Acute pancreatitis (inflammation of the pancreas) causes telltale symptoms that are usually unforgettable for the sufferer. The pancreas is a gland that produces hormones (insulin and glucagon) that are needed to store and mobilize glucose, the body's primary energy source. The pancreas also pumps out digestive juices that break down proteins, fats and carbohydrates.

An attack typically comes on suddenly and triggers searing pain in the upper abdomen, of ten spreading to the back. Eating makes the pain worse. Nausea and vomiting are common.

Acute pancreatitis is a medical emergency. Most people get better after a few days in the hospital, but in about 5% of cases, the condition is fatal due to such complications as infection, breathing problems and kidney failure. Common causes…

  • Gallstones can block the duct that carries bile (fluid secreted by the liver and stored in the gallbladder) and pancreatic secretions into the digestive system. These secretions back up into the pancreas, activating its enzymes. Surgery may be necessary to remove gallstones blocking the pancreatic duct.

Self-defense: If you have gallstones that have caused symptoms, such as pain in the upper middle or right part of the abdomen and nausea and/or vomiting, consider having your gallbladder removed.

  • Alcohol can damage the liver and, in some people, it can harm the pancreas. Binge drinking (beer, wine or whiskey) often triggers the attack.

Self-defense: If you drink excessively (more than two drinks daily for men and more than one drink daily for women), abstain from alcoholic beverages.

  • Medications, such as antibiotics, corticosteroids and diuretics, can, in rare cases, lead to acute pancreatitis.

Self-defense: If you experience an attack shortly after you started taking a drug, ask your doctor whether there is another medication that you can take instead. Other conditions affecting

the pancreas...

Chronic Pancreatitis

Chronic pancreatitis may follow repeated episodes of acute pancreatitis, or result from an inherited abnormality in the anatomy of the gland, but 70% of cases are caused by prolonged alcohol abuse.

Most of the time, chronic pancreatitis results in pain that flares up periodically over months or even years. Weight loss is common, because the pancreas cannot produce enough enzymes to break down food. Chronic pancreatitis is often difficult to diagnose-abdominal pain is common to any number of disorders, and blood tests may not detect abnormalities.

Latest development: A test known as endoscopic retrograde cholangiopancreatography helps doctors diagnose chronic pancreatitis. With this test, the doctor passes a thin tube through the stomach and into the small intestine. Dye is injected to make the bile and pancreatic ducts visible on an X-ray.

Tests that assess pancreatic function, which is measured by determining if the pancreas is producing the appropriate levels of digestive enzymes, also help make the diagnosis.

New thinking: Only recently have doctors begun to appreciate that in some people chronic pancreatitis is an autoimmune disorder-the body's tissues attack the gland for unknown reasons (as occurs with rheumatoid arthritis or lupus). This type of chronic pancreatitis can be diagnosed with a blood test and treated with drugs, such as steroids, that help reduce inflammation.

For most cases of chronic pancreatitis, there is no medical cure. A low-fat diet and pain medication may reduce symptoms. Also, pancreatic enzyme pills can be taken with meals to aid the absorption of nutrients. When symptoms do not improve with these approaches, a surgical procedure to drain secretions from the pancreas or remove diseased parts of the gland is performed.

Treatment advances: Patients who do not respond to other treatments may be candidates for removal of the pancreas. This can be followed by transplantation of insulin-producing cells (islet cells) from the patient's own cells or from another person into the patient's liver-a minor outpatient procedure that can be performed with a local anesthetic. Another option is a pancreas transplant--this is major surgery that requires a one-to three-week hospital stay.

Cancer Of The Pancreas

Each year, about 30,000 Americans are diagnosed with pancreatic cancer. The risk for pancreatic cancer is two to three times higher for smokers. Chronic pancreatitis also increases the risk.

Early-stage pancreatic cancer rarely produces usually vague-mid- or upper-abdominal pain, weight loss and fatigue. Only 5% of patients survive five years after diagnosis, primarily because the malignancy is difficult to detect before it spreads.

Caution: If you develop diabetes later in life (after age 60), ask your doctor to evaluate you for pancreatic cancer. Pancreatic cancer is diagnosed twice as often in people who have developed diabetes than it is in those without diabetes-particularly in the two years after diabetes appears.

If pancreatic cancer runs in your family: You should consider screening if you have two first-degree relatives (such as a parent or sibling) who have had pancreatic cancer, Screening strategies include annual endoscopic ultrasound and biopsies of the pancreas.

Recent finding: A study in the journal Annals of Surgery found that fewer than one-third of people diagnosed with early-stage pancreatic cancer-a time when treatment may be most effective-actually have surgery to remove the pancreas. Patients were less likely to be offered surgery if they were treated at community hospitals, rather than major cancer centers. They also were less likely to be offered surgery if they were older than age 65.

A Big Belly Raises Pancreatic Cancer Risk Among Women

Obese women who carry weight in their midsections are 70% more likely to develop pancreatic cancer. Obesity also has been linked to breast, colon and other cancers.

Antibiotics that Prevent Stomach Cancer

The Helicobacter pylori bacterium causes chronic stomach inflammation and peptic ulcers, which can progress to gastric cancer.

Recent finding: The sooner antibiotics are given, the more effectively they reverse cell damage that leads to cancer, animal studies show.

Best: See your doctor without delay if you have H. pylori symptoms-persistent abdominal pain, bloating, tarry stool-especially if you have a family history of peptic ulcers or gastric cancer.

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