Acute Pancreatitis, refers to inflammation of the pancreas, occurs in acute and chronic forms and may be due to edema, necrosis, or haemorrhage. In men this disease commonly associated with alcoholism, trauma, or peptic ulcer; in women, it’s linked to biliary tract disease. The prognosis is good when pancreatitis follows biliary tract disease, but poor when it follows alcoholism.[1]
Common causes such as:
Uncommon causes
Post operative causes like:
Factors that increase your risk of pancreatitis include:
The pathophysiology of acute pancreatitis is characterized by a loss of intracellular and extracellular compartmentation, by an obstruction of pancreatic secretory transport and by an activation of pancreatic enzymes. In biliary acute pancreatitis, outflow obstruction with pancreatic duct hypertension and a toxic effect of bile salts contribute to disruption of pancreatic ductules, with subsequent loss of extracellular compartmentation.
Alcohol induces functional alterations of plasma membranes and alters the balance between proteolytic enzymes and protease inhibitors, thus triggering enzyme activation, autodigestion and cell destruction. Once the disease has been initiated, the appearance of interstitial edema and inflammatory infiltration are the basic features of acute pancreatitis.
The accumulation of polymorphonuclear granulocytes in pancreatic and extrapancreatic tissue, and the release of leukocyte enzymes play an essential role in the further progression of the disease and in the development of systemic complications. Activation of different cascade systems by proteolytic activity, and consumption of alpha 2-macroglobulin further characterize the severe clinical course of acute pancreatitis.[6]
Types of Pancreatitis
There are mainly two types that is;
The most common symptom of acute pancreatitis is pain. Almost everybody with acute pancreatitis experiences pain.
In very severe cases with either infection or bleeding, a person may become dehydrated and have low blood pressure.
If the blood pressure becomes extremely low, the organs of the body do not get enough blood to carry out their normal functions. Hence, This very dangerous condition is called circulatory shock and is referred to simply as shock. [1]
The physical examination findings may be normal or reveal fever, hypotension, tachycardia, tachypnea, or diaphoresis. Abdominal examination typically reveals notable tenderness to palpation, guarding, also possible signs of peritoneal irritation, distension, or rigidity. Bowel sounds are typically decreased. Additionally, Jaundice may be present. In severe disease, patients may present with altered mental status. Overall, history also physical examination have moderate accuracy, especially when findings are abnormal (positive likelihood ratio [LR+] = 3.2; negative likelihood ratio [LR–] = 0.8).9 Two physical signs associated with pancreatitis are Cullen sign (ecchymosis and edema in the subcutaneous tissue around the umbilicus) and Grey Turner sign (ecchymosis of the flank).[7]
Once a working diagnosis of acute pancreatitis is reached, laboratory tests are obtained to support the clinical impression. In addition to confirming the diagnosis, laboratory tests are helpful in defining an etiology and looking for complications.
They are typically elevated in persons with acute pancreatitis. Serum amylase determinations are routinely available, but they are not specific for pancreatitis.
Lipase has a slightly longer half-life and abnormalities may support the diagnosis if a delay occurs between the pain episode also the time the patient seeks medical attention.
Elevated lipase levels are more specific to the pancreas than elevated amylase levels. The level of serum amylase or lipase does not indicate whether the disease is mild, moderate, or severe, and monitoring levels serially during the course of hospitalization does not offer insight into prognosis.
Obtain measurements for blood urea nitrogen (BUN), creatine, and electrolytes; a great disturbance in the electrolyte balance usually found, secondary to third spacing of fluids. Measure blood glucose level because it may be elevated from B-cell injury in the pancreas.
Measure calcium, cholesterol, and triglyceride levels to search for an etiology of pancreatitis (such as; hypercalcemia or hyperlipidemia) or complications of pancreatitis (for example, hypocalcemia resulting from saponification of fats in the retroperitoneum).
A complete blood count (CBC) demonstrates leukocytosis (white blood cell (WBC) count higher than 12,000/µL) with the differential being shifted toward the segmented polymorphonuclear (PMN) cells. Leukocytosis may represent inflammation or infection.
Ultrasonography of the abdomen is the most useful initial test in determining the etiology of pancreatitis and is the technique of choice for detecting gallstones. Although ultrasonography can be used as a screening test, it may not be specific if overlying gas shadows secondary to bowel distention are present. Ultrasonography cannot measure the severity of disease.
Imaging is indicated during the initial presentation if i.e.:
While CT considered the gold standard in diagnostic imaging for acute pancreatitis, magnetic resonance imaging (MRI) has become increasingly valuable as a tool for the visualization of the pancreas, particularly of pancreatic fluid collections and necrotized debris. Additional utility of MRI includes its indication for imaging of patients with an allergy to CT’s contrast material, and an overall greater sensitivity to hemorrhage, vascular complications, pseudoaneurysms, also venous thrombosis. [1]
Differential diagnoses include but is not limited to the following i.e.:
Treatment often requires a stay in the hospital and may involve i.e.:
Occasionally a tube will inserted through the nose or mouth to remove the contents of the stomach (nasogastric suctioning). This may done if vomiting or severe pain do not improve, or if a paralyzed bowel (paralytic ileus) develops. The tube will stay in for 1 – 2 days to 1 – 2 weeks.
Treating the condition that caused the problem can prevent repeated attacks.
In the most severe cases, surgery is needed to remove either dead or infected pancreatic tissue.
Avoid smoking, alcoholic drinks, and a fatty food after the attack has improved. [1]
You can reduce your risk of developing acute pancreatitis by cutting back on drinking alcohol. This helps to prevent your pancreas being damaged.
A unit of alcohol is equal to about half a pint of normal-strength lager or a pub measure (25ml) of spirits. A small (125ml) glass of wine (ABV 12%) or an alcopop is 1.5 units.
Remember, if you’ve had acute pancreatitis caused by drinking too much alcohol, you should avoid it completely.[8]
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.
A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.
A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?
The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.
The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.
So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).
Acute Pancreatitis, refers to inflammation of the pancreas, occurs in acute and chronic forms and may be due to edema, necrosis, or haemorrhage.
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