Pancreatic Diseases: Types and Symptoms

The pancreas is an organ behind the stomach and in front of the spine: it produces juices that break down food and hormones that regulate blood sugar levels. Its disorders are grouped together as pancreatic diseases — from inflammation to tumors and hereditary disorders. Below is an overview of which pancreatic diseases occur and by which symptoms they can be suspected.

What diseases affect the pancreas

Pancreatic diseases include pancreatitis (inflammation in which digestive enzymes begin to digest the gland itself), pancreatic cancer, cystic fibrosis (a hereditary disease in which thick mucus blocks the gland's ducts), and disorders in diabetes: in type 1, beta cells do not produce insulin; in type 2, the gland loses the ability to secrete enough of it in response to food intake. Exocrine insufficiency and pancreatic cysts are also mentioned separately.

How acute pancreatitis differs from chronic

Acute pancreatitis is sudden inflammation that requires immediate treatment, usually in a hospital. Chronic pancreatitis is a long-term condition in which the gland is inflamed, scars, and hurts; it cannot be cured, but the resulting problems can be treated. Most often, chronic pancreatitis is a consequence of prior acute pancreatitis. The most common cause is alcohol: if a person continues to drink and repeatedly has attacks, the gland eventually scars. According to statistical data, 70% of patients with destructive pancreatitis are people with alcoholism, in 20% pancreatitis developed as a complication of gallstone disease, and about 5% of cases are associated with complications after surgery and endoscopic procedures. Other causes include smoking, heredity (including the cystic fibrosis gene; in children this is the most common cause), an attack by the immune system on the gland itself, and certain medications, including some antibiotics and diabetes drugs. Sometimes the cause cannot be identified.

Common symptoms of pancreatic diseases

The main sign of chronic pancreatitis is abdominal pain. The pain may be in the upper abdomen just below the ribs, on one side, or throughout the abdomen; constant or paroxysmal; severe or a dull ache. It is less severe when sitting and leaning forward and worsens after eating.

• nausea and vomiting;
• diarrhea, very foul-smelling stool that floats and is difficult to flush away;
• abdominal bloating and increased gas formation;
• thirst and frequent urination;
• effortless weight loss.

In acute pancreatitis, the pain is sudden, severe, and constant in the upper half of the abdomen, radiating to the left side of the trunk; vomiting is uncontrollable, with an admixture of bile, and brings no relief. If the head of the gland is enlarged, obstructive jaundice is possible: the skin turns yellow, the urine darkens, and the stool becomes pale. Over time, chronic pancreatitis leads to complications: impaired absorption of nutrients with weight loss and weakened bones, type 3c diabetes, cysts around the gland, blockage of ducts with inflammation of the gallbladder; the risk of pancreatic cancer is higher in such patients.

How pancreatic diseases are detected

There is no single test for diagnosing chronic pancreatitis: first the doctor rules out other causes, since the symptoms resemble manifestations of irritable bowel syndrome or gallstone disease. The doctor palpates the abdomen, checks for yellowness of the skin and eyes, weighs the patient, orders blood and stool tests, and asks about relatives with pancreatitis. Next, consultation with a specialist and instrumental studies are possible — computed tomography or ultrasound, gastroscopy. In acute pancreatitis, ultrasound, fibrogastroduodenoscopy, laparoscopy, a blood test for amylase, and a urine test for diastase are used.

When to see a doctor

A routine visit to a doctor is needed for prolonged or recurring pain in the upper abdomen, changes in stool, weight loss, or thirst. With sudden severe abdominal pain, help is needed urgently: this may be acute pancreatitis or another condition requiring treatment in a hospital.

A pancreatic disease by itself is not a reason to call an ambulance; 103/112 — if abdominal pain occurs suddenly and is very severe, especially with uncontrollable vomiting that brings no relief, or with yellowing of the skin and eyes, darkening of the urine, and pale stool.

This material is for reference purposes and does not replace consultation with a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer