Pancreatitis

Overview

The pancreas is a very important organ located in the upper abdomen, behind the stomach. It is the organ that produces insulin, which is an important hormone. The shortage of insulin leads to diabetes. The pancreas also produces digestive enzymes which are then secreted into the small intestine to digest the food that we eat, so that our intestine can absorb the nutrients.

Pancreatitis refers to the inflammation of the pancreas. This can either be acute or chronic.

Symptoms

Acute Pancreatitis Is the sudden inflammation of the pancreas. This condition is characterized by

sudden severe upper abdominal pain. This pain may radiate to the back and may last for several days. The person may find that the pain is relieved by leaning forward or sitting up. Along with this acute intense pain, the person may also experience some of the following symptoms:

  • Nausea
  • Vomiting
  • Abdominal distention
  • Fever
  • Jaundice, which is the yellowing of the skin

Chronic Pancreatitis is characterized by recurrent attacks of upper abdominal pain and back pain. This is the hallmark of this condition. The pain is not sudden in nature but is ongoing. The person may find that eating food can trigger or worsen the pain.

The person may also experience nausea and vomiting.

Due to the poor appetite and malabsorption of nutrients, because of reduced production of digestive enzymes, this person may suffer from malnutrition.

With gradual destruction of the pancreas, this person may develop diabetes mellitus.

Common symptoms of diabetes are:

  • Feeling thirsty all the time
  • Keep having the need to pass urine
  • Feeling tired all the time
  • Unexplained weight loss

When to Seek Treatment

In pancreatitis, the pain will be so intense that the person will seek urgent medical attention, usually at the Accident and Emergency Department of a hospital.

Diagnosis

The diagnosis of acute pancreatitis is confirmed through a blood test. The doctor will check the amylase level as well as the lipase level. In acute pancreatitis, the amylase level and the lipase level will be raised.

Scans like CT scan will also show the pancreas to be swollen in acute pancreatitis.

For chronic pancreatitis, because of recurrent acute attacks of inflammation, the blood tests may be normal, as the pancreas becomes increasingly damaged and slowly loses its functions. CT scan may show a shrunken pancreas. The pancreas may also have calcification within it.

Treatment

Acute pancreatitis is an emergency. Whilst most people with acute pancreatitis recover by themselves, about 20% of acute pancreatitis can go down a severe course and may lead to multi-organ failure and even death.

Treatment therefore is to resuscitate and support the person until the attack resolves. If the person is very ill, ICU care may be needed.

Once the person is better, the focus then turns to finding out the underlying cause of the acute pancreatitis.

Definitive treatment of the underlying cause is important to prevent another attack of acute pancreatitis and to prevent the progression to chronic pancreatitis.

Causes

The 2 most common causes of acute pancreatitis are:

  • Gallstones
  • Alcohol

If it is due to gallstones, we will advise the person to consider removing the gallbladder.

If it is due to alcohol, the person should consider cutting down or stopping alcohol drinking altogether.

Other less frequent causes are:

  • Drugs
  • Viral infection
  • High fat level in blood (hypertriglyceridemia)
  • High calcium level in blood (hypercalcemia)
  • Autoimmune disorders

Risk Factors

Nil

Consult Our Doctors

Dr Ho Choon Kiat
Senior Consultant HepatoBiliary, Pancreas & General Surgeon

MBBS (Singapore), FRCS (Edin), FRCS (Glasg), M.Med (Surgery), FRCSEd (Gen), FAMS (Surgery) Adjunct Assistant Professor, NUS Yong Loo Lin School of Medicine

Dr Chan Chung Yip
HepatoBiliary, Pancreas & General Surgeon

MBBS, MMed(Surg), FRCS(Edin), MD, FAMS

Consult Our Doctor

Dr Ho Choon Kiat
Senior Consultant HepatoBiliary, Pancreas & General Surgeon

MBBS (Singapore), FRCS (Edin), FRCS (Glasg), M.Med (Surgery), FRCSEd (Gen), FAMS (Surgery) Adjunct Assistant Professor, NUS Yong Loo Lin School of Medicine

FAQs

Avoiding standing still for long periods will reduce the pressure in the veins in the legs. For people who need to stand for long periods at work, wearing compression stockings will reduce the pressure build up in the legs.

The ultrasound will be done of the legs from the thigh to the calves. Please wear or bring along a pair of shorts to change into for the scan.

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