Overview of Pancreatitis
Pancreatitis is inflammation of the pancreas. Pancreatitis can develop suddenly and resolve in a short amount of time (called acute pancreatitis), or can be long lasting and recurrent (called chronic pancreatitis). In some cases, the condition is genetic (called hereditary pancreatitis).
Pancreatitis is a serious medical problem that can be life threatening. It is more common in people who have a history of alcohol abuse or diseases of the biliary tract (e.g., liver, gallbladder, bile ducts). Symptoms of pancreatitis include abdominal pain (which may be severe), nausea, and vomiting.
Pancreatitis can cause serious complications, including tissue death (necrosis), bleeding, and infection. In severe cases, it can cause toxic substances and digestive enzymes to be released into the bloodstream, where they can spread throughout the body, damage other organs (e.g., heart, lungs, kidneys), and cause infection (e.g., bacteremia).
Anatomy of the Pancreas
The pancreas is a long, glandular organ that is part of the digestive system. It is located in the abdomen, behind the stomach and between the first part of the small intestine (called the duodenum) and the spleen. The pancreas is both an exocrine gland and an endocrine gland, and the organ is involved in digestion and metabolism.
The exocrine function of the pancreas is to produce and secrete a substance called pancreatic juice. Pancreatic juice is made up of sodium bicarbonate and certain enzymes (e.g., trypsinogen, chymotrypsinogen, amylase, lipase) that aid in digestion in the small intestine. It flows from the pancreas through the pancreatic duct to the duodenum, where the enzymes become active. If the enzymes start to work before leaving the pancreas, they can begin to "digest" the organ itself (called autodigestion), causing pancreatitis.
The endocrine function of the pancreas is to secrete certain hormones into the bloodstream that help regulate levels of blood glucose (sugar) and other substances in the body. This function is performed by small groups of endocrine gland cells called islets of Langerhans, which are scattered throughout the exocrine tissue of the pancreas.
There are three types of endocrine cells in the pancreas and each type secretes a certain hormone. Alpha cells secrete glucagon, which raises glucose (sugar) levels in the blood; beta cells release insulin, which lowers glucose levels in the blood; and delta cells secret somatostatin, which helps regulate the production of growth hormone.
Insulin is necessary to convert glucose into a form that can be used by cells for growth and energy. Diabetes mellitus, also called diabetes, is a disease that results from a defect in the ability of the pancreas to produce insulin or in the body's ability to utilize the hormone.
Incidence and Prevalence of Pancreatitis
Pancreatitis occurs more often in adults who have a history of alcohol abuse and in patients who have gallbladder disease (e.g., gallstones). According to the National Institutes of Health (NIH), approximately 80,000 cases of acute pancreatitis occur each year in the United States and about 20% of these cases are severe and life threatening.
Rates of recurrent attacks and chronic pancreatitis are difficult to determine. Approximately 70% of chronic cases in adults are related to alcohol abuse. Chronic pancreatitis is more common between the ages of 30 and 40.
Pancreatitis affects men more often than women and is more common in African Americans than in Caucasians. The condition is rare in children.