New England Journal of Medicine.
The pain of gallstone pancreatitis, for instance, is usually sudden, stabbing, and may radiate to the back. The pain of alcoholic pancreatitis, on the other hand, may develop more slowly and be less localized.
In addition to abdominal pain, nausea and vomiting are hallmark symptoms of pancreatitis. Other symptoms may include:
Dehydration, low blood pressure, and transient organ failure (lasting less than 48 hours) may also develop in people whose pancreatitis is moderately severe.
About 15 to 20 percent of pancreatitis cases are classified as severe, according a 2013 report in the American Journal of Gastroenterology. This means that the pancreatitis causes persistent organ failure, or organ failure that doesn't resolve on its own within 48 hours.
Severe pancreatitis can lead to multiple complications early on. These include:
Pancreatitis, including non-severe cases, may also lead to a few other complications, such as:
As with most diseases, diagnosis of pancreatitis often begins with a medical history review and a physical examination.
Your doctor will also order a blood test and, possibly, one or more imaging tests, such as:
To be diagnosed with pancreatitis, you need to have at least two of the following:
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Pancreatitis is the inflammation of the pancreas, a glandular organ located behind the stomach.
Its the cause of over 200,000 hospitalizations each year in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
The pancreas has two main functions: It produces insulin, glucagon, and other hormones to help regulate blood sugar levels, and it produces enzymes to help with food digestion.
It is this second function that can potentially result in pancreatitis.
Within the pancreas, so-called acinar cells produce proenzymes, which are inactive substances that turn into enzymes through metabolic processes.
These proenzymes travel to the duodenum (the first section of the small intestine) via the pancreatic duct where they are converted into their active forms.
Once active, the enzymes get to work to digest carbohydrates, proteins, fats, and other food substances.
However, if the acinar cells become damaged or the pancreatic duct is injured or blocked, the proenzymes may accumulate within the pancreas and activate prematurely.
When this happens, the enzymes digest cell membranes in the pancreas, sparking an inflammatory response from the immune system.
Gallstones stuck in the pancreatic duct are the single most common cause of pancreatitis, responsible for at least 40 percent of cases, according to a 2013 article in the American Journal of Gastroenterology.
It's not fully understood how gallstones induce pancreatitis, but increased pressure in the pancreatic duct from the obstruction is likely involved, according to a 2013 report in the journal Surgery.
Alcohol consumption is the second most common cause of pancreatitis, responsible for at least 25 percent of cases. It's unclear how it causes the condition, but it's thought that alcohol may generate aldehyde and ester compounds, which are toxic to acinar cells in the pancreas.
Alcohol may also sensitize acinar cells to the effect of cholecystokinin, a duodenum hormone that stimulates the release of proenzymes.
Other causes of pancreatitis are encapsulated by the following "I GET SMASHED" pneumonic:
Aside from steroids, an array of other drugs can cause pancreatitis, including:
In fact, there are published case reports of drug-induced pancreatitis for more than 40 of the top 200 most prescribed drugs, according to a 2008 report in the journal Baylor University Medical Center Proceedings.
The report also notes that the six most common drugs or drug classes that cause pancreatitis are:
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The pancreas is a glandular organ located in the upper abdomen, behind the stomach. One of its main roles is to help the body digest food by producing digestive enzymes and sending them to the small intestine.
But certain factors, including gallstones and chronic alcohol consumption, can cause these enzymes to activate early and start digesting pancreatic tissue. This results in pancreatic inflammation a condition called pancreatitis.
Pancreatitis is one of the most common diseases of the pancreas. In 2009, it resulted in 275,000 hospitalizations, according to a 2013 article in the journal Gastroenterology. For most people, pancreatitis is short-lived and resolves within a few days of hospital treatment.
Abdominal pain, nausea, and vomiting are among the most common symptoms of mild pancreatitis.
The condition frequently causes hypovolemia a decreased volume of blood circulating in the body due to several issues, including vomiting, reduced eating and drinking (consumption can often make pancreatic pain worse), and sweating.
Because of this, the initial treatment for pancreatitis is "aggressive" hydration using intravenous (IV) therapy with normal saline totaling about 250 to 500 milliliters per hour, according to a 2013 report on the management of pancreatitis that was published in the American Journal of Gastroenterology.
