In pancreatitis, the body's own digestive enzymes turn against the pancreas
The pancreas makes enzymes strong enough to break down a meal. When it becomes inflamed, those same chemicals can damage the organ and even the lungs. Roughly 80 percent of cases trace to just two causes, gallstones and alcohol, and global deaths rose from 83,000 in 1990 to 132,700 in 2015.
The pancreas sits behind the stomach, producing digestive enzymes and several hormones. Pancreatitis, its inflammation, comes in two main forms. Acute attacks bring severe upper-abdominal pain that often bores through to the back, with nausea and vomiting, and usually settle within days. The chronic form can cause weight loss and fatty stools because the damaged gland no longer supplies enough enzymes, and it can lead to diabetes or pancreatic cancer.
Gallstones lodged in the bile duct are the leading cause of acute cases; many years of heavy drinking are the leading cause of chronic ones. Medical students memorise the rest with the mnemonic GET SMASHED, which runs from trauma and steroids through mumps and scorpion stings to high blood fats and certain drugs. Smoking raises the risk of both forms, and type 2 diabetes is linked to a risk 2.8 times higher. One inherited version switches on the enzyme precursor trypsinogen inside the pancreas itself, so the gland starts digesting its own tissue.
Doctors confirm the condition when two of three criteria are met: the typical sudden pain, blood levels of amylase or lipase at least three times the normal ceiling, or telltale changes on a scan. Lipase is generally the more reliable signal because it is more specific and lasts longer in the blood. Ultrasound is cheap and good at spotting gallstones, but bowel gas hides the pancreas in a quarter to a third of patients, and a CT scan done too early can look falsely reassuring.
Around 8.9 million cases occurred worldwide in 2015. Acute pancreatitis strikes about 30 in every 100,000 people a year, chronic disease is more common in men and typically begins between 30 and 40, and the acute form was first described at autopsy in 1882. Hospital care centres on intravenous fluids and pain control, and removing a blocking gallstone where one is found.
Source: Pancreatitis
