Pancreatitis - OAWHealth

Pancreatitis

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Pancreatitis is a very serious illness that afflicts one of the busiest organs of the body: the pancreas. The pancreas is not the most popular of organs. It doesn’t get a lot of press, until something goes wrong. I would venture to say that it you were to take a poll, not many folks would be able to tell you what the pancreas does. Let’s see if we can learn more about what this workhorse of the body is designed to do, and what happens when it breaks down.

What is Pancreatitis?

Pancreatitis literally means “inflammation of the pancreas.” The pancreas is an organ that is a key player in the process of digestion. It is long and flat, and located directly behind the abdomen, and is surrounded by the duodenum (the first part of the of the small intestine), the liver, the stomach, and the spleen. Pancreatitis can be acute (coming on suddenly, usually with full recovery) or chronic (a more serious form that progresses slowly, and causes permanent damage).

The pancreas is a very complex organ. It is actually a gland. The main job of glands is to manufacture chemicals that are either put into the bloodstream (endocrine) or go directly into another organ (exocrine). The pancreas, unlike most other glands, performs both endocrine and exocrine functions. It produces three important and critical hormones: insulin, glucagon, and vasoactive intestinal polypeptide (VIP). Insulin and glucagon are involved in processing carbohydrates and regulating blood sugar. VIP is essential to normal gastrointestinal functioning. The pancreas is also responsible for manufacturing many digestive enzymes including trypsin, chymotrypsin, lipase, and amylase.

In a healthy person, the enzymes produced by the pancreas flow from the pancreas into the main pancreatic duct, and then into the duodenum where they are utilized in digestion. There are also chemicals in the duodenum that work as catalysts and enable the pancreatic enzymes to activate. Many of these enzymes are very potent chemicals.  What happens when the pancreas malfunctions is that the enzymes are abnormally activated inside the pancreas, and this causes them to begin digestion prematurely within the pancreas. The pancreas literally begins to digest itself.

This creates total havoc within the pancreas. Inflammation and swelling cause the pancreas to malfunction and it is not able to deal with its other duties. The deterioration of the pancreas leads to internal bleeding. As blood vessels within the pancreas become digested, other activated chemicals are allowed to leak out into the abdominal cavity. The activated enzymes and other chemicals eventually leach into the bloodstream and are spread throughout the body. This creates a highly toxic situation that can eventually affect all of the body’s systems. As you can imagine, this is a serious condition that can easily become life threatening.

What Are the Symptoms of Pancreatitis?

  • Pain is a major common symptom of pancreatitis. It is generally found in the upper right quadrant of the abdomen, and may be steady and intense. Some patients describe it as “boring,” not because they are bored, but because it seems to penetrate the body. It is often felt all the way through to the back. During intense pain, many people find they need to breathe shallowly to bear the pain. Some find that curling up into a fetal position or sitting up and bending forward helps to relieve the pain. Nausea, vomiting, and abdominal swelling are also common. Some patients may also develop a low fever.
  • Shock is a common complication of pancreatitis. In fact, some of the most serious symptoms can be a result of shock.  Shock occurs when the blood pressure or volume of blood is so low that the body’s organs can no longer function. Signs of shock include cold arms and legs, extremely low blood pressure, accelerated heart rate, and signs of incoherence or changes in mental status. Shock is a critical condition that needs immediate medical care. Death can come in minutes from severe cases of shock.

Pancreatitis is a very serious illness. The possible complications are varied, and many have the potential of being deadly. The list is long and ugly. The major ones, besides shock, are:

  • Pseudocysts:  At times, dead pancreatic tissue and pancreatic fluid will cluster into pockets within the pancreas or in a blocked duct. If they become infected or are bleeding heavily, they can be very serious and must be treated immediately. Sometimes they are removed surgically to avoid a lethal situation.
  • Abscesses:   These are collections of pus that may accumulate in or near the pancreas. They often occur 4-6 weeks after an acute attack of pancreatitis. They can often be drained through a catheter, or are sometimes removed surgically.
  • Infections:  This can be a dangerous problem for pancreatitis patients. As the pancreas deteriorates, especially in chronic cases, the organ is more and more susceptible to bacterial infections that can be spread from the gastrointestinal system. Infections can cause organ failure and death. Drainage or surgery is often necessary to save the patients life.
  • Respiratory Failure:  Problems in the pancreas affect all the systems of the body, mainly because the pancreas provides many necessary chemicals needed for functional operation of the body. The lungs are very sensitive to chemical changes, and can lose their ability to supply needed oxygen to the body. Oxygen levels in the blood can fall to dangerously low levels.
  • Internal Bleeding:  As the pancreas turns on itself, the blood vessels in and near the organ are damaged and can lead to serious and potentially fatal bleeding. This is also why shock is so common in pancreatitis patients. Internal bleeding can cause blood pressure to drop to dangerous levels.
  • Diabetes:  When the ability of the pancreas to produce insulin is compromised, the body can no longer process blood sugar efficiently. The result is often diabetes.
  • Pancreatic Cancer:  The ongoing inflammation of the pancreas increases risk for pancreatic cancer, one of the most deadly of all cancers.
  • Malnutrition:  Since the pancreas is responsible for digestive enzymes, when it is no longer able to produce them, the body does not absorb nutrients from food very effectively. Many patients also suffer from significant weight loss.
  • Addiction to Pain Killers:  It is not uncommon for pancreatitis patients to become addicted to narcotic pain medications. The pain can be intense and chronic. Addiction is probably a function of long time use of the drugs, along with the fact that many pancreatitis patients are problem drinkers, or have been in the past, and may have a propensity towards chemical dependency.

