Pancreatitis

What is Pancreatitis?

It is a condition that leads to swelling of the pancreas, a gland that can be found in a position that is posterior to the stomach. It is the pancreas that releases the hormones glucagon and insulin as well as the digestive enzymes which help humans absorb and digest foods.

Picture 1 – Pancreatitis
Source – animalhealthcare.com

Pancreatitis Types

There can be various types of Pancreatitis. These are

Chronic Pancreatitis

It is a pancreatic inflammation that is persistent and fails to heal or improve over time. It often results in permanent damage of the pancreas. It is mostly a result of alcohol abuse.

Acute Pancreatitis

It refers to a sudden inflammation of the pancreas. Alcohol abuse is supposed to be the main cause of this condition though genetic factors are also held partly responsible.

Pancreatic Pseudocyst

It is an abnormal sac that forms within the abdomen and consists of fluids, pancreatic enzymes, blood and pancreatic tissues. These usually arise after an episode of Acute Pancreatitis. It is basically a collection of secretions from the Pancreas that has been surrounded by swollen tissues and scars. These sacs may get ruptured, infected and suffer from Hemorrhage. Such Pseudocysts may give rise to pain and obstruct structures like the bile duct, thereby giving rise to jaundice. The sacs may even migrate around the abdominal area.

Pancreatic Abscess

It is a pus-filled cavity that develops inside the pancreas. It is generally a result of infected Pancreatic Pseudocysts.

What Causes Pancreatitis?

This condition is mostly found to be a result of alcohol abuse over a long period of time. Heredity is also believed to be a causative factor in certain cases. In the United States, approximately 70% cases of this disease are found to be a result of alcohol abuse and alcoholism.

Some other possible causes of Pancreatitis are

• Gallstones
• Autoimmune Disorders
• Trauma
• Mumps
• Use of steroids
• Scorpion sting
• Medicines, such as diuretics and azathioprine
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
• Hypercalcaemia
• Idiopathic Diseases (disorders arising from unknown causes)
• Infection of the pancreas by Coxsackie virus

If these factors are ruled out, however, further tests may be required to be performed to find out the cause.

Pancreatitis Symptoms

This condition is mainly characterized by severe pain and tenderness in the upper abdomen. Vomiting (Emesis) and Nausea are other prominent signs of Pancreatitis.

Some of the main symptoms of Pancreatitis are

• Fever
• Chills
• Sweating
• Fatty stools
• Weakness
• Clammy skin
• Mild jaundice
• Loss of weight

Patients of this condition are also typically seen to suffer from other discomforting symptoms like elevated respiratory and heart rates. There may also be bowel sounds in some patients.

Pancreatitis Diagnosis

The diagnosis of this disorder is performed with the aid of laboratory tests and imaging studies. Medical examinations performed in the laboratory for this condition involve

• Abdominal X-Rays
• Urine tests
• Blood tests

Laboratory examinations often involve determining the level of Lipase and Amylase. In acute cases of Pancreatitis, measurement of both enzymes may be carried out. The Phadebas Amylase Test was once used as a dominant method for testing this disease. However, it is no longer a dominant method for testing.

Imaging studies that are performed for this disease includes

• Abdominal Ultrasound
• CT scan of the abdomen

Pancreatitis Treatment

The treatment for this syndrome is mainly supportive. Cure usually depends on the severity and the type of the condition. However, certain general ways of treatment are

Analgesic medications

Analgesics or pain relieving medications are used when affected individuals suffer from severe aches in their abdomen. Earlier, Meperidine (Demerol) was the preferred drug for curing this disease. However, Meperidine has been found to have high toxic properties and low analgesic characteristics. Morphine is the medicine of choice these days.

Intravenous nutrition

High abdominal pain and tenderness makes it difficult to have food. In such cases, salts and fluids are administered to patients in an intravenous manner.

Limiting oral intake

It is important to limit oral ingestion of foods in patients of this condition. It is also important to restrict intake of foods that are rich in fat component. However, recent studies have shown that time for recovery can be shorter oral feeding is resumed more quickly. It can also lead to fewer complications.

Pancreatitis patients need to be constantly monitored and cared after to evade complications in later stages. If gallstone formation leads to this condition, Endoscopic Retrograde Cholangiopancreatography (ERCP ) should be used for cure. In case of acute hemorrhagic pancreatitis, antibiotic medications should be administered to sufferers.

Pancreatitis Prognosis

Various Scoring Systems can help in predicting the intensity of an attack of this condition. The prognosis of this disease actually depends on the type of the disorder.

Pancreatitis Complications

Some of the most severe complications of this disease involve

• Hypocalcemia (Low calcium level in bloodstream)
• High amount of glucose in blood
• Shock

Respiratory complications are a common complication of this disease. It leads to the death of many sufferers of this condition. Plural Effusion is evident to some degree in almost all patients of this disorder. The pain in abdomen results in shallow breathing which leads to partial or total collapse of the lungs.

Frequently, the lungs are damaged by pancreatic enzymes. This gives rise to a complicated condition known as Pneumonitis which leads to swelling of the lungs. Pneumonitis may also arise as some condition that results in the obstruction of the airways such as Acute Respiratory Distress Syndrome (ARDS).

Systemic Inflammatory Response Syndrome (SIRS) may also ensue in some cases. The condition also results in an infection of the swollen pancreatic bed at any period when the disease is present.

Late complications of this condition involve recurring cases of Pancreatitis and the growth of Pancreatic Pseudocysts.

Pancreatitis in Dogs

This condition is commonly seen in dogs. The disease shows no predisposition towards sex, age or breed of dogs. Canines suffer from two main types of Pancreatitis – Acute and Hemorrhagic. Acute Pancreatitis leads to inflammation of the pancreas that allows spillage of digestive enzymes into the abdominal cavity. It may also lead to secondary damage to the surrounding organs like the bile ducts, intestines, gall bladder and the liver.

