Pancreatitis

1. Anatomy and physiology of the pancreas.

1. It is located behind the stomach in a horizontal position, with the head attached to the small intestine and the tail reaching to the spleen.

2. The pancreas excretes a digestive juice, which is emptied into the small intestine.

3. The pancreas also produces two hormones, insulin and glucagon.

2. Definition of "pancreatitis."

1. It is an inflammation of the pancreas, which may be acute or chronic.

2. Damage to the pancreas is caused by premature activation of enzymes.

3. Chronic pancreatitis is progressive destruction of pancreatic tissue replaced by fibrotic tissue.

3. Factors that increase risk of pancreatitis.

1. Biliary disease.

2. Alcohol abuse.

3. Drugs.

4. Pregnancy.

5. Trauma.

6. Infection.

7. Post-op gastrointestinal surgery.

8. High calcium levels.

4. Signs and symptoms of acute pancreatitis.

1. Pain:

1. Pain usually has a sudden severe onset following ingestion of a heavy meal or alcohol.

2. Pain is located in left upper quadrant of abdomen or mid-upper abdomen and may radiate to the back.

2. Nausea or vomiting.

3. Abdominal rigidity and tenderness.

4. Fever.

5. Low blood pressure.

6. Fast heart rate.

7. Respiratory distress.

8. Edema.

5. Symptoms of chronic pancreatitis.

1. Dull, aching chronic pain.

2. Jaundice.

3. Impaired glucose tolerance.

4. Frothy, foul-smelling stools.

5. Weight loss.

6. Measures to prevent or control pancreatitis.

1. Avoid alcohol (refer to alcohol treatment program or Alcoholics Anonymous).

2. After acute stage has subsided, eat bland, high-carbohydrate, low-fat, high-protein foods.

3. Take fat-soluble vitamin supplements (vitamins A, D, E) and calcium as ordered.

4. Avoid stimulants such as nicotine and caffeine to decrease pancreatic secretions.

5. Eat small, frequent meals to minimize secretion of pancreatic enzymes.

6. Take analgesics for pain control.

7. Take medication as ordered.

8. Surgical intervention may be necessary.

7. Signs and symptoms of possible complications of pancreatitis.

1. Lung complications (shortness of breath, fever, etc.).

2. Pseudocyst (cavity outside pancreas, characterized by abdominal pain, epigastric mass, nausea, vomiting, fever, and loss of appetite).

3. Abscess (fluid containing cavity within the pancreas characterized by abdominal mass and high fever).

4. Malabsorption (weight loss, foul-smelling frothy stools, nausea, and vomiting).

5. Hemorrhage (gastrointestinal bleeding or coffee-ground vomitus).

6. Diabetes mellitus (intolerance to glucose).

7. Peptic ulcer (heartburn and indigestion).