Pancreatitis

Overview: Pancreatitis

Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types, acute pancreatitis and chronic pancreatitis.

There are a number of causes of acute pancreatitis. The most common, however, are gallbladder disease and alcoholism.

Diagnosis of pancreatitis can be made very early in the disease by noting high levels of pancreatic enzymes circulating in the blood (amylase and lipase). Later in the disease, and in chronic pancreatitis, these enzyme levels will no longer be elevated.

Because of this fact, and because increased amylase and lipase can also occur in other diseases, the discovery of such elevations are helpful but not mandatory in the diagnosis of pancreatitis.

Other abnormalities in the blood may also point to pancreatitis, including increased white blood cells (occurring with inflammation and/or infection), changes due to dehydration from fluid loss, and abnormalities in the blood concentration of calcium, magnesium, sodium, potassium, bicarbonate, and sugars.

Important Points to Consider

• High TG levels (higher than 500 mg/dL) result from elevations of chylomicrons, intermediate-density lipoproteins, or VLDLs. Fasting TG levels higher than 1000mg/dL can result from either genetics or a combination of genetics and a secondary cause, such as alcohol abuse, poorly controlled diabetes, estrogens, obesity, renal disease, or steroid use. Because patients with a TG level higher than 1000mg/dL have a high risk of developing pancreatitis, this is the priority of treatment.

• Estrogens, progestins, and other steroids are contraindicated for patients with hypertriglyceridemia because they elevate the TG level and may cause pancreatitis.

• The overlapping constellation of Peptic Ulcer Disease (PUD) symptoms with such diseases as gastritis, irritable bowel syndrome, gastroesophageal reflux disease, Crohn disease, pancreatitis, gallstones, and malignancies makes a first-time diagnosis of PUD challenging, especially because the best current standard diagnostic test is endoscopy and the next best tool for diagnosis is a barium GI series. One study even showed that a physical examination finding of epigastric tenderness to palpation lessens the likelihood of Peptic Ulcer Disease (PUD).

• Signs of vitamin D toxicity include nausea and vomiting, pancreatitis, nephrocalcinosis or vascular calcinosis, metallic taste, and headache.

• X rays or ultrasound examination of the abdomen may reveal gallstones, perhaps responsible for blocking the pancreatic duct.

• Pancreatic disease, including pancreatitis (inflammation of the pancreas) can cause severe persistent pain that may travel to the back.

• Higher serum calcium levels can cause inflammation and pain in the linings of the stomach and pancreas often causing and developing symptoms of pancreatitis.

• Damage to the kidneys as a result of hyperparathyroidism is often irreversible. Prognosis is generally good; however, complications of hyperparathyroidism such as osteoporosis, bone fractures, kidney stones, peptic ulcers, pancreatitis, and nervous system difficulties may worsen prognosis.

Caution: As a general rule, most good-quality probiotics are quite safe with few side effects, but use caution in patients with severe pancreatitis, immunocompromised people, and those with indwelling medical equipment.

Dietary Modifications

A tailored diet plays a crucial role in managing pancreatitis:

• Low-Fat Diet: Reducing fat intake lessens the pancreas’s workload. Opt for lean proteins, fruits, vegetables, and whole grains. Cooking methods like baking, steaming, grilling, or boiling are preferable over frying. Consuming smaller, more frequent meals can also be beneficial.

• Abstinence from Alcohol and Smoking: Both alcohol consumption and smoking are significant risk factors for pancreatitis. Ceasing these habits can help reduce inflammation and prevent further pancreatic damage.

• Barley grass can be used to treat disorders of the stomach and duodenum; pancreatitis; and as an anti-inflammatory agent.

• Increase intake of yellow and orange fruits and dark- green vegetables, which are good sources of beta- carotene, whole foods, vitamin C, and other antioxidants.

• Take high-potency multivitamin/mineral supplements.

• Use chromium (300 mcg daily) supplements to help control blood sugar level and enhance insulin effectiveness.

• Take lipotrophic agents(which increase bile flow to and from the liver), such as vitamin B6, vitamin B12, folic acid, choline, betaine, and methionine.

• Take pancreatic enzymes at mealtime

• Methionine in combination with several antioxidants may reduce pain and recurrences of attacks of pancreatitis (inflammation of the pancreas).

The results of a CT scan can also be used to predict the severity of pancreatitis. Slight swelling of the pancreas indicates mild illness. Significant swelling, especially with evidence of destruction of the pancreas and/or fluid buildup in the abdominal cavity, indicates more severe illness. With severe illness, there is a worse prognosis.

Nutritional Supplements

Certain supplements may support pancreatic health:

• Pancreatic Enzyme Replacement Therapy (PERT): For those with exocrine pancreatic insufficiency, PERT aids digestion by providing necessary enzymes. It’s essential to consult a healthcare provider for appropriate dosing and monitoring.

• Antioxidants: Supplements containing antioxidants may help reduce inflammation and oxidative stress associated with pancreatitis. A high-quality multivitamin/mineral supplement can support nutrient absorption and prevent deficiencies.

Herbal Remedies

Some herbal treatments have shown potential benefits:

• Turmeric: Contains curcumin, a powerful antioxidant that may reduce inflammation and alleviate symptoms of an inflamed pancreas. A typical recommendation is 500 to 700 mg per day, but it’s crucial to consult with a healthcare provider before starting any supplement.

• Ginger: Known for its anti-inflammatory and antioxidant properties, ginger may help manage pancreatitis symptoms. It can be consumed as a tea or incorporated into meals.

Traditional Chinese Medicine (TCM)

TCM offers alternative approaches:

• Herbal Formulations: Certain TCM herbs, such as rhubarb and Salvia miltiorrhiza, have been used to manage pancreatitis. These herbs may help reduce inflammation, inhibit pancreatic enzymes, and promote pancreatic repair. However, more research is needed to confirm their efficacy.

• In Chinese medicine, the Spleen channel (with some of its functions being comparable to those of the pancreas) is in charge of all movement in the body. Excess sugar damages the Spleen.

Mind-Body Practices

Incorporating stress-reduction techniques can be beneficial:

• Meditation and Yoga: These practices may help manage stress, which can influence digestive health. They can be tailored to individual needs and incorporated into daily routines. 

Caution

Before starting any integrative treatments, it’s essential to consult with a healthcare provider to ensure they’re appropriate for your specific condition and to avoid potential interactions with conventional therapies.