Pancreas and pancreatic complaints: symptoms and causes

The pancreas is an organ that has two important functions in digestion. Firstly, the production of enzymes to digest food and secondly, the production of hormones to maintain blood sugar levels. Disorders of the liver, bile ducts and pancreas are relatively common. Various disorders of the pancreas can be distinguished, including acute pancreatitis / acute pancreatitis, chronic pancreatitis / chronic pancreatitis, hereditary pancreatitis / hereditary pancreatitis and pancreatic cancer / pancreatic cancer.

Pancreatic complaints

  • The pancreas
  • Digestive organ
  • Where is the pancreas located?
  • Functions of the pancreas
  • Symptoms of pancreatic complaints
  • Examination of the pancreas
  • Physical examination
  • Additional research
  • Acute pancreatitis
  • Chronic pancreatitis
  • What is it?
  • Treatment of chronic pancreatitis
  • Hereditary pancreatitis
  • Pancreatic cancer

Gallbladder and pancreas / Source: Nerthuz/Shutterstock.com

The pancreas

Digestive organ

The pancreas is an organ that has two important functions in digestion:

  • the production of enzymes to digest food; and
  • the production of hormones to maintain blood sugar levels.

The pancreas is sometimes also called the parotid gland.

Where is the pancreas located?

The pancreas lies below and behind the stomach in a location referred to as the retroperitoneum. The pancreas is therefore outside the peritoneal cavity. The so-called retroperitoneal organs are not surrounded by the peritoneum. The pancreas is about six inches long and one to three inches thick. It is surrounded by the stomach, small intestine, spleen and liver. The pancreas has three main parts: the head, the body and the tail.

Functions of the pancreas

The pancreas is responsible for producing enzymes to digest food. These enzymes enter the duodenum through a drainage tube. A deficiency of enzymes leads to disorders in the digestion of sugars, fats and proteins. Without these enzymes, food is not adequately digested and absorbed, leading to malnutrition, weight loss and diarrhea. The pancreas also makes insulin and glucagon , two important hormones that regulate blood sugar levels, that is, keep them within normal ranges. Insulin lowers blood sugar levels and glucagon increases blood sugar levels. These hormones are released into the blood. When insulin production is too low, diabetes occurs.

Symptoms of pancreatic complaints

Disorders of the liver, bile ducts and pancreas are common. Various disorders of the pancreas can be distinguished, including acute pancreatitis, chronic pancreatitis, hereditary pancreatitis and pancreatic cancer.

Stomachache / Source: Andrey Popov/Shutterstock.com

The main difference between pancreatitis and a gastrointestinal infection or other digestive system condition is the severity of abdominal pain. Children or adults with acute pancreatitis have severe upper abdominal pain that makes it difficult for them to stand or sit upright, and they are likely to sit or lie in the fetal position to feel less pain. After the first two days, the pain usually intensifies.

Other symptoms of pancreatic complaints include:

  • (persistent) vomiting
  • loss of appetite
  • when able to eat, inability to keep food down
  • vomit that is yellowish, greenish, or brownish in color
  • jaundice (yellowing of the eyes and skin)
  • fever
  • in some cases back pain or pain in the left shoulder

Examination of the pancreas

Physical examination

It is not always easy to examine the pancreas due to the inaccessibility of this organ (due to its location). There are several methods to examine the pancreas. It often starts with a physical examination and that is – as mentioned – no easy task, since this organ is located deep in the back of the upper abdomen, behind the stomach and the posterior peritoneum and in front of the spinal column.

CT scan / Source: IStock.com/Pavel Losevsky

Additional research

Blood tests are often helpful in determining whether the pancreas is involved in a specific symptom. A radiographic examination can visualize the structure of the pancreas. Examples include computed tomography (usually abbreviated to CAT or CT scan), endoscopic ultrasound and MRI (magnetic resonance imaging). The bile ducts and the ducts of the pancreas can also be examined by making them visible. This can be done using ERCP (endoscopic retrograde cholangiopancreatography) and MRCP (magnetic resonance cholangiopancreatography). There are also cases where surgical examination is the only appropriate way to confirm the diagnosis of pancreatic disease.

Acute pancreatitis

In acute pancreatitis or pancreatitis, a short-term or temporary inflammation of the pancreas occurs, which usually resolves within a few weeks. It is accompanied by severe upper abdominal pain that can last for days. Other symptoms of acute pancreatitis include nausea, vomiting, diarrhea, bloating and fever. A common cause of acute pancreatitis is gallstones. Other causes include chronic alcohol use, hereditary conditions, trauma, medications, infections, electrolyte abnormalities, high lipid levels, hormonal abnormalities or other causes. The treatment for acute pancreatitis depends on the underlying cause. Most patients with acute pancreatitis recover completely, but sometimes permanent damage to the pancreas can occur.

Chronic pancreatitis

What is it?

Chronic pancreatitis is a progressive condition that eventually leads to the destruction of the pancreas. The disease is more common in women and usually develops in people between 30 and 40 years old. Initially, chronic pancreatitis may be confused with acute pancreatitis because the symptoms are similar. The most common symptoms are upper abdominal pain and diarrhea. As the disease progresses, patients may develop malnutrition and weight loss. If the pancreas continues to deteriorate in the final stages of the disease, patients can develop diabetes mellitus.

Chronic alcohol use / Source: Istock.com/Csaba Deli

Chronic pancreatitis is associated with chronic alcohol consumption and dietary habits. Additional causes include Cystic Fibrosis (CF) and hereditary disorders of the pancreas. In a significant percentage of patients, no cause can be identified. More research is needed to identify other causes of the disease.

Treatment of chronic pancreatitis

The treatment of chronic pancreatitis depends on the symptoms. Treatment usually focuses on pain management, giving medications to replenish pancreatic hormones and enzymes, and nutritional support. Furthermore, it is important to avoid alcohol. Sometimes surgery is necessary to combat severe pain.

Hereditary pancreatitis

Hereditary pancreatitis is an autosomal dominant condition, which occurs when a child inherits an altered gene from one parent (even though he inherits the normal gene from the other parent). Hereditary pancreatitis eventually leads to chronic pancreatitis. This condition often manifests itself before the age of 10 with attacks of acute pancreatitis. The child then suffers from piercing pain in the upper abdomen, which radiates to the back. This is accompanied by nausea and vomiting. This usually involves 3 to 4 attacks per year, but some patients even experience them on a monthly basis. The severity of the attacks varies.

Many patients eventually develop chronic pancreatitis with severe pain. These complaints can be aggravated by:

  • high-fat meals;
  • alcohol consumption; and
  • emotional stress.

The treatment is purely supportive and aimed at relieving the complaints.

Pancreatic cancer

Pancreatic cancer is often discovered at a late stage. This is because complaints generally only arise when the tumor has infiltrated another organ or has grown into the surrounding nerve pathways. When pancreatic cancer is discovered when it has already spread, cure is often no longer possible. In that case, the treatment will be palliative, which means that it is aimed at slowing down the disease as much as possible and reducing the symptoms.

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