Pancreatitis Definition

Pancreatitis is a disease in which pancreas becomes inflamed. It happens when digestive enzymes start digesting the pancreas itself.

Types of Pancreatitis

Pancreatitis can occur as two forms

a.     Acute pancreatitis:
It appears suddenly in upper abdomen and lasts a short time. it can be mild or severe

Symptoms

•     Fever

•     Nausea and vomiting

•     Fast heartbeat

•     Swollen or tender abdomen

b.     Chronic pancreatitis

It occurs over many years and may become worse after eating.

Symptoms

•     Diarrhea

•     Nausea

•     Greasy, foul-smelling stools

•     Vomiting

•     Weight loss

Pancreatitis Causes

Some conditions which may lead to pancreatitis include:

•     Gallstones

•     Cystic fibrosis

•     Some medications

•     Alcoholism

•     Abdominal surgery

•     Hypercalcemia

•     Pancreatic cancer

•     Hypertriglyceridemia

•     Infections

•     Obesity

Gallstones are the most common cause of acute pancreatitis and the most common cause of chronic pancreatitis is long-term alcohol abuse.

Pancreatitis Diagnosis

To diagnose pancreatitis doctors use:

•     Medical history

•     A physical exam

•     Lab and imaging tests

There are some tests to diagnose acute pancreatitis

•     Blood test to measure amylase and lipase

•     Pancreatic function test

•     CT scan and MRI

•     Biopsy

Pancreatitis Treatment

Primary care in the hospital may include

•     Fasting

•     Medications to provide comfort

•     Intravenous fluids

Depending on the cause of pancreatitis, treatment include

•     Procedures to remove bile duct obstructions: endoscopic retrograde cholangiopancreatography (ERCP)

•     Gallbladder surgery (cholecystectomy)

•     Pancreas surgery

•     Treatment for alcohol dependence (addiction to alcohol)

Some treatments for chronic pancreatitis

•     Enzymes to improve digestion

•     Changing diet

Diet Therapy in Pancreatitis

Initially, no nutrition is given to rest the pancreas and bowels during the first 24 to 48 hours. After 48 hours, a plan to provide nutrition should be implemented because acute pancreatitis is a highly active state of inflammation that requires a lot of calories to support the healing process. In most cases, patients can start to take in food on their own by 48 hours. If this is not possible, then a feeding tube can be used that is passed through the nose into the intestines to provide nutrition. This method is safer than providing nutrition intravenously. There is no benefit in using probiotics for acute pancreatitis.       When doctors allow a patient to eat again, they will recommend eating small meals frequently throughout the day.

Best foods to eat

•     Whole grains

•     Beans and lentils

•     Fruits

•     Vegetables

These foods are beneficial because of their fiber and also low in fat.

Avoid eating some foods such as

•     Fried foods and high-fat foods

•     Alcohol

•     Refined carbohydrates

•     Caffeine

•     gas-forming foods

•     Red meat

Pancreatic surgery

Because the pancreas is hard to reach, pancreatic surgery is challenging.

Pancreatic surgical procedures include:

•     Minimally Invasive Pancreatic Resections (laparoscopic)
  It allows the surgeon to access the abdomen via a number of small "keyhole" incisions. This type may use in patients with pancreatic cysts that require surgery.

•     Spleen-Preserving Pancreatectomy                    
  It is a technically demanding technique in which the blood supply to the spleen is carefully preserved so that it can be left behind, preserving the immunologic function of the spleen and reducing the risk of long-term infectious complications.

•     Enucleation of Pancreatic Tumors
  A subset of benign or low-grade pancreatic tumors can be safely enucleated rather than requiring more extensive surgical removal of a portion of the pancreas.

•     The "Whipple"
  This operation involves removal of the head of the pancreas, duodenum, bile duct, gallbladder, and sometimes a small portion of the stomach. The pancreas, stomach, and bile ducts are reattached to the bowel to allow normal digestion of food following recover.

Pancreas Transplant

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas into a person whose pancreas no longer can supply sufficient insulin to the body. It offers a potential cure for type 1 or insulin-dependent diabetes.

Types of Pancreas Transplants

1.      Simultaneous pancreas-kidney transplant (SPK)

2.      Pancreas-after-kidney transplant (PAK)

Diet therapy in Pancreas Transplants:

some diet recommendations

•     Eating at least five servings of fruits and vegetables each day

•     Having enough fiber in daily diet

•     Eating low-fat dairy products

•     Limiting salt and unhealthy fats

•     Avoiding grapefruit and grapefruit juice