Pancreatitis: tipos, síntomas, causas, prevención y tratamiento

The pancreas is an organ located between your stomach and spine. The primary capabilities of your pancreas are:

• Releasing strong digestivo enzymes into your small intestine
• Hace que la sangre libere glucagón e insulina. El cuerpo utiliza estas hormonas para regular el modo en que utiliza los alimentos como combustible.

Digestion enzymes that begin to function earlier than your pancreas releases them might cause damage to your pancreas. When this organ gets inflamed, it doesn't work right. This leads to many health problems.

Pancreatitis refers to the medical condition leading to the swelling of the pancreas. It can develop from a minor sore to a severe, even fatal ailment. You may experience back pain in addition to stomach pain if you have pancreatitis.

Tipos de pancreatitis

There are two types of pancreatitis: Acute and Chronic.

• Acute Pancreatitis: Acute pancreatitis is marked by an abrupt onset of swelling. It can be caused by your gall bladder stones, drinking too much alcohol, some drugs, sickness or trauma. The signs like extreme stomach discomfort, feeling sick and throwing up can show quickly and strongly. Quick medical help is very important to manage acute pancreatitis and avoid complications. When given the right care, most people who have it get cured. In really bad cases of acute pancreatitis, it can lead to bleeding, excessive damage to the body's tissue, infection, and cysts. Severe pancreatitis can also harm the heart, lungs, and riñones, besides affecting the pancreas.
• Chronic Pancreatitis: In contrast, chronic pancreatitis is a long-term condition marked by ongoing inflammation that damages the pancreas. This form of pancreatitis often develops gradually and is linked to long-term alcohol abuse, cystic fibrosis, certain genetic factors, or repeated episodes of acute pancreatitis. Chronic pancreatitis leads to irreversible damage to the pancreas, affecting its ability to function properly over time. The pancreas' tissues become scarred (fibrosis) as a result of ongoing inflammation, preventing the organ from producing hormones and enzymes.

Síntomas de Pancreatitis

The most common symptom of either acute or chronic pancreatitis is discomfort in the middle left upper abdomen. On diagnostic imaging scans, some patients with chronic pancreatitis may show signs of inflammation; nevertheless, they may not exhibit any other symptoms.

• Síntomas de pancreatitis aguda:
  • Dolor abdominal superior intenso y repentino que puede irradiarse a la espalda.
  • Náuseas, vómitos y dolor abdominal.
  • Pulso rápido y fiebre.
  • Abdomen hinchado o sensible
• Síntomas de pancreatitis crónica:
  • Constant, dull stomach discomfort
  • La pérdida de peso and malnutrition due to poor digestion and nutrient absorption
  • Oily, smelly stools resulting from the body's inability to properly digest fats
  • Diabetes debido al daño a las células productoras de insulina en el páncreas.

¿Cuándo ver a un médico?

Seek emergency medical assistance if you experience chronic stomach discomfort, particularly if it's severe or accompanied by other symptoms like nausea, vomiting, or fever. Early identification and treatment are essential to avoid complications and properly manage the illness.

What Causes Pancreatitis?

Muchas de las causas de la pancreatitis aguda y crónica son similares. Entre ellas se encuentran:

• La causa más frecuente de pancreatitis aguda son los cálculos biliares. La bilis, un líquido que ayuda a la digestión, puede solidificarse y formar pequeños bultos conocidos como cálculos biliares.
• El consumo excesivo de alcohol a lo largo del tiempo puede provocar pancreatitis crónica.
• El consumo de tabaco.
• Ciertas condiciones genéticas o antecedentes familiares.
• Elevated blood levels of triglycerides or fat particles.
• Infecciones como la salmonela, la hepatitis A o B o las paperas.
• The pancreas' congenital anomalies.
• Algunos medicamentos, como ciertos antibióticos o inmunosupresores, pueden desencadenar pancreatitis. 

Pancreatitis Risk Factors

Existen varios factores de riesgo que aumentan la probabilidad de desarrollar pancreatitis:

• An individual's susceptibility to pancreatitis can be genetic.
• La obesidad y el exceso de peso aumentan las posibilidades de padecer pancreatitis.
• La pancreatitis es más probable en aquellos que tienen diabetes.
• Medical pancreatitis predisposition may be extended with the aid of conditions such as cystic fibrosis or excessive triglyceride ranges.
• Los fumadores tienen aproximadamente tres veces más probabilidades que los no fumadores de desarrollar pancreatitis crónica. Dejar de fumar también podría reducir el riesgo.
• El consumo excesivo de alcohol también puede provocar pancreatitis persistente, un trastorno que se ha relacionado con un mayor riesgo de cáncer de páncreas.
• La pancreatitis crónica se ha relacionado con muchos genes, en particular cuando se combina con otros factores de riesgo. Los antecedentes familiares de la infección se asocian con un mayor riesgo.

