The pancreas is a much needed organ that not only helps with the digestive process, but maintains your body’s blood sugar levels by keeping a perfect balance with the help of hormones such as insulin and glucagon, among others.
As with all organs in our bodies, the pancreas is susceptible to several disorders that can affect its functionality to varying degrees. Today we will take a look at some of the most common pancreatic disorders including their symptoms and what treatment options are available.
Detecting Pancreas Disease
It is often difficult to diagnose pancreatic disease because the pancreas is located far behind the stomach and in front of the spine, deep within the abdomen.
Physical examinations rarely lead to pancreatic disease discovery and blood tests can often provide a mistaken diagnosis. The best way to determine whether you are experiencing a pancreatic disorder is through a CAT scan, endoscopic ultrasound, or MRI. Additionally, tests such as an ERCP (endoscopic retrograde cholangiopancreatography) or MRCP (magnetic resonance cholangiopancreatography) are helpful in evaluating the pancreatic ducts for problems.
Unfortunately, there are situations severe enough that may require pancreatic surgery to determine the extent of your pancreatic disease and make a proper diagnosis.
Common Pancreatic Disorders
Pancreatitis is an inflammation of the pancreas. This disorder is associated with early activation of the digestive enzymes that are released into the small intestine during the digestive process. Rather than activating at the appropriate time to digest food, these enzymes attack the pancreatic tissue instead causing damage.
There are several different levels of pancreatitis, all resulting from different things and exhibiting their own symptoms:
Usually accompanying severe upper abdominal pain, this form of pancreatitis is a sudden attack that causes inflammation of the pancreas. Other symptoms include nausea, vomiting, fever, and an increase in heart rate.
This can be a single or recurring event and is often caused by things such as: chronic alcohol consumption, hereditary conditions, trauma, medications, infections, and hormonal abnormalities. In the United States the most common cause of acute pancreatitis is the formation of gallstones.
Most people recover quickly form acute pancreatitis with treatments such as IV fluids and pain medications until the inflammation ceases. In extreme cases the inflammation can kill part of the pancreatic tissue and may require pancreatic surgery to remove the dead or damaged tissue to prevent further infection.
This disorder is a progressive disease that eventually alters the pancreas’ normal structure and functionality. Having similar symptoms as acute pancreatitis, this disorder often goes misdiagnosed for some time. However, as the symptoms persist, the patient will often develop malnutrition and experience extreme weight loss indicating a more serious issue than acute pancreatitis. In addition, chronic pancreatitis causes irreversible damage to the pancreas.
The most common cause for chronic pancreatitis is alcoholism. It is suggested that up to 70% of all cases are somehow related to alcohol consumption. However, several bouts of acute inflammation of the pancreas can result in a chronic pancreatitis diagnoses as well. People with chronic pancreatitis will often experience abdominal pain and diarrhea and may also develop type 2 diabetes due to the inefficiency of the digestive process and the damage to the insulin-producing cells.
Treatment varies depending of the severity of the case. Medication to treat pain, pancreatic enzyme supplementation to help with digestion, and long term insulin dependence may be required. Resection of the pancreas is also a common treatment option to remove the damaged pancreatic tissue.
Inherited abnormalities of the pancreas or intestine may lead to pancreatitis at some point in a patient’s life. These mutations often affect the pancreas’ ability to secrete digestive enzymes correctly and cause deficiencies in the digestive process. Cystic fibrosis is one example of an inherited disease that may lead to chronic pancreatitis later on in life.
People with hereditary pancreatitis usually experience chronic pain, diarrhea, malnutrition, and can even develop diabetes due to the mutated genes and the effect they have on the digestive process. Treatment is normally pancreatic enzyme replacement and pain treatment through medication.
According to the Mayo Clinic, autoimmune pancreatitis (AIP) is chronic inflammation that is a result of the body’s immune system attacking the pancreas. This new and rarely recognized disorder can be mistaken as pancreatic cancer. The symptoms are relatively similar to pancreatic cancer however treatment is significantly different making it crucial to distinguish between the two.
AIP is sometimes asymptomatic, though when symptoms do occur, they include: dark urine, floating stool, abdominal pain, weight loss, and fatigue. The most common symptom affecting up to 80% of all patients with AIP is jaundice, caused by blocked bile ducts.
This pancreatic disorder is the only known pancreas disease to respond positively to steroid treatment. This is useful in making a correct diagnosis and usually helps treat the disease quickly. Bile duct stenting is also an option to help drain the bile ducts correctly and treat the jaundice. Should the patient have complications such as pancreatic enzyme deficiency or diabetes, appropriate treatments would be provided.
Accounting for more than 37,000 new cases per year, pancreatic cancer is the 4th leading cause of cancer death among men, and the 5th among women in the United States. Risk factors for getting pancreatic cancer include smoking, age, gender, chronic pancreatitis, and exposure to some industrial chemicals.
Pancreatic cancer is typically asymptomatic though as mentioned above it may cause symptoms similar to AIP such as weight loss and jaundice. It is usually detected via radiographic imaging techniques though the disease is often very progressed by this time.
Unfortunately, by the time pancreatic cancer is diagnosed, usually only 10% of the cancer remains in the pancreas itself. This causes issues when it comes to treatment plans, though doctors and scientists work around the clock in an effort to find better options. More so, pancreatic cancer does not respond well to current treatments making a full recovery extremely difficult. The three main treatment options for someone with pancreatic cancer include: the Whipple Procedure, Distal Pancreatectomy to help prevent the spread of the cancer throughout the body, and a total Pancreatectomy for those who have many tumors throughout the pancreas.
This list is not exhaustive by any means though it does give insight into some of the most common pancreatic disorders there are. If you or someone you know suffers from any of the above disorders consider contacting Dr. Fraiman and his team of specialists to help you develop a treatment that is right for you.
Dr. Fraiman has over 20 years of experience in dealing with pancreatic disease and is one of the very few physicians performing pancreatic surgery in Baltimore, Maryland. Rest assured that his patient-centered approach and personalized treatment plans will help you get on the road to recovery quickly.