Pancreas Health Article

Pancreatitis

Pancreatitis is a relatively common condition that affects the pancreas. It can occur as an acute (sudden onset) problem or chronic (slow, ongoing) disorder. The common element in both types is inflammation caused by the normal digestive enzymes of the pancreas. In pancreatitis, these secretions act abnormally and start to digest the pancreas itself. Between 50,000 and 80,000 people in the United States develop acute pancreatitis every year, usually related to gallstones or alcohol abuse. Most patients recover within a week, but the most severe forms of pancreatitis have a mortality rate of 10%. Chronic pancreatitis is slow and insidious in onset, and

so harder to diagnose. Alcohol use is the most common cause of deterioration in pancreatic function over time. Without adequate levels of enzymes and hormones produced by the pancreas, such diseases as diabetes mellitus and malabsorption syndromes will develop. A malabsorption syndrome is a condition in which the body is not able to absorb the nutrients it needs from the food it attempts to digest. Vitamin deficiencies, protein malnutrition, and problems with frequent, greasy stools may occur.

Complications of pancreatitis include pancreatic necrosis (the death of a significant portion of the cells in the pancreas, putting the patient at risk of bleeding, infection, shock, and failure of many major organs); pancreatic abscess (an infection with a wall of scar tissue around it); and pancreatic pseudocyst (a pocket full of fluid and pancreatic enzymes that may shrink, expand, or rupture). Patients with chronic pancreatitis are also at increased risk of developing cancer of the pancreas.

KEY TERMS

Amino acids—The category of molecules used to build proteins.

Diabetes mellitus—A chronic form of diabetes in which insulin does not effectively transport glucose from the bloodstream.

Duodenum—The portion of the small intestine that lies between the stomach and the jejunum. The pancreas empties some of its secretions into the duodenum via a Y-shaped duct.

Endocrine—A type of gland that secretes hormones directly into the blood or lymph.

Enzymes—Complex protein molecules that speed up chemical reactions, or make reactions happen under conditions where they normally would not occur.

Exocrine—A type of gland that secretes its products to an epithelial surface.

Glucagon—A hormone secreted by the pancreas that opposes insulin in the regulation of blood sugar levels.

Insulin—A hormone produced in the islet cells of the pancreas that regulates the metabolism of glucose and other nutrients.

Islet cells—Endocrine cells in the pancreas that are specialized to secrete glucagon or insulin.

Jaundice—A condition in which the skin and whites of the eyes are yellow because of bile products retained in the bloodstream.

Pancreatitis—Inflammation of the pancreas.

Zymogens—Enzyme precursor molecules that may change into enzymes as a result of catalytic change.

Cancer of the pancreas

Pancreatic cancer is a major cause of death from cancer around the world. Tumors of the pancreas may arise from either endocrine or exocrine cells. Some rare types of pancreatic tumors hypersecrete either glucagon (glucagonomas) or insulin (insulinomas). Cancer of the pancreas is difficult to diagnose in its early stages; about 90% of patients present with pain, diarrhea, blood clots, weight loss, or jaundice when the cancer has already spread outside the pancreas. As of 2001, about 25,000 people die every year with this disease, and there are few medical interventions to help these patients. Under certain circumstances, chemotherapy or surgery to remove part of the pancreas may be attempted. Only 2–5% of patients are alive five years after being diagnosed.

BOOKS

"Gastrointestinal Disorders." Section 3 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Izenberg, Neil, et al. Human Disease and Conditions. New York: Charles Scribner's Sons, 2000.

Tierney, Laurence M., Stephen J. McPhee, and Maxine A. Papadakis. Current Medical Diagnosis and Treatment 2001. New York: McGraw-Hill, 2001.

ORGANIZATIONS

American Diabetes Association. 1660 Duke Street, Alexandria, VA 22314. (800) 232-3472.

National Digestive Diseases Information Clearinghouse. 2 Information Way, Bethesda, MD 20892. (301) 654-3810 or (800) 891-5389.

OTHER

National Institutes of Health. <http://www.niddk.nih.gov>.

Pancreas Foundation. <http://www.pancreasfoundation.org>.

Erika J. Norris