Pancreatitis: causes, symptoms, diagnosis, diet and treatment

By Cristiano Antonino On Jun 7, 2023

Pancreatitis is an inflammation of the pancreas, a gland that manages the digestive and glycemic balances of our body

There are two different forms of pancreatitis, one acute and one chronic.

The first appears suddenly and violently, the second can have a prolonged effect over time and worsen as a result.

But what are the causes that can give rise to pancreatitis? And what are the symptoms that should alarm us?

What are the symptoms of pancreatitis?

Pancreatitis, especially acute pancreatitis, is manifested by sudden, severe pain in the upper abdomen, where the pancreas is located.

The inflammation often tends to extend to the back as well, causing discomfort in that area.

The disturbances generally increase after meals with deep inspirations and during palpation of the abdomen.

Instead, they are relieved when the patient leans forward and maintains an antalgic position.

Severe pain can cause nausea and vomiting of food and bile, which is dark green in color.

The patient, therefore, appears very suffering; fever may occur, anxiety about being unwell, and often signs of shock may also occur (cold pale skin, marked hypotension, small and rapid pulse).

Focusing now on chronic pancreatitis, the main signs that can predict this disorder are milder and more nuanced, so much so that sometimes the inflammation runs in a paucisymptomatic way.

Usually the patient complains of stitches in the upper part of the abdomen, associated with rapid weight loss, lack of appetite and digestive difficulties with the onset of steatorrhea, i.e. fatty, greasy stools, especially in conjunction with copious, high-fat meals. lipid content.

The causes of pancreatitis

Many of the pancreatic digestive enzymes, such as proteases, are synthesized in an inactive form to protect the cells that produce them from being harmful.

When these enzymes, which are transported by the pancreatic juice, pour into the initial tract of the small intestine (duodenum) they undergo an activation process, which serves to carry out the digestive activity in an optimal way.

The rapid and early activation of these enzymes within the pancreas feeds the inflammatory process of the gland.

Constant insults can therefore lead to chronic pancreatic damage, such as self-digestion, necrosis of the vessels and the consequent inflammatory reaction, with the progressive loss of its functionality.

Unfortunately, the reduced function of the pancreas causes serious digestive problems and poor blood sugar control, with the possible onset of diabetes.

The causes of pancreatitis are varied and numerous

Among the best known certainly is gallstone disease, which leads to the deposit of some “pebbles”, the stones in fact, in the ampulla of Vater (this is the dilatation of the common bile duct in which the pancreatic juices carried by the bile duct join the bile, which comes from the liver and gallbladder, before pouring into the duodenum from the gallbladder or bile ducts).

Any blockage or obstruction at this level will prevent the normal outflow of bile and pancreatic juice in the intestine, consequently these secretions tend to go back up and concentrate inside the gland, causing the inflammatory process.

Different obstructions at various levels can also be determined by hyperparathyroidism and hypercalcemia, which facilitate the activation of enzymes within the pancreas and the appearance of calcifications of the excretory ductal system and pancreatic parenchyma.

Alcoholism

Pancreatitis can also be caused by continued abuse of alcohol (alcoholism).

In this case we speak of alcoholic pancreatitis, which can lead to ductal hypertension and edema especially when the picture is aggravated by other unhealthy habits, such as a diet that is almost always high in fat and high in protein and that is tobacco (smoking).

Hypertriglyceridemia

Another problem that can lead to pancreatitis is hypertriglyceridemia.

Obviously we should not forget the cases of family predisposition and to some drugs, such as azathioprine, corticosteroids, thiazide diuretics, asparaginase, estrogens and tetracyclines.

Other causes

Less common causes include cystic fibrosis, tumors, violent abdominal trauma, tumors of the pancreas or sphincter of Oddi, viral infections, penetrating duodenal ulcer, surgical operations on nearby organs (stomach, gallbladder, duodenum, spleen) and an interventional diagnostic procedure called endoscopic retrograde cholangiopancreatography.

Treatments for pancreatitis

To treat pancreatitis, it is important first of all to communicate the symptoms you have in order to be able to analyze them.

The doctor, in fact, will evaluate the ailments reported by the patient and will prescribe blood tests, in this way it is possible to find a rise or not in pancreatic enzymes.

In fact, if the pancreatic tissue is damaged, these enzymes pass into the bloodstream and blood tests are enough to find it.

Considering the damage to the pancreas, it is also common to identify hyperglycemia, a sign of reduced insulin production.

Also for diagnostic purposes, an ultrasound and CT scan can also be prescribed.

Ultrasound is used to ascertain the extent of the damage to the pancreas and to bring out the presence of any gallstones.

Diet

To resolve pancreatitis, of course, we need to go back to the causes that generated it and fight them.

Treatment varies according to the symptoms and causes.

In the presence of stones, for example, to remove them it may be necessary to subject the patient to a surgical operation, if they obstruct the common bile duct.

As equally important is to avoid drinking alcohol, eating fatty foods or heavy foods.

In fact, the cure for pancreatitis can initially be based on almost absolute fasting and possibly on the administration of food and nutritional substances through the use of a nasogastric tube.

This restrictive diet essentially serves to rest the pancreas, consequently it is important to respect a fasting period without ingesting liquids or foods, only basic nutrients that do not require the digestive phase to be disposed of.

What drugs are required to treat pancreatitis?

The diet to be respected is usually associated with the prescription of some drugs.

Medical therapy is mainly based on pain control with analgesics and on the administration of rehydrating solutions to combat the loss of fluids caused by vomiting and sweat.

The mildest forms of acute pancreatitis can resolve within a few days, without serious clinical consequences.

While the more intense and chronic forms of the disorder in question may require repeated surgical interventions, which have the aim of draining the pancreatic duct and removing fragments of damaged tissue, the milder forms of acute pancreatitis can pass in a few days, without serious clinical consequences.

Foods to avoid

In general, inflammation of the pancreas requires the patient to give up certain foods, such as fried foods, rich in saturated fats and/or simple sugars.

We list several: