How do I know if I have pancreatitis? What are the signs and symptoms?
Upper abdominal pain is the most common symptom of both acute and chronic pancreatitis. The pain is centralized and is continuous. Most patients typically say that it radiates to the back. Many say it is worse when they lie down but is relieved when sitting up. Within an hour of beginning, the pain is usually at its worst and often lasts for hours (or in some cases, for days). Occasionally there is nausea and vomiting to go along with this pain.
In some cases it is common to experience distension or swelling of the abdomen. Fluids leak in behind organs and push them forward. In some cases, a slight fever is present. In the severest of cases, patients may find bruising around the navel.
With chronic pancreatitis, pain can become more persistent. It can result from or be exacerbated by eating, so patients often limit food intake, which can result in dramatic weight loss. The patient may develop steatorrhoea, a pale, loose bowel movement that is full of fat. The body begins to become unable to digest and absorb fat, thus releasing it through the stool. In many cases, the symptoms of diabetes mellitus can appear due to the imbalance of insulin and glucagons.
What tests will be carried out to see if I have pancreatitis?
Tests are carried out for two reasons. One is to diagnose the presence of pancreatitis and secondly to find out the root cause of the problem. These help the doctor to evaluate the extent of the condition and chart out a treatment procedure for that particular patient. Most of the likely tests are described in the book. As a first step in the diagnosis your doctor will generally review your medical history. This may reveal some of the factors that contribute to pancreatitis and inform future diagnostic approaches. The next step is to do a thorough physical examination. Blood tests are likely to be recommended as these tests can offer key signals of pancreatic dysfunction. Of particular interest will be amylase and lipase levels.
Apart from the blood tests there are other tests that might be performed. Abdominal and Chest X-Rays may be taken. Ultrasound scans and CT Scans are also often performed.
Contrast-Enhanced Computed Tomography is often used in the evaluation of pancreatitis. This method is used to evaluate the presence of fluid in the patient. Abscesses, venous thrombosis, pseudoaneurysms, and pseudocysts are also detected with the help of CECT.
During attacks of pancreatitis, patients are also tested for the possible development of necrotizing pancreatitis where enzymes and toxins start to cause multi-organ failure (see Les’s Story).
Pancreas function tests are usually performed to reveal any abnormalities in the function of the pancreas. Endoscopic Retrograde Cholangiopancreatography (ERCP) is the technique most often used to evaluate the function of the pancreas. Ultrasonic imaging and CAT scans are also done during diagnosis. Urine and Stool tests are also usually conducted.
What kind of doctor do I see if I suspect I have pancreatitis?
In most cases, you will simply start with your general practitioner. He or she may refer you to a specialist if pancreatitis is suspected. Your doctor should be able to recommend exactly which doctors and specialists you will need to see to help care for your medical concerns.
Your first visit will probably be to a gastroenterologist. A gastroenterologist is a physician who specializes in diseases and conditions of the digestive system. He will be able to diagnose and recommend treatment.
If surgery is needed, you may see either a general surgeon or a gastrointestinal surgeon. A gastrointestinal surgeon performs operations for the treatment of diseases affecting the digestive system.
How curable is pancreatitis?
Currently there is no complete cure available for pancreatitis. Unfortunately, in the majority of cases, the pancreas is not able to repair itself and return to normal functional capacity after damage has occurred. The level to which a patient can recover depends on a number of factors such as when the diagnosis is made, the extent of damage done when diagnosis is made, the success of surgery if it is performed and how well the patient commits to new dietary and lifestyle regimes. It also depends on the cause of the pancreatic attack.
How important is the pancreas? Can it be removed surgically?
The pancreas is one of the most important organs in the body, but it can be removed by surgery and its functions replaced in various ways. The pancreas supplies the body with insulin, so when it is removed, diabetes mellitus must be considered. This is solved by the patient receiving regular insulin injections. Because the pancreas also plays a very important role in the digestion of food, when it is removed the patient is usually treated with an extract of pancreatic digestive enzymes from animal sources. These are added to the patient’s food. The drug cimetdine is used to stop the stomach from producing acids, thus preventing the breakdown of pancreatic enzymes by acid. (Source: Encyclopedia of Family Health, 3rd Edn, 2005)
Does a person who has a diseased pancreas always get diabetes?
No; many pancreatic problems do not cause diabetes. However, if there is inflammation of the entire pancreas as there is in pancreatitis, the insulin-producing cells in the islets are almost bound to be involved, leading to a diabetic tendency that is often less marked than might be expected from the extent of the damage. (Source: Encyclopedia of Family Health, 3rd Edn, 2005)
Can the pancreas be injured in an accident?
Yes, injuries to the pancreas most commonly occur as a result of car accidents in which the upper part of the abdomen is struck with force during the crash. It can be difficult to tell if the pancreas s is involved, and surgery is always preformed if a pancreatic injury is suspected; if it is left untreated, the digestive juices of the pancreas leak into the abdomen. (Source: Encyclopedia of Family Health, 3rd Edn, 2005). Bicycle accidents can be quite common causes of pancreatitis in children. The bike’s handlebars are often the cause of trauma as they impact on the upper abdomen.
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Can You Recommend Any Products That May Help With Pain Relief From Pancreatitis?
We’ve had several people contact us about our thoughts in relation to products to help with pain relief. One type of product that has proven helpful to many are the memory foam bed wedges available from ‘Make Me Heal’. June Henry, who writes many of the articles for our e-newsletter, uses this type of product. With pancreatitis it can sometimes be difficult to find a comfortable position when lying down. If you are interested you can check this out by clicking on the picture below. This will take you to ‘Make Me Heal’.