Intravenous therapy appears to be most beneficial during the first 12 to 24 hours of treatment, and may not help much after this.
In addition to giving fluid therapy, doctors may treat pancreatitis pain with opioids, such as morphine and fentanyl (Durgesic).
Antibiotics may also be necessary if an extra-pancreatic (outside of the pancreas) infection has developed.
Up to a third of people with pancreatitis develop an extra-pancreatic infection, such as pneumonia, bloodstream infections, and urinary tract infections, according to a 2014 report in the journal Pancreatology.
Gallstones are the number one cause of pancreatitis, according to the American Journal of Gastroenterology report. For the majority of these cases, the gallstones are small and don't remain in the bile duct or pancreatic duct for long.
But sometimes the obstruction doesn't resolve without treatment, and doctors need to remove it using a procedure called endoscopic retrograde cholangiopancreatography (ERCP).
If gallstones are found in the gallbladder, the gallbladder may need to be removed via surgery to prevent the recurrence of pancreatitis after treatment.
Historically, it was thought that people with pancreatitis needed to abstain from food or drink to give the pancreas time to heal.
But this isn't necessary for cases of mild pancreatitis in which there is no longer nausea, vomiting, and pain, according to the American Journal of Gastroenterology report. Additionally, a low-fat solid diet appears to be as safe as a clear liquid diet.
About 20 percent of pancreatitis cases are severe, meaning they result in multiple organ failure that doesn't naturally resolve within 48 hours.
People with severe pancreatitis may need to be transferred to an intensive care unit for an extended treatment, which could last more than a week.
One of the most common complications of severe pancreatitis is an infection of necrotic tissue in the pancreas, or tissue that has died due to a lack of blood supply. These infections are treated with antibiotics. The dead or damaged tissue is then removed surgically.
Probiotics do not appear to reduce the risk of infectious complications in severe pancreatitis, according to a 2008 study in the journal The Lancet.
People with severe pancreatitis may require several weeks of nasogastric feeding, in which a feeding tube carries food to the stomach through the nose. Theres some evidence that this procedure might help prevent infectious complications.
In addition to hospital treatment, the following lifestyle changes are recommended to help aid recovery and possibly prevent pancreatitis:
Some preliminary research suggests that antioxidants may help treat pancreatitis, but more well-designed clinical trails are needed to prove this, according to a 2010 article in the journal Gastroenterology and Hepatology.
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Pancreatitis, an inflammation of the pancreas, comes in two forms: acute and chronic.
Acute pancreatitis, which is sometimes simply referred to as "pancreatitis," is the most common form of the condition and often resolves within a few days with hospital treatment.
Chronic pancreatitis, on the other hand, is a lasting illness that can cause serious and life-threatening problems.
The worldwide prevalence of chronic pancreatitis is about 50 per 100,000 people, according to 2013 report in the journal Gastroenterology. It affects men more than women, and is most common in middle-aged people.
The pancreas, which is located in upper left area of the abdomen, has two main functions: It produces digestive enzymes that are sent to the small intestine to aid food digestion; and it excretes insulin, glucagon, and other hormones that help regulate blood-sugar levels.
Pancreatitis (both acute and chronic) arises when the digestive enzymes activate while in the pancreas and begin digesting pancreatic tissue, leading to an inflammatory response.
Long-term, heavy alcohol consumption is the most common cause of chronic pancreatitis. Some estimates suggest chronic alcohol use accounts for up to 70 percent of chronic pancreatitis cases in adults, according to a 2007 report in American Family Physician.
Other potential causes and risk factors of chronic pancreatitis are outlined in this TIGAR-O classification system pneumonic:
The most common symptom of chronic pancreatitis is upper abdominal pain. In fact, pain is the overriding symptom for 85 to 90 percent of people with chronic pancreatitis, according to a 2011 report in the journal The Lancet.
This pain can be constant or occur in weeklong episodes, and is often associated with nausea and vomiting. For many people, it spreads to the back and worsens after eating or drinking, potentially causing them to fear food and lose weight.
