Overview
The pancreas is a vital organ that produces digestive enzymes and hormones (like insulin). Disorders such as acute pancreatitis, chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer disrupt these functions, leading to pain, malnutrition, and metabolic complications.
Symptoms
Acute Pancreatitis
- Severe abdominal pain (often radiating to the back)
- Nausea and vomiting
- Fever
- Rapid heart rate
- Tender abdomen
Chronic Pancreatitis
- Persistent or recurrent abdominal pain
- Indigestion and bloating
- Fatty, oily stools (steatorrhea)
- Weight loss and malnutrition
- Diabetes due to loss of insulin production
Other Pancreatic Disorders
- Pancreatic insufficiency: diarrhea, vitamin deficiencies, weight loss
- Pancreatic cancer: jaundice, unexplained weight loss, abdominal pain
Routine Diagnostic Tests
- Blood tests: amylase and lipase (elevated in acute pancreatitis), triglycerides, calcium
- Imaging:
- Ultrasound (detects gallstones, inflammation)
- CT scan (extent of damage, necrosis)
- MRI or MRCP (ductal abnormalities, tumors)
- Endoscopic ultrasound (detailed view of pancreas and ducts) (ERCP)
- Stool tests: fat content to assess malabsorption
- Pancreatic function tests: enzyme output during endoscopy
- Glucose tolerance test: evaluates endocrine function in chronic cases
Routine Treatment Recommendations
Acute Pancreatitis
- Hospitalization for supportive care
- IV fluids for hydration
- Pain management
- Nutritional support (oral feeding once tolerated; sometimes feeding tube)
- Treat underlying cause:
- Gallstone removal (ERCP or surgery)
- Stop alcohol use
- Adjust medications if drug-induced
Chronic Pancreatitis
- Pain management: medications, nerve blocks, or endoscopic procedures
- Pancreatic enzyme supplements with meals to aid digestion
- Dietary changes: low-fat, nutrient-rich diet; referral to dietitian
- Lifestyle modifications: stop alcohol and smoking
- Surgery: duct bypass or partial removal of pancreas if severe
General Recommendations
- Monitor for complications: diabetes, malnutrition, pseudocysts
- Preventive care: regular imaging, lab monitoring
- Patient education: importance of lifestyle changes a healthy diet, avoiding alcohol, smoking, vaping
- A diet diary to help identify sources of irritation
Key Takeaways
- Symptoms differ between acute and chronic forms but abdominal pain is the hallmark.
- Routine tests include blood enzymes, imaging, stool studies, and pancreatic function tests.
- Treatment is supportive and cause-specific, with lifestyle changes being critical for long-term management.
References:
Mayo Clinic: Pancreatitis – Diagnosis and treatment – Mayo Clinic
Cleveland Clinic: Pancreatitis: Symptoms, Causes & Treatment
WebMD: Pancreatitis: Symptoms, Causes, Diagnosis, Treatments, Tests
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