What Are the Causes of Pancreatitis?

The vast majority of pancreatitis cases are caused by two factors: alcoholism and gallbladder disease. These two conditions are responsible for over 80% of all hospitalizations for acute pancreatitis. Alcohol causes digestive enzymes to be activated sooner than normal, which is the mechanism that causes the pancreas to turn on itself. It also contributes to the formation of “protein plugs” which are precursors to small stones that can block up pancreatic ducts. Gallbladder disease creates gallstones that also block up ducts and cause digestive juices from the pancreas to end up “digesting” healthy pancreatic tissue.

Approximately 5% of all pancreatitis cases are caused by certain drugs that are very harmful to the pancreas. I think it is important to list them so that folks are aware that if they use these, they are risking getting this vicious disease called pancreatitis. The list is not long, but it is important that we know what they are. I will mostly give the brand names, as these are more easily recognizable. The following drugs are definitely associated with pancreatitis:

  • Imuran
  • Videx
  • Birth Control Pills
  • Lasix
  • NebuPent
  • Urobak
  • Azulfidine
  • Tetracycline
  • Diuril
  • Enduron
  • Depakote

These drugs might be linked to pancreatitis:

  • Acetaminophen
  • Capoten
  • Vasotec
  • Erythromycin
  • Aldomet
  • Flagyl
  • Protostat
  • Furadantin
  • Furan
  • Aleve
  • Naprosyn
  • Motrin

There are some other risk factors that cause a small percentage of cases:

  • Some viral infections such as hepatitis, Epstein-Barr virus, and mumps.
  • Elevated levels of blood fats called triglycerides
  • Elevated levels of calcium in the blood (hypercalcemia)
  • Some surgeries, especially abdominal
  • The inherited disease called Cystic Fibrosis. This illness can obstruct pancreatic ducts, leading to infection.

How Can Pancreatitis be Prevented and/or Treated?

Avoiding alcohol or limiting it to moderate amounts will eliminate the biggest risk factor for this awful disease. If you do have a dependency on alcohol, by all means seek some help. The first step must be a desire to stop.

Other than that, the best course I can recommend is to eat a wholesome diet and try to keep your body in a healthy state via making good choices.

If you already have pancreatitis, here are some dietary suggestions:

  • Eliminate any use of alcohol
  • Avoid high fat foods, especially hydrogenated or saturated fats. These are particularly difficult to digest when your digestive system is compromised by pancreatitis.
  • Avoid refined sugar and processed foods.
  • Eat whole grains, and lots of fruits and vegetables. Especially beneficial are yellow and orange fruits, and dark green leafy vegetables. These provide plenty of antioxidants, vitamin C, and beta-carotene.
  • The B vitamins, especially B6 and B12, act as “lipotrophic” agents to aid bile flow into and out of the liver. This is helpful to pancreatitis patients.

Other tips for self-care include:

  • Stop smoking, if you haven’t already. There is thought to be a greater risk of pancreatitis for smokers, especially when you combine smoking with alcohol use.
  • Be sure to get plenty of fluids. Water is the best. Dehydration can aggravate the pancreas and increase inflammation and pain.
  • Eat several small meals throughout the day. This spreads out the work for your pancreas and allows it to more easily produce digestive enzymes for the next meal.
  • Be very careful about the amount and types of pain medications you use. Having pancreatitis is stressful enough. You don’t need to become addicted to painkillers on top of it. The side effects from the drugs can also make the pancreatitis worse in the long run. The pain of pancreatitis can be considerable, but try to look at the big picture.

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