Common symptoms of this disorder in dogs involve fever, vomiting, abdominal pain, nausea and diarrhea. In case of a acute attack, depression, severe shock and even death may also happen.

In dogs, the disease is diagnosed with the aid of laboratory tests, ultrasound examination and radiographs (X-Rays). Laboratory examination usually reveals an increase in the amount of white blood cells in the body of the dog. There is also a rise in pancreatic enzymes in the bloodstream due to Canine Pancreatitis. Ultrasound examinations and Radiographs may also be helpful in detecting swollen areas within the pancreas.

Gallstone Pancreatitis

This is a type of Pancreatitis caused by formation of stones in the gall bladder. Over 20 million adults in the United States have gallstones. However, only 1- 4% of such affected individuals suffer from signs of gallstone disease. Only 5 percent of these patients develop Pancreatitis. It is, thus, a rare condition.

Gallstones are formed of a combination of crystallized deposits of cholesterol or crystals of calcium that are ionized with Bilirubin. Such stones can obstruct bile flow from the gallbladder. This is generally demonstrated as aches in the upper right quarter of the abdominal area. Gallstone pancreatitis arises when a migrating gallstone blocks the ampulla (dilated part) of Vater.

Pancreatitis in Cats

Pancreatitis arising in cats is of lower intensity than the variation which occurs in dogs. Cats with this condition display symptoms like, dehydration, lethargy, weight loss and loss of appetite. Less than 50% cats with this disorder suffer from abdominal pain and vomiting. In some cases of Feline Pancreatitis, jaundice, elevated heart rate and changes in respiratory patterns may also be seen.

The condition is diagnosed in cats with the help of Urinalysis, Chemistry Panel and Complete Blood Count (CBC). A biopsy may lead to a conclusive diagnosis. The disease is generally treated with oral medications, appetite stimulants, Pancreatic Digestive Enzyme supplements and Vitamin B12 injections. Small, digestible foods that are low in fat content are also fed to suffering cats.

Necrotizing Pancreatitis

It is the name given to a very severe case of the condition. In this condition, bleeding increases in the abdomen and the tissues located within the pancreas begin to die. Abdominal bleeding gives rise to two different signs. These are

Turner’s Sign

It is a greenish brown or reddish purple color in the flank region.

Cullen’s Sign

It is indicated by a bluish color in the region surrounding the navel.

Alcoholic Pancreatitis

It is a type of pancreatic inflammation caused by consumption of alcohol for many years. It usually arises in men who are about forty years old. Early symptoms of this condition involve vomiting and severe abdominal pain in upper abdominal area and also the back. One can get relief from such painful symptoms by leaning forward.

The pain may remain for 2 to 3 days in mild cases of this disease. The short-term prognosis is very good in such cases However, the pain may last for several weeks in acute cases and the risk of death increases to approximately 30 percent. Pancreatitis can be entirely free of pain in rare cases and can only be diagnosed from signs of insufficient pancreatic function, like Steatorrhea (excessive fat in stool) and diabetes.

Hemorrhagic Pancreatitis

It is a severe case of Pancreatitis that is very fatal in nature. Substantial immunosuppressive Therapy is needed for patients of this disorder. Acute cases of this disease are the result of problems in the pancreas due to autolysis of various tissues.

This condition is usually the result of factors like

• Fatty necrosis
• Overconsumption of alcohol
• Pregnancy
• Choledocholithiasis
• Pancreatic cancer
• Steroids
• Trauma

Bleeding disorders such as Gastrointestinal Bleeding, Rectal Bleeding, Digestive Bleeding and also bruising can lead to this condition. The presence of this disease is indicated by symptoms like

• Weak pulse rate
• Vomiting
• Abdominal tenderness
• Nausea
• Constipation
• Fever

This is a very severe disease that needs to be treated and monitored in time. Delay in cure can put the life of the sufferers at risk. If not treated in time, death of sufferers may be unavoidable.

Can Pancreatitis Cause Cancer?

Chronic cases of this condition have been associated with cancer of the Pancreas. However, this condition has not been directly reported as a cause of Pancreatic Cancer. However, people with this condition in their family have been found to be at higher risk of suffering from this condition.

Hereditary Pancreatitis

This is a variation of Pancreatitis that is genetic in nature and affects production of enzymes in the pancreas. This condition is caused by the activation of the abnormal Trypsinogen that leads to the damage of the pancreas from within.

The symptoms of this disease are similar to that of Acute Pancreatitis which is marked by constipation, vomiting and acute abdominal pain. There is no known cure for this disease. However complications like malnutrition can be cured with the aid of Supplementary Pancreatic Enzymes.

In the United States, approximately 1000 individuals suffer from this condition on an annual basis.

Pancreatitis Diet

The diet of Pancreatitis patients should consist of low fat foods. Consumption of fatty foods can supply large amounts of fat to the bloodstream which triggers conditions such as Pancreatitis. Fat content should not be more than thirty percent of the total calorie intake of the body.

Breakfast can involve fruits, yoghurt and honey. Lunch can include cheese sandwiches while grilled fishes can be incorporated in the diet for dinner. A best diet for Pancreatitis should be a low carbohydrate plan.

Pancreatitis in Children

Acute types of this condition are relatively rare in children. Chronic variety of this disorder is even rarer. However, acute types of this disease usually result from a viral infection, abdominal injury or side effects of drugs. Classic symptoms of the condition include nausea, vomiting and abdominal pain. Fortunately, the condition resolves in a few days or weeks although treatment and hospital stay is required during this period.