Pancreatitis Explained
(SYMPTOMS, CAUSES,
GALLSTONES)

The pancreas is a large
gland located behind the stomach and next to the duodenum (the first
section of the small intestine). The pancreas has two primary
functions:
1. To secrete powerful digestive enzymes into the small
intestine to aid the digestion of carbohydrates, proteins, and fat.
2. To release the hormones insulin and glucagon into the
bloodstream. These hormones are involved in blood glucose
metabolism, regulating how the body stores and uses food for energy.
Pancreatitis is a disease in which the pancreas becomes inflamed.
Pancreatic damage occurs when the digestive enzymes are activated
before they are secreted into the duodenum and begin attacking the
pancreas. There are two forms of pancreatitis: acute and chronic.
Acute pancreatitis- Acute pancreatitis is a sudden
inflammation that occurs over a short period of time. In the
majority of cases, acute pancreatitis is caused by gallstones or
heavy alcohol use. Other causes include medications, infections,
trauma, metabolic disorders, and surgery. In about 10% to 15% of
people with acute pancreatitis, the cause is unknown.
The severity of acute pancreatitis may range from mild abdominal
discomfort to a severe, life-threatening illness. However, the
majority of people with acute pancreatitis (more than 80%) recover
completely after receiving the appropriate treatment. In very severe
cases, acute pancreatitis can result in bleeding into the gland,
serious tissue damage, infection, and cyst formation. Severe
pancreatitis can also cause damage if enzymes and toxins are
released into the bloodstream, which can harm other vital organs
such as the heart, lungs, and kidneys.
Chronic pancreatitis- Chronic pancreatitis occurs most
commonly after an episode of acute pancreatitis and is the result of
ongoing inflammation of the pancreas. In more than 70% of the cases,
chronic pancreatitis is caused by prolonged alcohol use. Other, less
common causes include metabolic disorders. Very rarely, patients
have chronic pancreatitis that tends to run in families (hereditary
pancreatitis). Damage to the pancreas from excessive alcohol use may
not cause symptoms for many years, but then the person may suddenly
develop severe pancreatitis symptoms, including severe pain and loss
of pancreatic function, resulting in digestion and blood sugar
abnormalities.
What Are the Symptoms of ‘Acute’ pancreatitis?
Upper abdominal pain (that travels to the back. Patients may
describe this as a "boring sensation" that may be aggravated by
eating foods high in fat.)
Swollen and tender abdomen.
Nausea and vomiting.
Fever .
Increased heart rate.
What Are the Symptoms of ‘Chronic’ pancreatitis?
The symptoms of chronic
pancreatitis are similar to those of acute pancreatitis. Patients
frequently experience constant pain in the upper abdomen that
radiates to the back. In some patients, the pain may be disabling.
Other symptoms may include weight loss caused by poor absorption (malabsorption)
of food. This malabsorption occurs because the gland is not
secreting enough enzymes to break down the food normally. Also,
diabetes may develop if the insulin-producing cells of the pancreas
become damaged.
What Causes Pancreatitis?
In the majority of
cases, gallstones and alcohol ingestion primarily cause acute
pancreatitis. Other causes include medications, lipid (triglyceride)
disorders, infections, surgery or trauma to the abdomen. In about
10% to 15% of people with pancreatitis, the cause is unknown. In
more than 70% of people with chronic pancreatitis, the condition is
caused by prolonged alcohol drinking, resulting in pancreatic damage
and scarring. In other cases of chronic pancreatitis, the cause may
be metabolic, hereditary, or simply unknown.
Who Is at Risk for Pancreatitis? Pancreatitis can happen to anyone;
however, it is more common in people with certain risk factors. Risk
factors of acute pancreatitis include:
Gallstone disease
Heavy alcohol consumption
Acute pancreatitis maybe the first sign of gallstone disease. The
link between gallstones and acute pancreatitis is the anatomical
union of the ducts that drain the gallbladder and pancreas, called
the ampulla, or major papilla of the duodenum. The passage of
gallstones from the gallbladder can become blocked at the ampulla,
causing an obstruction of the pancreatic duct and then acute
pancreatitis. (www.my.webmd.com/content/article/103/107181.htm)
THE GALLBLADDER

GALLSTONES
The sole function of
the gallbladder is to store bile, which is produced in the liver and
aids in the digestion of fats in the small intestine. The
gallbladder has become a prime target for surgical intervention; in
fact, this is the most common type of major surgery. Sometimes it's
done to reduce pain, some-times to remove gallstones. Approximately
80% of all gallstones show no symptoms and may remain "silent" for
years affecting millions. Once symptoms arise, they persist and
increase in frequency. The most common triggers for gallbladder
attacks are: caffeine, chocolate, eggs, dairy products and greasy or
deep fried foods. Symptoms may include right upper quadrant
abdominal discomfort or sharp pain, gas or fullness after a heavy
meal. The pain can also spread to the chest, shoulder, neck or back.
In addition to these symptoms, stones expelled from the gallbladder
during contraction may become lodged within the bile duct
leading to infection of the bile duct or gallbladder.

GALLSTONES
Gallstones are also among the most painful. Gallbladder attacks are
caused by an inflamed gallbladder going into spasms when a stone
hits the sensitive inner lining of the gallbladder. The pain can
last for days. Gallstones are also extremely dangerous. If left
untreated, they can lead to potentially fatal complications such as
ruptured gallbladder, liver failure and pancreatitis (inflammation
of the pancreas). Each year, thousands of people die from conditions
brought on by untreated gallstones, and thousands more undergo risky
surgery to remove their gallbladder.
Gallstones are not just a problem of the gallbladder - they're also
a problem of the liver. New research on gallstones has revealed
they're formed by a combination of poor liver function and
incomplete gallbladder contractions. Your liver produces digestive
fluid called bile. This fluid is stored in the gallbladder and
breaks down dietary fat. When we eat foods that contain fats, the
gallbladder contracts completely, releasing the bile into the small
intestine. Because the liver also acts as the blood's main filter,
it is exposed to many toxins. These toxins take their toll on the
liver and weaken it. Instead of producing free flowing bile, the
liver produces thick, sticky bile- Gallstones form when this bile
builds up in the gallbladder. Usually, the gallbladder fully
contracts and empties out bile. However, many people have
gallbladders that, for one reason or another, only partly contract.
These partial contractions leave behind bile sludge in the
gallbladder, which eventually hardens to form gallstones.
By the time you feel a gallstone, it is probably too late to wait
for it to pass- as it’s already too large to move safely through the
bile ducts. If it tries to pass through, it could become stuck,
which will block the flow of bile and lead to tissue and organ
damage. (Caution: If a stone is forced out of the gall-bladder
(naturally by contractions or with a flush) without first being
dissolved it can get lodged and damage organs in the digestive
system.)
If the stone gets lodged while leaving the gallbladder, it causes
inflammation of the gallbladder or cholecystitis, leading to severe
abdominal pain and requiring the surgical removal of the
gallbladder.
If the stone passes completely out of the gallbladder area and gets
stuck in the bile duct, it causes cholangitis or inflammation of the
bile duct walls. This inflammation narrows the bile duct walls,
causing bile to back up until it damages the liver. Cirrhosis of the
liver is a potentially fatal complication of this condition.
If the stone travels down the bile duct, it can get caught in the
passageway leading to the pancreas, inflaming the pancreas in a
condition known as pancreatitis. When pancreatitis occurs, digestive
enzymes produced by the pancreas become active in the pancreas and
actually digest the pancreas itself.


Gallstones
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