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Pancreatitis

Pancreatitis is a term that refers to inflammation of the pancreas. This inflammation can be caused by many potential factors. The key division in these conditions is between acute pancreatitis and chronic pancreatitis.

Acute pancreatitis is associated among other conditions with binge alcohol drinking (a major cause), a family history of high serum triglycerides, recent surgery, and a history of biliary colic. Signs and symptoms of acute pancreatitis include intense upper abdominal pain often times radiating through to the back (major symptom), nausea, vomiting, fever, rapid heart rate, abdominal tenderness, and sometimes jaundice and even shock. Acute pancreatitis can be a life-threatening emergency and must be treated with urgency and with great care.

Chronic pancreatitis is more of an ongoing or even intermittent inflammation of the pancreas taking place over months or years which typically produces intermittent severe mid or left upper abdominal pain that can radiate to the back, which may be associated with eating or come unbidden with no association to food. It is often accompanied by diarrhea and weight loss. Standard physical examination will generally not be sufficient for diagnosis, which will likely necessarily include a high index of suspicion on the part of a physician, laboratory testing and imaging studies.

Pancreatic cancer is increased with chronic pancreatitis and with certain genetic or hereditary causes of pancreatitis. Hereditary pancreatitis can progress to chronic pancreatitis. But, it is important to note that most cases of chronic pancreatitis do not result in pancreatic cancer. However, those with hereditary pancreatitis have about a 40% lifetime risk of developing pancreatic cancer. It appears that the risk among those with hereditary pancreatitis in increased for those individuals who additionally drink alcohol or smoke cigarettes. The majority of individuals with hereditary pancreatitis carry a familial mutation of the PRSS1 gene.

An indication that one may have hereditary pancreatitis is if two or more first degree relatives OR three or more second degree relatives have been diagnosed with pancreatitis.

The exact screening measures and potential procedures are not fully agreed upon (in medical terms) in patients with hereditary pancreatitis, but it is advised that one seek the services and counsel of highly experienced specialists. Both chronic pancreatitis and hereditary pancreatitis require careful and thoughtful follow-up and care – both for the conditions themselves, and for their relationship to pancreatic cancer.

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