Acute pancreatitis- What Patient & Relatives should know?

What is pancreatitis?

The pancreas is a tadpole-shaped organ located behind the stomach and below the ribcage. It has two important functions:

• It produces digestive juices that are used by the intestines to help digest food.
• It produces chemicals called hormones including insulin, which regulates the levels of sugar in the blood.

Acute pancreatitis is a serious condition where the pancreas becomes inflamed. Acute pancreatitis can either be:

• Mild – which accounts for four out of five cases where the inflamed pancreas usually improves within three to five days. However, mild acute pancreatitis will still make you feel very ill. It is termed ‘mild’ because the person recovers without any complications.
• Severe – which accounts for the remaining one in five cases. The inside of the pancreas is severely in inflamed which can trigger two life-threatening complications – inflammation can spread throughout the body or the tissues of the pancreas begin to die and become infected which can cause a life- threatening infection to spread throughout the body.

Risk factors

• Alcohol consumption – there is a definite link between alcohol use and acute pancreatitis, and the more alcohol you drink, the higher your risk.
• Gallstones – sometimes a gallstone can move out of the gallbladder and block the openings (ducts) to the pancreas. It is thought that the blockage causes a disruption in the chemical reactions that occur within the pancreas leading to acute pancreatitis.
• Being 70 years of age or over.
• Being obese – a person is considered obese if they have a body mass index (BMI) of 30 or above.
• Smoking.
  Signs and symptoms
• Upper abdominal pain radiating to the back
• Nausea and vomiting
• Diarrhoea
• Loss of appetite
• A high fever
• Yellowing of the skin and the whites of the eyes (jaundice) – a less common symptom.

Treatment

You will not be able to eat until the inflammation inside your pancreas has settled down, which usually takes around five days. This is because trying to digest solid food could place too much strain on your pancreas. You will therefore be given intravenous fluids via a drip and because pancreatitis can damage your lungs you may be given oxygen to breathe. The pain associated with even mild cases of acute pancreatitis can be severe, so you may require quite strong painkillers which may make you feel very drowsy. If your pancreatitis is severe you may require care in a high dependency or intensive care setting.

If the pancreatitis is shown to be caused by a gallstone, surgical removal of the gallbladder will usually be recommended. This may be done while you are in hospital or, alternatively, the surgery may be planned for a number of weeks in the future. You may be given a procedure called an ERCP in the meantime to remove any gallstones that are causing the pancreatitis.

All patients who have had acute pancreatitis should avoid alcohol completely for at least six months, whatever the cause of the pancreatitis. This is because alcohol can cause further damage to the pancreas during the recovery period.

Prevention

Alcohol misuse and gallstones are the two main causes of acute pancreatitis. The risk can be reduced by making changes to your diet and lifestyle.

Limiting the amount of alcohol that you drink can help prevent your pancreas being damaged and can lower your risk of developing acute pancreatitis.

The recommendations are that men should not drink more than three to four units of alcohol a day and women should not drink more than two to three units a day. You should have at least 2 or 3 alcohol free days each week. A unit of alcohol is equal to about half a pint of normal strength lager, a small glass of wine or a pub measure (25ml) of spirits.

The most effective way to prevent gallstones is to eat a healthy, low-fat diet that includes plenty of fresh fruit and vegetables (at least have portions a day). Your diet should also include whole grains, which are found in whole meal bread, brown rice and oats. Being overweight increases the amount of cholesterol in your bile and your chances of developing gallstones. Maintain a healthy weight by eating a balanced diet and taking plenty of regular exercise.