Chronic Pancreatitis: Symptoms, Causes & Treatment
What is Chronic Pancreatitis? Chronic (long-term) Pancreatitis constitutes undeviating inflammation of the pancreas that impairs your system’s ability to digest food properly and regulate the blood sugar level in your body. Although acute, short-term pancreatitis often gets cured through conservative treatment, chronic pancreatitis seldom gets permanently cured. As a matter of fact, the damage caused due to a high degree of alcoholism and other causes over an extended period of time leaves so much ill effect on the organ that no line of ethical treatment can provide enduring relief. However, acute abdominal pain and secondary symptoms can be managed through medication and other means to some extent. What are the symptoms of chronic pancreatitis? Symptoms are usually absent in the initial stage, which, however, occur as outlined below as the ailment progresses. ■ Nausea and vomiting ■ Upper abdominal pain ■ Diarrhea ■ Pale, yellowish, sticky stool ■ Undue fatigue and too much thirst ■ Inexplicable weight loss However, as the disease progresses further, more alarming symptoms begin to appear that include: ■ Typical yellowish discoloration in the eyes and the skin, indicating the onset of Jaundice ■ Presence of pancreatic fluid in the abdomen ■ Internal bleeding ■ Intestinal blockage ■ Unrelenting abdominal pain What causes chronic pancreatitis? Although there could be numerous self-induced as well as inherited causes behind the onset of chronic pancreatitis in a person’s life, the commonest of all is alcohol abuse. Medical studies reveal that more than 70% of people affected by chronic pancreatitis have a long history of excessive alcohol consumption. However, some of the other causes that are also there are listed below: ■ Blockage of the pancreatic duct either by gallstones or pancreatic stones ■ Abdominal surgery ■ High calcium levels in blood (hypercalcemia), which may have been caused by an overactive parathyroid gland (hyperparathyroidism)/li> ■ High triglyceride level in blood (hypertriglyceridemia) ■ Chronic infection that remained untreated ■ Cystic fibrosis ■ Autoimmune disease ■ Excessive cigarette smoking ■ Family history of pancreatitis ■ Incredible, yet true – ERCP may lead to chronic pancreatitis. Wonder of all wonders – sometimes no cause is found at all! How is chronic pancreatitis diagnosed? Chronic Pancreatitis is not only difficult to treat but also difficult to diagnose. For instance, blood tests that normally reveal causes related to a lot of maladies prove to be of little value in diagnosing chronic pancreatitis, at least during the early stages of this deadly disease. However, blood tests do reveal the level of pancreatic enzymes in your blood. Nevertheless, some of the following tests are conducted to obtain more definite information, while imaging tests prove more helpful in diagnosing chronic pancreatitis. ■ X-rays ■ Ultrasound ■ CT scans ■ MRI scans To obtain conclusive evidence of the extent of damage caused to your pancreas, doctors (gastroenterologists) also go for an endoscopic ultrasound. During the procedure, the doctor inserts a long, flexible tube into your mouth, down through your stomach, and right up to the small intestine. The tube contains an ultrasonic probe that emits sound waves that create detailed images of your pancreas on a monitor attached to it. What are the modes of Treatment for chronic pancreatitis? To be honest about it, there isn’t much in the medical world to cure chronic pancreatitis, because the pancreas, like the liver, once damaged, cannot be recovered back to its original condition. However, medical help is available to manage the symptoms by way of medication, endoscopic therapies, and surgery. Medications that are often prescribed to manage the symptoms include: ■ Pain management medications to suppress agonizing abdominal pain ■ Supplementary digestive enzymes if your enzyme levels are found to be much too meager for digesting food properly ■ Insulin if you become diabetic ■ Steroids, if you happen to develop autoimmune pancreatitis Endoscopic treatment of chronic pancreatitis has currently drawn benefits from endoscopic procedures previously practiced for the main bile duct. While endotherapy is widely acclaimed as the most accepted alternative to surgery, cyst drainage procedure today presents the largest step forward in that non-surgical approach, regardless of whether direct (through stomach or duodenum) or indirect through the papilla in the duodenum. Pancreatic duct drainage, associated with stone clearance, is also feasible, while the procedure gives similar results to surgery with lower morbidity. Surgery, though not indicated for all, becomes inevitable for people who cannot endure excruciating abdominal pain that does not respond to pain-killing drugs. The only alternative then entails surgical removal of part of the organ. Postscript: People suffering from chronic pancreatitis should stay away from alcohol, even if hooch hasn’t been responsible for their dreaded illness, because it will exacerbate their sickness to a great extent. They should also refrain from smoking, as it would increase their risk of developing pancreatic cancer.