Complicaciones de la pancreatitis

Si no se trata o se controla mal, la pancreatitis puede provocar complicaciones graves:

• Kidney failure: Acute pancreatitis may compromise the kidneys' ability to filter waste from the blood.
• Breathing problems: Acute pancreatitis can alter lung function, leading to dangerously low blood oxygen levels.
• Pancreatic Pseudocysts: A pseudocyst is a "pocket" within the pancreas where fluid and particles can accumulate due to both acute and chronic pancreatitis. Ruptures of large pseudocysts can result in complications, such as infection and internal bleeding.
• Infections: Acute pancreatitis may increase the pancreas's susceptibility to infections. Serious pancreatic infections require aggressive treatments, including surgery or other methods to remove infected tissue.
• Diabetes: Diabetic conditions can arise from damage to the cells that produce insulin.
• Malnutrition: Impaired digestion and nutrient absorption can lead to malnutrition.
• Pancreatic cancer: Pancreatic cancer is a risk factor for persistent pancreas infection.

¿Cómo se diagnostica la pancreatitis?

Diagnosing pancreatitis involves a series of tests and examinations to confirm this condition and determine its severity. The doctor treating you will review your medical history. A physical checkup will be conducted to assess abdominal tenderness, swelling, or jaundice. Several imaging and blood tests may also be performed, including:

• Análisis de sangre: Analysing blood samples for elevated levels of pancreatic enzymes, such as amylase and lipase, whose increased levels indicate pancreatic inflammation.
• Estudios de imagen
  • Ultrasound: A non-invasive imaging technique that helps visualise the pancreas and surrounding areas, detecting inflammation or blockages.
  • EUS (endoscopic ultrasound): This internal ultrasonography is performed while you are asleep, using a flexible tube called an endoscope.
  • CT Scan: A detailed imaging method that provides clearer images of the pancreas, aiding in identifying inflammation or complications.
  • MRCP (Magnetic Resonance Cholangiopancreatography): This creates detailed pictures of your pancreas, gallbladder, and pancreatic and bile ducts using magnetic resonance imaging (MRI). To enhance the clarity of the photographs, a dye is injected into your vein.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): In this procedure, a flexible tube with a camera is passed through the mouth to examine the pancreas, bile ducts, and surrounding areas. It can identify blockages or structural abnormalities.
• Pruebas de heces: La evaluación del contenido de grasa en muestras de heces ayuda a determinar si el páncreas está funcionando correctamente al digerir las grasas.
• Biopsia: Ocasionalmente, se puede recolectar una muestra de tejido del páncreas para examinarla a fin de confirmar el diagnóstico o descartar otras afecciones.

How is Pancreatitis Treated?

El tratamiento de la pancreatitis se centra en aliviar los síntomas, abordar la causa subyacente y prevenir las complicaciones. Según la gravedad de la afección, los métodos de tratamiento pueden variar:

• Pain Management: Severe, persistent pain is a common side effect of chronic pancreatitis. Your doctor will not only provide medication but also investigate the underlying causes or painful consequences of chronic pancreatitis. Injections to stop nerve impulses from the pancreas to the brain or surgeries to increase pancreatic outflow are possible forms of treatment. A pain expert could be recommended to you.
• Fluid and Nutritional Support: Patients may require intravenous fluids to prevent deshidratación and maintain electrolyte balance. In severe cases where eating is problematic, a feeding tube or nutritional supplements may be necessary.
• Gallstones: It could be advised to have the gallbladder surgically removed if pancreatitis was brought on by gallstones. Cholecystectomy is the term for this operation.
• Alcohol Dependency: An alcohol addiction treatment program is advised if pancreatitis is due to excessive alcohol consumption. Drinking alcohol continuously makes pancreatitis worse and can have major consequences.
• Alterations to medications: Your medical practitioner will collaborate with you to explore other choices if a medication is the likely cause of acute pancreatitis.
• Percutaneous Drainage or Surgery: In cases of fluid collection or severe complications, drainage procedures or surgery might be necessary to remove the fluid or treat damaged pancreatic tissue.
• Enzymes to facilitate better digestion: You may use pancreatic enzyme supplements if diarrhoea or weight loss are symptoms of chronic pancreatitis. These enzyme supplements, when taken with each meal, assist your body in utilising and breaking down the nutrients in food.
• Lifestyle Changes: Adopting a low-fat diet, quitting smoking, and maintaining a healthy weight are crucial for managing pancreatitis and preventing recurrences.

Prevention of Pancreatitis

La prevención de la pancreatitis implica adoptar un estilo de vida saludable y controlar los factores de riesgo subyacentes para disminuir la probabilidad de infección en el páncreas:

• Moderate Alcohol Consumption: You can also reduce your chance of developing pancreatitis and defend your pancreas from the dangerous consequences of alcohol by consuming less or not at all.
• Healthy Diet: Maintain a balanced diet that is low in fats, refined sugars, and processed ingredients to support pancreas health.
• Lose Excess Weight by Engaging in Regular Exercise: Gallstones may be prevented from developing by losing excess weight and retaining it by ingesting a balanced food regimen and getting regular exercise.
• Avoid Smoking: Quitting smoking decreases the chances of developing pancreatitis and various related problems.
• Medication Use: Follow prescribed medications cautiously and regularly.

La pancreatitis, ya sea aguda o crónica, requiere atención médica inmediata. Buscar atención médica oportuna y adoptar un estilo de vida saludable puede reducir significativamente el riesgo y el impacto de la pancreatitis. Al priorizar estos cambios en el estilo de vida y controlar las afecciones de salud subyacentes, las personas pueden reducir significativamente el riesgo de desarrollar pancreatitis.