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  Pancreatitis  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations

 

Pancreatitis means an inflammation of the pancreas. The pancreas is a large gland behind the stomach. It secretes insulin, which is of fundamental importance in the handling of glucose. If the pancreas is not functioning properly, diabetes may develop.

Another function of the pancreas is to secrete digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. In pancreatitis, the enzymes that help digest fats, proteins and carbohydrates in food become active inside the pancreas and start digesting the pancreas.
There are two main types of pancreatitis: acute and chronic. Acute pancreatitis occurs suddenly and lasts for a short period of time. It usually resolves. Some people with acute pancreatitis may have more than one attack and recover completely after each. However, acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year. About 20% of the cases are severe.

Chronic pancreatitis occurs over a long period of time and does not resolve itself. Chronic pancreatitis results in a slow destruction of the pancreas. The usual cause of chronic pancreatitis is many years of alcohol abuse, but the chronic form may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged. The result of chronic pancreatitis is an inability to properly digest fat caused by a lack of pancreatic enzymes. The production of insulin is also affected.

Acute pancreatitis is usually caused by drinking too much alcohol or by gallstones. A gallstone can block the pancreatic duct, trapping digestive enzymes in the pancreas and causing pancreatitis.

Chronic pancreatitis occurs when digestive enzymes attack and destroy the pancreas and nearby tissues. Chronic pancreatitis is usually caused by many years of alcohol abuse, excess iron in the blood, and other unknown factors. However, it may also be triggered by only one acute attack, especially if the pancreatic ducts are damaged.

Treatment depends on how bad the attack is. If no complications such as kidney failure or lung problems occur, acute pancreatitis usually improves on its own.
 

 
 

Signs, symptoms & indicators of Pancreatitis:
 
 
Lab Values - Common  Rapid pulse rate

Symptoms - Bowel Movements

  Pale stools

Symptoms - Gas-Int - General

  Unexplained vomiting
  Unexplained nausea
  Epigastric pain
 The symptoms of acute pancreatitis usually begin with severe pain in the upper abdomen.

Symptoms - Metabolic

  Frequent/occasional unexplained fevers
  (Occasional) daytime sweating
  Having a high/having a moderate/having a slight fever

Symptoms - Skin - General

  (Possibly) jaundiced skin
 Jaundice may be due to blockage of the bile duct from an inflamed pancreas.

Symptoms - Urinary

  Dark urine color
 
 

Conditions that suggest Pancreatitis:
 
 
Circulation  Congestive Heart Failure
  Hypotension

Digestion

  Steatorrhea / Fat Malabsorption
 In chronic pancreatitis, episodes of acute pancreatitis recur until the pain becomes persistent and severe. The pain is brought on by eating, so that sufferers often avoid food and may lose much weight. Eventually, symptoms develop that are related to the failure of normal pancreatic function. Steatorrhoea are bowel motions that are pale, loose, fatty, and offensive, caused by the lack of lipase with subsequent malabsorption of fat.

Organ Health

  Kidney Failure
  Diabetes Type II
 
 

Risk factors for Pancreatitis:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 A few preliminary reports suggest that food allergy may cause some cases of acute pancreatitis.

Environment / Toxicity

  Cigarette Smoke Damage
 Smoking appears to be associated with an increased risk of acute and chronic pancreatitis, according to a report in the March 23, 2009 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, the risk of developing the disease may be higher in those who smoke more.

Hormones

  Hyperparathyroidism

Lab Values

  Elevated Triglycerides
 If the initial level of fasting triglycerides is 500mg/dL or higher, the initial focus is on triglyceride lowering to prevent pancreatitis because it can be a life-threatening condition.

Lab Values - Chemistries

  Hypocalcemia

Metabolic

  Hemochromatosis (Iron overload)
 Chronic pancreatitis is usually caused by many years of alcohol abuse, but can also be caused by excess iron in the blood.

