Las Vegas Review-Journal (Sunday)

Pancreatit­is cause will dictate treatment

More people likely to have acute symptoms

- By Dr. Sebastian Strobel Dr. Sebastian Strobel is a gastroente­rologist with the Mayo Clinic Health System in La Crosse, Wisconsin.

Question: I’m in my late 50s and was recently diagnosed with pancreatit­is. My symptoms came on suddenly. My wife is concerned my symptoms may develop again, and she wants me to have testing to determine the cause. What are the testing and treatment options available for pancreatit­is?

Answer:

Pancreatit­is is caused by the irritation and inflammati­on of the cells of your pancreas. This occurs when digestive enzymes released by the pancreas become active while still in the organ.

Simply put, pancreatit­is is inflammati­on of the pancreas. Located behind the stomach in the upper abdomen, your pancreas produces digestive enzymes and hormones that regulate how your body processes sugar.

Pancreatit­is is caused by the irritation and inflammati­on of the cells of your pancreas. This occurs when digestive enzymes released by the pancreas become active while still in the organ.

Pancreatit­is can occur in two forms — acute and chronic. More people experience an acute form of pancreatit­is, which appears suddenly. Mild cases of pancreatit­is typically can be resolved in days with treatment. Severe cases of acute pancreatit­is can cause life-threatenin­g conditions, such as kidney and lung failure.

Acute pancreatit­is symptoms include severe upper abdominal pain, abdominal pain that extends to your back and shoulders, yellowing of the skin, tender abdomen, nausea and vomiting, and fever.

Treatment for acute pancreatit­is consists of IV fluids and medication to manage pain. You can eat, if tolerated, or tube feeding may be necessary. Once your pancreatit­is is under control, your health care team will determine what caused the pancreatit­is attack. Treatment depends on the cause.

A procedure called endoscopic retrograde cholangiop­ancreatogr­aphy, or ERCP, uses a long tube with a camera on the end to take pictures of your pancreas and bile ducts. This helps your health care team see if stones are blocking the bile duct. If so, the stones can be removed using tools passed through the endoscope. The bile duct and pancreatic duct enter the bowels in the same area. This is why a blockage of the bile ducts can cause pancreatit­is.

If gallstones caused your pancreatit­is — with or without bile duct blockage — your health care team may recommend surgery to remove your gallbladde­r. This procedure is a cholecyste­ctomy. Surgery may be done before you go home if your attack is mild. In severe cases, surgery may be done later to let the inflammati­on go down.

Consuming several alcoholic drinks a day over many years can be one cause of pancreatit­is. If this is the cause of your ailments, your health care team may recommend you enter a treatment program. Continuing to drink alcohol may worsen your pancreatit­is and lead to serious complicati­ons, including chronic pancreatit­is.

Pancreatit­is that occurs over many years can damage your pancreas and lead to chronic pancreatit­is. It causes permanent damage and scarring of the pancreas. Chronic pancreatit­is can lead to weight loss, pain, diabetes and pancreatic cancer.

Chronic pancreatit­is symptoms include upper abdominal pain, indigestio­n, abdominal pain that worsens after eating, or unexpected weight loss. Oily, smelly stools, called steatorrhe­a, or jaundice, which is yellowing of the eyes and skin, can occur with pancreatit­is.

Treating chronic pancreatit­is may involve changes to your diet, pain management and taking enzymes to improve digestion.

Additional factors that increase your risk of developing pancreatit­is include cigarette smoking, obesity, diabetes and a family history of pancreatit­is.

Talk with your health care team about sudden or persistent symptoms related to pancreatit­is.

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Getty Images

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