Pain can be partially eased by sitting up and leaning forward, or by applying heat packs to the spine or upper abdomen. Generally, the pain subsides as the pancreatitis worsens, possibly because the pancreas has stopped making the destructive digestive enzymes.
Other symptoms of chronic pancreatitis can include:
Chronic pancreatitis may lead to complications, such as:
Chronic pancreatitis is easily misdiagnosed as acute pancreatitis because their symptoms are similar. However, there are a number of tests to help diagnose chronic pancreatitis, including:
There are also tests to diagnose specific causes of chronic pancreatitis. For instance, serum IgG4 tests look for an antibody associated with isolated autoimmune pancreatitis
Treatment goals for chronic pancreatitis include relieving pain, preventing recurring symptoms, managing complications such as diabetes and malnutrition, and helping with digestion.
Treatments for chronic pancreatitis can include:
Doctors sometimes prescribe antioxidant therapy to relieve pain from chronic pancreatitis, but it's unclear if this treatment is effective.
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The pancreas is an approximately 6-inch (15-centimeter) glandular organ located in the upper left area of the abdomen, behind the stomach.
Its main functions are to produce digestive enzymes to break down food in the small intestine, and to excrete hormones (particularly insulin and glucagon) to control blood sugar levels.
Sometimes, sac-like pockets of fluid can develop on or in the pancreas these are called pancreatic cysts or, medically speaking, walled-off pancreatic necrosis. The cysts can be benign (noncancerous) or malignant (cancerous).
Benign cysts typically develop from inflammation of the pancreas a condition called pancreatitis.
In general, there are two main varieties of true pancreatic cysts, which differ by the type of fluid they contain: Serous cysts contain a thin fluid, and mucinous cysts hold a thicker, more viscous fluid.
Serous cysts are almost always benign, while mucinous cysts start off benign but can become cancerous if left untreated.
Mucinous cysts can be further divided into subtypes, such as mucinous cystic neoplasms, which contain ovarian tissue, and intraductal papillary mucinous neoplasms, which grow within the main pancreatic duct.
Many pancreatic cysts are actually pseudocysts, which are always noncancerous. Whereas true cysts are self-contained sacs lined with a type of cell called epithelial cells, pesudocysts develop within a cavity or space in the pancreas and are surrounded by fibrous, non-epithelial tissue.
Pseudocysts develop from acute and chronic pancreatitis, an inflammation of the pancreas that arises when the organ's digestive enzymes activate early and begin digesting pancreatic cells.
Chronic pancreatitis is most often caused by long-term, heavy alcohol use, and acute pancreatitis is usually caused by gallstones (followed in frequency by alcohol use).
About 5 to 16 percent of people with acute pancreatitis develop pseudocysts, and 20 to 40 percent of people with chronic pancreatitis develop pseudocysts, according to a 2006 report in the journal HPB.
It's often unknown what causes a true pancreatic cyst to develop, but it's sometimes associated with rare inherited disorders, including von Hippel-Lindau disease and polycystic kidney disease, both of which predispose people to cysts affecting multiple organs.
Pancreatic cysts, including pseudocysts, often produce no symptoms. When they do, symptoms can include:
Pancreatic cysts can lead to several complications, including:
Pseudocysts may also rupture, damaging nearby blood vessels and causing massive hemorrhaging (bleeding).
Ruptured pseudocysts may also cause peritonitis, a life-threatening infection of the membrane lining the abdominal cavity (the peritoneum).
Pancreatic cysts can be detected with various imaging techniques, including:
Surgery is the primary treatment for malignant cysts, large benign cysts, and benign cysts that have a high chance of becoming malignant. The exact surgical technique used depends on the location of the cyst.
Pseudocysts often go away without treatment. However, doctors may need to drain a pseudocyst if it causes persistent symptoms, is larger than 2.3 inches (6 centimeters), or is obstructing the pancreatic or bile duct.
Surgeons may decide to create a connection between the cyst and an adjacent organ of the intestine instead of directly draining the fluid from the cyst. This allows pancreatic juices that may later leak into the cyst to also drain out of the body.
The connection is generally made between the cyst and the back wall of the stomach (a procedure called a cystgastrostomy), the small intestine (cystjejunostomy), or the first part of the intestine (cystduodenostomy).
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