Symptoms - Food - Beverages

  Moderate/high alcohol consumption
 The most common cause of pancreatitis is long term excess alcohol consumption.
 
 

Pancreatitis suggests the following may be present:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 A few preliminary reports suggest that food allergy may cause some cases of acute pancreatitis.

Infections

  Dysbiosis, Bacterial
 Supplementation with a specific Lactobacillus strain prevented the development of serious complications in people with acute pancreatitis. The group treated with live Lactobacilli had an 85% reduction in the number of pancreatic infections severe enough to require surgery. In addition, the average duration of hospital stay was 36% lower in the treated group than in the placebo group.

Normal intestinal bacteria rapidly disappear in cases of acute pancreatitis and are replaced by potentially disease-causing organisms. Beneficial bacteria can compete with the disease-causing organisms, thereby preventing them from gaining a foothold in the intestines and infecting the inflamed pancreas.

Different probiotic strains have different effects in the body. Therefore, one cannot assume that other commonly used probiotics (such as Lactobacillus acidophilus or Lactobacillus GG) would have the same beneficial actions as Lactobacillus plantarum 299, used in this study. Supplementing with the appropriate probiotic strain may not be enough, as probiotic organisms must be also supplied with the food they need to thrive. Oat fiber was used in this study. [Br J Surg 2002;89: pp.1103–7]
 
 

Pancreatitis can lead to:
 
 
Nutrients  Antioxidant Need/Oxidative Stress w/ Supplements
 Evidence suggests that acute and chronic pancreatitis is due to free radical pathology and that antioxidants may be of benefit in reducing its incidence and proliferation.

Thirty-five individuals with chronic pancreatitis, compared to 14 healthy controls, were evaluated for antioxidant status. Hemoglobin, vitamin E, vitamin A, selenium and plasma glutathione peroxidase were significantly lower in patients than in controls. White blood cell count, C-reactive protein and plasma copper levels were significantly higher in patients than in controls. Vitamin E was lower in patients with steatorrhea, while vitamin A was lower in individuals with diabetes mellitus. Even though their intake of the antioxidants selenium and vitamin E were adequate, many alcohol-related chronic pancreatitis patients have low levels of many antioxidants. This may be due to increased requirements due
to oxidative stress. [Digestive Diseases and Sciences, June, 1996;41(6): pp.1225-1231]

  Antioxidant Need/Oxidative Stress w/o Supplements
 Evidence suggests that acute and chronic pancreatitis is due to free radical pathology and that antioxidants may be of benefit in reducing its incidence and proliferation.

Thirty-five individuals with chronic pancreatitis, compared to 14 healthy controls, were evaluated for antioxidant status. Hemoglobin, vitamin E, vitamin A, selenium and plasma glutathione peroxidase were significantly lower in patients than in controls. White blood cell count, C-reactive protein and plasma copper levels were significantly higher in patients than in controls. Vitamin E was lower in patients with steatorrhea, while vitamin A was lower in individuals with diabetes mellitus. Even though their intake of the antioxidants selenium and vitamin E were adequate, many alcohol-related chronic pancreatitis patients have low levels of many antioxidants. This may be due to increased requirements due
to oxidative stress. [Digestive Diseases and Sciences, June, 1996;41(6): pp.1225-1231]

Organ Health

  Diabetes Type II

Risks

  Increased Risk of Pancreatic Cancer
 Long-term pancreatitis has been linked to an increased risk of pancreatic cancer. The reason for this association is not clear, but it is strongest in patients with inherited chronic pancreatitis.
 
 

Recommendations for Pancreatitis:
 
 
Animal-based  Probiotics / Fermented Foods
 See the link between Pancreatitis and Dysbiosis, Bacterial.

February 18, 2008 — In patients with predicted severe acute pancreatitis, probiotic prophylaxis did not reduce the risk for infectious complications and was associated with an increased risk for mortality, according to the results of a multicenter, randomized, double-blind, placebo-controlled trial reported in the February 14 Online First issue of The Lancet.

