1. What is Acute Pancreatitis?
Acute pancreatitis is an inflammatory disease of the pancreas, in response to an irritant, which leads to a spectrum of symptoms. It usually affects young individuals in the prime of their lives.
2. What are the causes of Acute Pancreatitis?
The two common causes of pancreatitis are alcohol consumption and gallbladder stones migrating into the bile duct. The other possible causes are hypertriglycidemia, autoimmune pancreatitis, developmental anomalies of the pancreas (pancreas divisum), ingestion of certain drugs and trauma to the pancreas. In 15-20% of all patients, no cause is identified, which is labeled as Idiopathic pancreatitis.
3. What you can do to prevent pancreatitis?
A healthy lifestyle, avoiding smoking and limiting alcohol intake are the most important ways to preventing pancreatitis. One must take a balanced diet, with good intake of antioxidants and undertake a regular health check to detect any other risk factors for developing pancreatitis.
4. What to do if there is pain?
The diagnosis for pancreatitis should be made by a physician. Meet a doctor and present exact details of the pain, its onset and course. Give a complete medical and personal history. Follow the doctor’s advice regarding treatment especially with regard to hospital admission and investigations.
5. What is the usual course of the disease?
Mild pancreatitis is self-limiting and pain abates in 2-3 days. During this period, medication and diet should be maintained, as prescribed by the doctors. In case of high severity, the disease becomes unpredictable and has a long drawn course. Patients with severe disease require prolonged hospitalization and ICU care. The course of the disease is dictated by the complications and the resolution of the same.
6. What to expect in terms of treatment and outcomes?
In mild pancreatitis, most patients will improve with medical treatment and will have no further problems. If an underlying cause, such as alcohol or gallstones, is identified, then abstinence from alcohol and surgery for removal of gallbladder, respectively, should be advised.
In severe disease, any of the complications which ensue may require some procedure, such as endoscopic intervention, ultrasound or CT guided intervention and/or surgery. The timing and method of intervention, is a critical in decision making, which is undertaken by a multidisciplinary team. Patients and family should be prepared for a long haul with fluctuating course of illness including the need for one or multiple procedures. Patients may even be required to be put on ventilator and dialysis. With improving ICU care, multidisciplinary team approach and availability of sophisticated methods of intervention, 70-80% of patients survive this terrible disease. Despite the best efforts, 20-30% patients succumb.
7. What is the key to achieving a successful outcome?
Early diagnosis and critical supportive care is the key to a successful outcome. Patients suffering high severity of the disease, should be identified, carefully monitored for development of any complications, and appropriate intervention should be performed at the right time. An expert multidisciplinary team, experienced in managing pancreatitis, is vital to critical decisions being taken.
8. What are the long term ill-effects of severe pancreatitis?
Patients recovering from severe pancreatitis will require a prolonged period of rehabilitation and nutritional support. They may develop diabetes on follow-up, making it important to get regular blood sugar checks and monitoring. These patients may also develop malnutrition due to the decreased secretion of pancreatic juices. Patients should be placed on pancreatic enzyme replacement therapy, under medical supervision. About 10% of patients will develop chronic pancreatitis on a follow up of 2-3 years.
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