Gallstones: Types, Symptoms, Diagnosis & Treatment
Clinically speaking, gallstones are not stones such as rocks or minerals but stone-like hard deposits made of cholesterol, calcium salt, or bilirubin that are often found within the gallbladder, which is a small organ that stores bile. However, these stone-like substances may vary in volume, from as tiny as a grain of salt to as large as an apricot. To be precise, certain components in bile often crystallize and harden, thus forming gallstones. According to Harvard Health Publications, 80% of gallstones are made of cholesterol, while the remaining 20% consist of calcium salts and bilirubin that are known as Pigment Stones. Types of Gallstones As earlier said, gallstones are mostly made of cholesterol, as well as a few other substances that are outlined below. Cholesterol Stones: Gallstones often form within the gallbladder when the liver tends to secrete excessive amounts of cholesterol in the bile that it cannot break down or dissolve, and as a result, hard stone-like substances develop over time. Bilirubin originated from stones: Bilirubin is a byproduct that is formed while the liver routinely breaks down old red blood cells. However, due to certain disease conditions such as cirrhosis of the liver, as well as a few blood disorders, the liver tends to produce more bilirubin than is good for the body. Hard substances resembling stones form when the gallbladder fails to break down the excess bilirubin. These are often termed as Pigmented Stones. Symptoms of Gallstone According to the American College of Gastroenterology, 80% of people having gallstone do not have any symptoms at all and so are known as Silent Gallstones. However, others have symptoms that include pain in the right upper quadrant of the abdomen. The pain may extend to the right shoulder or the shoulder blade. Besides, gallstones also have the following symptoms: ■ Fever ■ Yellowish tint in the skin or the eyes (as in jaundice) ■ Nausea or queasiness ■ Clay-colored stool. Gallbladder Attack Excessive and unbearable gallstone/gallbladder pain is medically termed a gallbladder attack. In most cases, this may last up to 2 or more hours. However, the gallstones are not actually responsible for the excruciating pain. It happens when the gallstones tend to arrest the movement of the bile from the gallbladder. Nevertheless, the ‘attack’ is preceded by the following three stages that are easy to trail. Stage I: Gallstones form within the gallbladder. It is a painless stage. Stage-II: Gallbladder pain gradually develops but does not continue for long hours. However, the condition exacerbates with the consumption of fatty and fried food, while sundry symptoms such as stomach pain, nausea, and indigestion appear on the scene. Stage-III: Medical emergency! Gallstones block the duct while bile moves from the gallbladder. Symptoms include severe stomach/back pain, high temperature, and chills. Gallstone Diagnosis Apart from physical examination, such as checking the color of the skin and the eyes, the attending physician will also ask for diagnostic tests that include: Ultrasound that provides the most convincing proof of gallstone/gallstones within the gallbladder. An abdominal CT scan will provide a picture of the patient’s liver and surrounding areas. A gallbladder radionuclide scan is the most effective diagnostic test for gallstones, which takes around an hour to complete. The test involves the injection of a radioactive substance into the patient’s veins that travels through the blood and reaches the liver and the gallbladder, immediately detecting any infection or blockage in these organs. Blood Tests Will reveal the amount of bilirubin in the blood and help the process of diagnosis. Treatment for Gallstone Surgery – Among some of the most sure-shot methods of gallstone treatment involves removal of the source, i.e., the gallbladder itself, through laparoscopic surgery. However, general anesthesia is required for this surgery, while the surgeon will make three or four incisions on the abdomen. A lighted device will be inserted into the abdomen to locate the gallbladder, while appropriate surgical instruments will be sent through the other incisions to remove the gallbladder. In most cases, the patient goes home the same day or the day after. Medication – Drugs that dissolve gallstones caused by cholesterol are an option if surgery is not recommended. These medications may take several years to remove the gallstones.