The researchers conclude from these findings that prophylaxis with this combination of probiotic strains should not be administered in this category of patients as it did not reduce the risk of infectious complications and was associated with an increased risk of mortality.

This study does not negate the potential benefit of a specific probiotic discussed in the link mentioned at the top of this comment. The combination probiotic used in the Lancet study contained different Lactobaccilus strains and other species.

Botanical

  Chlorella / Algae Products

Diet

  Alcohol Avoidance
  Therapeutic Fasting
 In one 1988 trial of 88 people with acute pancreatitis, fasting was found better than any other medical intervention. Neither nasogastric suction or cimetidine were found to produce as beneficial effects as those from fasting.

Drug

  Conventional Drugs / Information
 In one study on acute pancreatitis, PTX (Pentoxifylline) was shown to reduce pancreatic inflammation and attenuate the depletion of pancreatic glutathione. PTX also inhibited the expected increase in TNF-a levels and prevented mitochondrial damage. Mitochondria are the power plants within all of our cells. The scientists suggested that PTX be considered as an adjuvant treatment of acute pancreatitis. [Gomez-Cambronero et al. 2000]
 
 


KEY
Weak or unproven link
Strong or generally accepted link
May do some good
Highly recommended







GLOSSARY

Acidophilus:  A microflora (good bacteria) that acts as a digestive aid and lives in your intestines helping your body fight disease.

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Antioxidant:  A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.

Bacteria:  Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Bile:  A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Carbohydrates:  The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Chronic Renal Failure:  (CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.

Copper:  An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Free Radical:  A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.

Gallstone:  (Biliary Calculus): Stone-like objects in either the gallbladder or bile ducts, composed mainly of cholesterol and occasionally mixed with calcium. Most gallstones do not cause problems until they become larger or they begin obstructing bile ducts, at which point gallbladder "attacks" begin to occur. Symptoms usually occur after a fatty meal and at night. The following are the most common ones: steady, severe pain in the middle-upper abdomen or below the ribs on the right; pain in the back between the shoulder blades; pain under the right shoulder; nausea; vomiting; fever; chills; jaundice; abdominal bloating; intolerance of fatty foods; belching or gas; indigestion.

Glucose:  A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.

Glutathione Peroxidase:  A family of antioxidant enzymes containing selenium which are important in the reduction of different hydroperoxides, including hydrogen peroxide which is involved in the irritation of the gastrointestinal tract and increase in perspiration.

Hemoglobin:  The oxygen-carrying protein of the blood found in red blood cells.

Insulin:  A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Iron:  An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.

Jaundice:  Yellow discoloration of the skin, whites of the eyes and excreta as a result of an excess of the pigment bilirubin in the bloodstream.

Lipase:  An enzyme secreted by the pancreas to assist in fat breakdown.

Milligram:  (mg): 1/1,000 of a gram by weight.

Pancreatitis:  Inflammation of the pancreas. Symptoms begin as those of acute pancreatitis: a gradual or sudden severe pain in the center part of the upper abdomen goes through to the back, perhaps becoming worse when eating and building to a persistent pain; nausea and vomiting; fever; jaundice (yellowing of the skin); shock; weight loss; symptoms of diabetes mellitus. Chronic pancreatitis occurs when the symptoms of acute pancreatitis continue to recur.

Placebo:  A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.

Probiotic:  Derived from the Greek word for "life." Probiotic refers to organisms and substances which contribute to intestinal microbial balance. They are beneficial or "friendly" intestinal bacteria.

Protein:  Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Selenium:  An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.

Stomach:  A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Triglyceride:  The main form of fat found in foods and the human body. Containing three fatty acids and one unit of glycerol, triglycerides are stored in adipose cells in the body, which, when broken down, release fatty acids into the blood. Triglycerides are fat storage molecules and are the major lipid component of the diet.

Vitamin A:  A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.

Vitamin E:  An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.

White Blood Cell:  (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.