GHS Cares: Health Topics from Your Local Family Doctors- Pancreatitis
August 30, 2018
We aren’t sure all of you are familiar with this month’s featured organ, the pancreas. Pancreatitis means inflammation of the pancreas, and for most of us, we aren’t thinking about the pancreas too often. The pancreas is a small organ in your upper abdomen between your stomach and liver. It is shaped like a long fish, with the “tail” pointing away from your intestines and the “head” connecting through a small tube to the small bowel. The small bowel is part of your digestive system, which begins right after food leaves the stomach.
The pancreas is extremely important, and we cannot live easily without it. The pancreas makes digestive enzymes to help us digest food. It also contains the cells called “Islet Cells” which make the hormone insulin that help us process energy in our whole bodies.
Fact #1 The symptoms of pancreatitis are severe upper stomach and back pain, nausea and vomiting and inability to eat or drink anything.
Fortunately, pancreatitis is rare, about 35 cases per 100,000 people each year, which is less than a 1/10th%. Usually nausea, vomiting and abdominal pain are caused by viral illness or food poisoning. However, when there is abdominal pain that is severe over the upper central abdomen, it is important to consider testing for pancreatitis.
Fact #2 Most episodes of pancreatitis happen due to gallbladder stones or alcohol consumption over many years.
Gallstones are the most common cause of pancreatitis, accounting for about 35% of cases. Chronic alcohol consumption is responsible for another 30% of cases. The mechanisms for each of these are different. Small gallstones which pass from the gallbladder toward the intestine may sometimes cause swelling or directly block the pancreas’ digestive juices. This blockage causes the pancreatic enzymes to be trapped, and they start to break down within the pancreas. Alcohol causes pancreatitis by increasing the production of digestive enzymes within the pancreas, or by forcing the pancreas into “overdrive.” Similarly, this causes break down to occur in the pancreas. There are many other less common causes of pancreatitis including high triglycerides, medications like diabetes medications, and infections. The cause remains unknown in about 20% of cases of pancreatitis.
Fact #3 Pancreatitis is diagnosed with a blood test and/ or abdominal imaging.
The diagnosis of pancreatitis can be made by checking a blood test for the level of a pancreatic digestive enzyme called “lipase.” Lipase levels in the blood are usually low -- when they are more than three times the normal amount, this is highly suggestive of pancreatitis. It may also be diagnosed with pancreatic inflammation on a CT or MRI scan of the abdomen.
Fact #4 Pancreatitis is treated with fluids, rest, and trying to cure the underlying cause.
When pancreatitis is caused by a gallstone blockage, the stone must be removed before the pancreas can heal. However, in all other cases of pancreatitis, the main treatment consists of resting the digestive system by avoiding any food or drink. Due to the inflammation and vomiting, patients with pancreatitis often get dehydrated and require IV fluids. With rest and time, the pancreas usually heals itself. Eating and drinking can then be slowly resumed starting with clear liquids and gradually working up to a bland diet and then a more regular diet.
Pancreatitis is a rare, but serious cause of upper abdominal pain and vomiting. Most of you will never need to worry about pancreatitis. However, the bottom line is that everyone should see their doctor for any sudden and severe abdominal pain, especially if they aren’t able to eat.
Dr. Liz Baltaro and Dr. Amy Nayo are primary care physicians expanding community access to quality pediatric and family medicine at Granville Primary Care, Butner-Creedmoor, located at 1614 NC Highway 56, Butner. To schedule your primary care appointment, please call 919-575-6103 or schedule online at ghshospital.org. You can schedule a primary care appointment with a provider as far as 12 months in advance through online scheduling.