Pancreatitis is inflammation of the pancreas, which can either appear suddenly and last for days (acute) or for many years (chronic). The main causes include alcoholism and gallstones. Treatment may include a change in diet and taking supplements to help provide pancreatic support and reduce inflammation.
What is the pancreas?
The pancreas is a long, flat gland that sits in the abdominal cavity behind the stomach. It serves two crucial functions:
Digestion—the pancreas is an exocrine gland which releases digestive enzymes that are important in the digestion of the foods we eat. It also produces alkaline substances to reduce the acidity of food before it enters the small intestine.
Blood sugar balancing—produces a hormone called insulin which helps to move sugar from the bloodstream into cells. Problems with the production of insulin can lead to high blood sugars and diabetes. In this instance the pancreas is referred to as an endocrine gland that secretes substances into the bloodstream.
Causes of pancreatitis
Pancreatitis occurs when digestive enzymes become activated while still in the pancreas. This irritates the cells of the pancreas—leading to inflammation. More than half of all people with acute pancreatitis have been heavy drinkers, which makes alcohol consumption one of the most common causes. Gallstones which block the pancreatic duct is the second leading cause of pancreatitis. Weirdly enough this can sometimes happen even if the gallbladder has been previously removed.
In rare cases, pancreatitis can be caused by:
- trauma or surgery to the pancreas region
- inherited abnormalities of the pancreas
- inherited disorders of metabolism
- viruses
- certain medication such as diuretics
Sometimes, a cause for pancreatitis is never found.
Acute pancreatitis
Acute pancreatitis is a sudden, debilitating attack of severe upper abdominal pain. Pancreatic enzymes burn and damage the pancreas and leak out into the abdominal cavity. Complications can be fatal and include respiratory, kidney or heart failure.
Common symptoms of an acute attack include:
- severe abdominal pain that radiates to your back
- abdominal pain that is worse after eating
- bloating
- fever
- sweating
- nausea
- vomiting
- collapse
The symptoms of acute pancreatitis can sometimes be confused with symptoms of other emergencies such as heart attack, biliary colic (gallbladder stones) or perforation of a gastric or duodenal ulcer.
Chronic pancreatitis
Chronic pancreatitis typically involves recurring bouts of pancreatic inflammation, often even when known triggers are eliminated. People who drink excessive amounts of alcohol are at increased risk of developing this condition. Over time, the pancreas may be damaged, or parts of it destroyed, by the relentless inflammation. If much of the pancreas has been damaged, loss of insulin production can lead to diabetes.
Chronic pancreatitis can contribute to the development of pancreatic cancer.
Signs and symptoms of chronic pancreatitis include:
- nausea and/or vomiting
- abdominal pain that radiates to the back
- upper abdominal pain
- digestive upsets
- oily, smelly stools (steatorrhea)
- clay coloured or pale stools
- diarrhoea
- weight loss
Treatment for pancreatitis
In many cases pancreatitis requires hospitalisation and medical treatment. Once at home there are many management techniques you can implement to promote normal pancreatic function and reduce inflammation. These suggestions can be used short-term for those with acute pancreatitis but more so in those with chronic pancreatitis. Simple dietary and lifestyle measures, such as eating healthy, exercising and quitting smoking will reduce your risk of developing pancreatitis.
Lower fat intake
Eating a low-fat diet reduces your risk of pancreatitis. It also reduces your risk of gallstones which is a leading cause of acute pancreatitis. Gallstones develop when too much cholesterol accumulates in your bile—which is a substance produced by the liver to digest fats.
Specific foods to avoid include fatty or fried foods and full-fat dairy. Instead, eat a diet rich in fruits, vegetables and wholegrains, with small amounts of animal proteins such as lean meats, fish, dairy and eggs. Small meals are ideal as they take the pressure off the pancreas and are easier to digest.
Limit alcohol consumption
By drinking less, or not at all, you can help protect your pancreas from the toxic effects of alcohol. A high intake of alcohol is the leading cause of pancreatitis, and this is especially the case in alcoholics. Some people may require additional support to help in the abstinence of alcohol by attending treatment programs. When triggered by excessive alcohol consumption, acute pancreatitis usually resolves itself with rest and abstinence from alcohol.
Exercise regularly and lose weight
Being overweight or obese puts you at greater risk for acute pancreatitis as you are more likely to develop gallstones. By eating a balanced diet and performing regular exercise this can assist in gradual weight loss. For those with chronic pancreatitis, weight loss may not be recommended if body mass index is already low. Regular exercise can still be performed for a variety of other health reasons.
Antioxidants
An intriguing aspect of dietary therapy in chronic pancreatitis is the emerging possible role of antioxidants. Reported deficiencies in patients with pancreatitis include selenium, vitamins A, C, and E, and riboflavin. Malnutrition in chronic pancreatitis is a common concern which can include a vast array of micronutrients, especially fat-soluble vitamins A, E, D and K. These findings have fueled the hypothesis that a reduction in these micronutrients could enhance oxidative stress and link to the development of chronic pancreatitis.
A randomized trial of antioxidant supplementation with selenium, vitamin C, beta-carotene, vitamin E, and methionine reported a significant reduction in the number of painful days per month.
Turmeric is an antioxidant which has also been found to be beneficial in pancreatitis and reducing complications such as cancer and diabetes.
Digestive enzymes
Supplementation with pancreatic enzymes has long been used as an adjuvant to the treatment of patients with pancreatic pain largely based on the premise that replacement of lost enzymes might rest the pancreas.
The long-term use of enzyme therapy for those with enzyme insufficiency is associated with improvements in stool frequency, faecal fat loss, stool consistency, and both clinician and patient assessment of symptoms. Digestive enzymes can be purchased from pharmacies and health food stores and contain a range of enzymes to assist in breaking down foods. Alternatively, your doctor may prescribe a pancreatic enzyme to help malabsorption, bloating and to improve bowel movements.
And lastly, studies have found that smoking cigarettes increases your risk of both acute and chronic pancreatitis. So, if you are still smoking—now’s the time to give it up!
References
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pancreatitis
- https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227
- Yuhara H, et al. Smoking and risk for acute pancreatitis: a systematic review and meta-analysis. Pancreas. 2014 Nov;43(8):1201-7 https://www.ncbi.nlm.nih.gov/pubmed/25333404
- Park JM, et al. Antioxidative phytoceuticals to ameliorate pancreatitis in animal models: an answer from nature. World J Gastroenterol. 2014 Nov 28;20(44):16570-81https://www.ncbi.nlm.nih.gov/pubmed/25469025
- Hobbs PM, et al. Management of pain in chronic pancreatitis with emphasis on exogenous pancreatic enzymes. World J Gastrointest Pharmacol Ther. 2016 Aug 6;7(3):370-86 https://www.ncbi.nlm.nih.gov/pubmed/27602238
- Seo SW, et al. Protective effects of Curcuma longa against cerulein-induced acute pancreatitis and pancreatitis-associated lung injury. Int J Mol Med. 2011 Jan;27(1):53-61 https://www.ncbi.nlm.nih.gov/pubmed/21069254
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