Home > Health A – Z > Pancreatitis

Pancreatitis

Inflammation of the pancreas. Gallstones or alcohol abuse most often cause this condition. Pancreatitis can be acute or chronic. Both forms are serious and can lead to complications. NIH - National Institute of Diabetes and Digestive and Kidney Diseases

About Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum - the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile - a liquid produced in the liver and stored in the gallbladder - to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy.

Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them.

Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur. NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

Endoscopic treatment of acute biliary pancreatitis: a systematic review

Bibliographic details: Chai C, Cao N, Li Q, Yang KH.  Endoscopic treatment of acute biliary pancreatitis: a systematic review. World Chinese Journal of Digestology 2010; 18(4): 404-408

Adjuvant treatment of severe acute pancreatitis with rhubarb: a systematic review

Bibliographic details: Sheng YY, Zou XP, Yu CG, Lv Y, Zhang LL.  Adjuvant treatment of severe acute pancreatitis with rhubarb: a systematic review. World Chinese Journal of Digestology 2010; 18(7): 730-735

Prophylactic use of ulinastatin against post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review

Bibliographic details: Guo Q, Hu WM.  Prophylactic use of ulinastatin against post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review. World Chinese Journal of Digestology 2009; 17(34): 3561-3567

See all (323)

Summaries for consumers

Pancreatic enzymes for chronic pancreatitis

Chronic pancreatitis is a condition afflicting nearly 0.04% to 5% of the population worldwide. The disease presents as recurrent episodes of abdominal pain, fatty stools and weight loss, or may be asymptomatic. Patients may develop complications over a variable period of time. Medical treatment often involves prescription of pancreatic enzyme preparations for these patients. This practice is based on studies which have shown the benefit of pancreatic enzymes on various outcomes such as abdominal pain, weight loss, analgesic use, fatty stools and quality of life. However, a collective conclusion about the role of pancreatic enzymes in chronic pancreatitis patients needs to be established from these studies. This systematic review aimed to collect all published and unpublished data on this subject in order to evaluate whether pancreatic enzymes have any benefit on various parameters in chronic pancreatitis, to compare different types of enzyme preparations and to evaluate whether different dosage schedules have any influence on the various outcomes. We included 10 studies in the review. These studies had enrolled small numbers of patients. Though individual studies showed benefit of varying degrees on the parameters mentioned above, we could not pool the results of these studies. With the evidence available so far, no definitive conclusion can be drawn for the benefit of pancreatic enzymes in patients with chronic pancreatitis.

Nutritional support, through the intestine (enteral) versus by injection (parenteral) for people with acute pancreatitis

The pancreas is a gland that lies behind the stomach. It produces enzymes that help digestion. Acute pancreatitis is an inflammation in the pancreas which causes severe pains in the stomach. Extra nutrition is needed to recover. However the pancreas needs rest in order to repair. Nutrition must therefore be given either by a tube into the intestines (enteral) or by injection (parenteral). This review found that patients with acute pancreatitis receiving enteral nutrition have fewer episodes of death, systemic infections, multiple organ failure and operative interventions. This data suggests that EN should be considered the standard of care for patients with acute pancreatitis requiring nutritional support.

Antioxidants to reduce pain in chronic pancreatitis

Chronic pancreatitis is a persistent inflammation of the pancreas that in the long run can cause irreparable damage. The major causes of chronic pancreatitis are genetics, alcohol toxicity and other conditions that might damage or obstruct the pancreas. This inflammation can cause pain that often is severe and leaves patients socially isolated and unable to perform their jobs. Unfortunately, treatment options are scarce, and often strong morphine‐like pain medications are needed. Patients might benefit from alternative medication without the adverse effects associated with morphine‐like medication. This review summarises the evidence from randomised trials on the effects of antioxidants in chronic pancreatitis. Antioxidants are substances that prevent damage to cells caused by toxic byproducts of oxygen in the body. Levels of these byproducts are increased in chronic pancreatitis. Antioxidants constitute a large group that contains many natural and man‐made products. Examples include vitamin C, vitamin E, flavonoids (present in tea and cocoa) and many specialised medications. We found 12 randomised trials on this topic. The quality of these trials was mixed, and many had small sample sizes and high rates of dropout. Evidence shows that antioxidants may reduce pain in patients with chronic pancreatitis, but the reported reduction in pain was small. Whether this small decrease really had an impact on patients' complaints is not clear. Given the methodological problems of these trials, a strong conclusion could not be drawn. Use of antioxidants resulted in adverse effects in about 16% of study participants. Most adverse effects were mild, such as headache, nausea and constipation. However, participants who developed these adverse effects tended to stop using antioxidant medication. Other outcomes important for decision making such as use of analgesics, rate of exacerbation of pancreatitis and quality of life, were not very well reported. Therefore, we were unable to reach conclusions on these outcomes.

See all (32)

More about Pancreatitis

Photo of an adult

See Also: Acute Pancreatitis, Chronic Pancreatitis

Other terms to know:
Enzymes, Hormones, Pancreatic Duct

Keep up with systematic reviews on Pancreatitis:

RSS

PubMed Health Blog...

read all...