An Explanation of Acute Pancreatitis

QUESTION: I need one of your special run downs about a disease. Your stuff
is better than anything in the medical advisors that cost so much to purchase.
Can you explain acute pancreatitis to me? As you might imagine, I and my
family have a real need for this information. Thank you.
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ANSWER: Thanks for that nice compliment. Acute pancreatitis is inflammation
of the pancreas gland, most commonly resulting from heavy drinking or disease
of the bile ducts or gallbladder. But it can also be the result of trauma,
peptic ulcers or a high level of blood calcium. So there are many potential
causes, and it is difficult to diagnose.
The end result can be mild and self-limiting or severe and fatal,
depending on the amount of cell damage that occurs. This in turn is
reflected in the number of signs and symptoms present. In severe cases,
digestive enzymes in the pancreas, such as trypsin, run amok and attack and
destroy the cells of the gland itself.
Like some other diseases, acute pancreatitis is a "great imitator," as
clinical symptoms vary widely. But the most common are constant ulcer-like
abdominal pain (worsened by eating and lessened by sitting upright), nausea
and vomiting. Mild cases might produce only abdominal pain, while severe
cases include fever, rapid heart rate, bloated belly, and even a
semi-conscious state.
Because it can appear under different disguises, the only sure-fire way
to establish a diagnosis would be to examine the gland at operation. This is
impractical and rarely done, unless bile duct obstruction exists. Instead,
acute pancreatitis can be differentiated from other possible imitators by
laboratory tests and imaging techniques. A high level of amylase in the blood
or urine is one indicator that is highly sensitive but not specific.
To firm up the diagnosis, tests for tripsinogen, hemoglobin level,
leucocyte count, blood sugar and others are often needed. All this tests help
the physician obtain a clearer idea of the exact nature of the disease state.
In addition, x-rays might help reveal suspicious secondary changes in the
small bowel associated with the disease. Ultrasound and CT scans are helpful
in diagnosis and management.
The outcome of acute pancreatitis is uncertain, and the chances of death
increase for those over 55 years with a high white cell count, high blood
sugar, high blood urea nitrogen (BUN), high serum calcium, high hematocrit,
and high levels of various enzymes associated with destruction of the gland.
The anti-ulcer drug, cimetidine, and antacids are used in treatment to
decrease acids and prevent stress ulceration. Analgesics are used to reduce
pain and prevent spasm of the gland. But each case must be diagnosed and
treated individually, according to specific symptoms and life-styles.
Tube-feeding might be required; heart complications might arise, so
oxygen is often given; washing the abdominal cavity to remove toxic material
might be necessary; antibiotics might be needed for associated infections.
Since alcohol only worsens the disease, it should be strictly forbidden,
and that may help prolong your life. With careful medical management the
mortality from acute pancreatitis is slowly decreasing. Anticipating possible
complications and the course of the illness seems to be the best course to
follow at present.