PANCREATITIS

PANCREATITIS

Pancreatitis is the inflammation of pancreatic acini. It is a rare but dangerous disease.

Pancreatitis is of two types:

1. Acute pancreatitis

2. Chronic pancreatitis.

1. Acute Pancreatitis

Acute pancreatitis is more severe and it occurs because of heavy alcohol intake or gallstones.

Features of acute pancreatitis:

i. Severe upper abdominal pain

ii. Nausea and vomiting

iii. Loss of appetite and weight

iv. Fever

v. Shock.

2. Chronic Pancreatitis

Chronic pancreatitis develops due to repeated acute inflammation or chronic damage to pancreas.

Causes of chronic pancreatitis

i. Longtime consumption of alcohol

ii. Chronic obstruction of ampulla of Vater by gallstone

iii. Hereditary cause (passed on genetically from one generation to another)

iv. Congenital abnormalities of pancreatic duct

v. Cystic fibrosis, a generalized disorder affecting the functions of many organs such as lungs

(due to excessive mucus), exocrine glands like pancreas, biliary system and immune system

vi. Malnutrition (poor nutrition; mal = bad)

vii. Idiopathic pancreatitis (due to unknown cause).

Features of chronic pancreatitis

i. Complete destruction of pancreas: During the obstruction of biliary ducts, more amount of

trypsinogen and other enzymes are accumulated. In spite of the presence of trypsin inhibitor in

acini, some trypsinogen is activated. Trypsin in turn activates other proteolytic enzymes. All

these enzymes destroy the pancreatic tissues completely

ii. Absence of pancreatic enzymes: Pancreatitis is more dangerous because the destruction of

acinar cells in pancreas leads to deficiency or total absence of pancreatic enzymes. So the

digestive processes are affected; worst affected is fat digestion that results in steatorrhea

iii. Severe pain in upper abdominal region, which radiates to the back

iv. Fever, nausea and vomiting

v. Tender and swollen abdomen

vi. Weight loss.

STEATORRHEA

Steatorrhea is the formation of bulky, foulsmelling, frothy and claycolored

stools with large quantity of undigested fat because of impaired digestion and

absorption of fat.

Causes of Steatorrhea

Any condition that causes indigestion or malabsorption of fat leads to steatorrhea. Various causes of steatorrhea are:

1. Lack of pancreatic lipase: Since most of the fat is digested only by pancreatic lipase, its deficiency

leads to steatorrhea

2. Liver disease affecting secretion of bile: Bile salts are essential for the digestion of fat by lipase and

absorption of fat from intestine. Absence of bile salts results in excretion of fatty stool

3. Celiac disease: Atrophy of intestinal villi leads to malabsorption, resulting in steatorrhea

4. Cystic fibrosis