Pancreas is a gland present behind stomach. It secretes digestive juices, and the hormones insulin and glucagon. Inflammation of pancreas is called pancreatitis. It occurs in two forms: acute and chronic. Acute pancreatitis patient presents with sudden and severe abdominal pain in upper left or mid-abdominal region.
Nausea and vomiting are also present. Chronic pancreatitis on the other hand is a long-standing disease characterized by chronic abdominal pain, weight loss due to malabsorption, and diabetes due to destruction of pancreatic tissue. However, it may also present with acute attacks in between.
Analgesics like morphine or pethidine are needed for pain relief. You may need to be hospitalized for giving fluids through a vein (IV fluids) to correct fluid deficits. Intake of food and fluids through mouth is stopped so as to give rest to pancreas. This is followed by nutritional support. Intravenous antibiotics may be necessary in case of infection. Heparin is given to prevent blood clots.
If your case is severe, then admission into intensive care unit is necessary. Catheters are inserted to monitor blood and urine. Oxygen therapy is given if your oxygen levels are low. Ventilatory support is mandatory if you develop respiratory distress. Insulin is administered if the blood sugar levels are high.
If calcium level is low, with symptoms like spasms of hand, then intravenous calcium injections are given. If intestinal obstruction occurs, as evidenced by abdominal distention and constipation, then a tube is inserted into stomach and its contents are aspirated. The tube may need to be left in place for a couple of days to a couple of weeks. If that does not clear up the obstruction then surgery is necessary.
If fluid has collected around the pancreas it is drained. Any blockages in pancreatic duct are cleared. If you have jaundice due to gallstones (stones in gall bladder), then you need to undergo surgery for their removal. Any infected or dead pancreatic tissue is removed.
It needs to be noted that death occurs in about 10 to 15% of the cases despite the best treatment given for acute pancreatitis, usually due to multiple organ failure or infection of dead pancreatic tissue. If one survives, then one needs to avoid fatty foods, smoking and alcohol after recovery.
Acute attacks are treated as above. Since alcohol consumption is a major cause of pancreatitis, avoidance of alcohol is critical to halt the progression of the disease. You may need counseling and psychiatric intervention to help you abstain from alcohol. Analgesics should be taken for pain relief.
IV fluids are essential. Pancreas should be given rest by curtailing oral intake of food. Pancreatic enzyme supplements, taken with meals, are an aid to digestion. If pain persists despite these measures, then endoscopic or surgical therapy is necessary to blockade or excise certain nerve plexuses. Sometimes total pancreatectomy (removal of pancreas) is needed, but this causes diabetes.
Take a diet low in fat since the pancreatic enzymes are deficient. Eating small but frequent meals helps with digestion problems. You may need to take vitamin supplements because their absorption is impaired in pancreatitis, particularly fat-soluble vitamins A, D, E and K.
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