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Common Disorders of The Pancreas

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COMMON DISORDERS OF THE PANCREAS

There are a variety of disorders of the pancreas including acute pancreatitis, chronic
pancreatitis, hereditary pancreatitis, and pancreatic cancer.

Acute Pancreatitis

Acute pancreatitis is a sudden attack causing inflammation of the pancreas and is usually
associated with severe upper abdominal pain. The pain may be severe and last several
days. Other symptoms of acute pancreatitis include nausea, vomiting, diarrhea, bloating,
and fever. In the United States, the most common cause of acute pancreatitis is
gallstones. Other causes include chronic alcohol consumption, hereditary conditions,
trauma, medications, infections, electrolyte abnormalities, high lipid levels, hormonal
abnormalities, or other unknown causes. The treatment is usually supportive with
medications showing no benefit. Most patients with acute pancreatitis recover
completely.

Chronic Pancreatitis

Chronic pancreatitis is the progressive disorder associated with the destruction of the
pancreas. The disease is more common in men and usually develops in persons between
30 and 40 years of age. Initially, chronic pancreatitis may be confused with acute
pancreatitis because the symptoms are similar. The most common symptoms are upper
abdominal pain and diarrhea. As the disease becomes more chronic, patients can develop
malnutrition and weight loss. If the pancreas becomes destroyed in the latter stages of the
disease, patients may develop diabetes mellitus.
The most common cause of chronic pancreatitis in the United States is chronic alcohol
consumption. Additional causes include cystic fibrosis and other hereditary disorders
ofthe pancreas. For a significant percentage of patients there is no known cause. More
research is needed to determine other causes of the disease. The treatment for chronic
pancreatitis depends on the symptoms. Most therapies center on pain management and
nutritional support. Oral pancreatic enzyme supplements are used to aid in the digestion
of food. Patients who develop diabetes require insulin to control blood sugar. The
avoidance of alcohol is central to therapy.

Hereditary Pancreatitis

In some cases, pancreatitis is related to inherited abnormalities of the pancreas or


intestine. Acute recurrent attacks of pancreatitis early in li fe (under age 30) can often
progress to chronic pancreatitis. The most common inherited disorder that leads to
chronic pancreatitis is cystic fibrosis. Recent research demonstrates genetic testing can be
a valuable tool in identifying patients predisposed to hereditary pancreatitis. As in
chronic pancreatitis, hereditary pancreatitis is a progressive disease with a high risk of
permanent problems. Patients with these disorders may have chronic pain, diarrhea,
malnutrition, or diabetes. Treatment focuses on pain control and pancreatic enzyme
replacement.

Pancreatic Cancer

Pancreatic cancer is the fourth most common cause of cancer death in men and the fifth
in women. It accounts for more than 37,000 new cases per year in the United States.
Cancer of the pancreas is resistant to many standard treatments including chemotherapy
and radiation therapy. This cancer grows insidiously and initially does not cause
symptoms. The classic presentation of pancreatic cancer is referred to as painless
jaundice, a yellowish skin discoloration with no other symptoms. The diagnosis is usually
made using different radiographic imaging techniques.

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