Dr Ian Berkowitz

GASTROENTEROLOGIST

Pancreatitis.

Pancreatitis is inflammation in the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that help digestion and hormones that help regulate the way your body processes sugar (glucose). Pancreatitis can occur as acute pancreatitis — meaning it appears suddenly and lasts for days. Or pancreatitis can occur as chronic pancreatitis, which is pancreatitis that occurs over many years.Mild cases of pancreatitis may go away without treatment, but severe cases can cause life-threatening complications.

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Image: Pancreatitis caused by gallstones - Gallstones are a common cause of pancreatitis. Gallstones, produced in the gallbladder, can block the bile duct, stopping pancreatic enzymes from traveling to the small intestine and forcing them back into the pancreas. The enzymes then begin to irritate the cells of the pancreas, causing the inflammation associated with pancreatitis.

Symptoms

Signs and symptoms of pancreatitis may vary, depending on which type you experience.

Acute pancreatitis signs and symptoms include:

Upper abdominal pain

Abdominal pain that radiates to your back

Abdominal pain that feels worse after eating

Fever

Rapid pulse

Nausea

Vomiting

Tenderness when touching the abdomen

Chronic pancreatitis signs and symptoms include:

Upper abdominal pain

Losing weight without trying

Oily, smelly stools (steatorrhea)

When to see a doctor

Make an appointment with your doctor if you have persistent abdominal pain. Seek immediate medical help if your abdominal pain is so severe that you can't sit still or find a position that makes you more comfortable.

How is pancreatitis diagnosed?

When a health-care professional identifies symptoms suggestive of pancreatitis, specific questions are asked about the person's symptoms, lifestyle and habits, and medical and surgical history. The answers to these questions and the results of the physical examination allow the health-care professional to rule out some conditions and make the correct diagnosis.

In most cases, laboratory tests are needed. The tests check the functioning of several body systems, including the following:

Pancreas, liver, and kidney functions (including levels of pancreatic enzymes amylase and lipase)

Signs of infections, for example, fever or fatigue

Blood cell counts indicating signs of anemia

Pregnancy test

Blood sugar, electrolyte levels (an imbalance suggests dehydration) and calcium level

Results of the blood tests may be inconclusive if the pancreas is still making digestive enzymes and insulin.

Diagnostic imaging tests are usually needed to look for complications of pancreatitis, including gallstones.

Diagnostic imaging tests may include the following:

X-ray films may be ordered to look for complications of pancreatitisas well as for other causes of discomfort. This may include a chest X-ray.

A CT scan is like an X-ray film, only much more detailed. A CT scanshows the pancreas and possible complications of pancreatitis in better detail than an X-ray film. A CT scan highlights inflammation or destruction of the pancreas. Occasionally an MRI is ordered.

Ultrasound is a very good imaging test to examine the gallbladder and the ducts connecting the gallbladder, liver, and pancreas with the small intestine.

Ultrasound is very good at depicting abnormalities in the biliary system, including gallstones and signs of inflammation or infection.

Ultrasound uses painless sound waves to create images of organs. Ultrasound is performed by gliding a small handheld device over the abdomen. The ultrasound emits sound waves that "bounce" off the organs and are processed by a computer to create an image. This technique is the same one that is used to look at a fetus in apregnant woman.

Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging test that uses an endoscope (a thin, flexible tube with a tiny camera on the end) to view the pancreas and surrounding structures.

ERCP is usually used only in cases of chronic pancreatitis or in the presence of gallstones.

To perform an ERCP, a person is first sedated. After sedation, an endoscope is passed through the mouth, to the stomach, and into the small intestine. The device then injects a temporary dye into the ducts connecting the liver, gallbladder, and pancreas with the small intestine (biliary ducts). The dye makes is easier for the health-care professional to see any stones or signs of organ damage. In some cases, a stone can be removed during this test.

Phone for appointment

Mon - Friday: 

08:30 - 16:30 

Tel: +27(0)11 482 8556/7