Guest guest Posted May 15, 2003 Report Share Posted May 15, 2003 Welcome Janet: You have come to the correct place for information. There are several folks in this group who have high fat levels or high triglyerides i.e. " hypertriglyceridemia " and that is a definite and very common cause of pancreatitis. Please let us know what kind of treatment you are getting, if it is working, how you are feeling etc. You can find just about any kind of info you need here. AGain, welcome. Kaye NC In pancreatitis , " pinkie302 " <pinkie302@y...> wrote: > Hello Everyone, I'm new to the group. I was hoping to find some > information about causes of pancreatitis. Does anyone have high fat > levels in the blood and is that the cause of the pancreatitis? > Thanks for all your help > > Janet S from Ohio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2003 Report Share Posted May 15, 2003 Has anyone else had experience with being on tube feeding for weeks at a time and then changing over to regular food? That's what my husband is on now -- Boost HP into a J-tube - due to severe acute infection and two weeks in the hospital. The doctor wants him to keep on the tube feeding until his return visit in three weeks. My husband's pseudo cysts were drained and are still draining. He has two tubes left in. Has anyone else come home with all this going on? Thanks for any insight into long-term results of this. Ginny White Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2003 Report Share Posted May 15, 2003 Thank you for the " welcome " . I'm not trying to upset anyone with telling you this. My husband died of acute pancreatitis. I'm trying to find out all the information I can about it. What it came from was hypertriglyceridemia. After having attacks of pancreatitis he was told he had acid reflux disease or gerd. Never any mention of pancreatitis until his last attack. His triglycerides were around 6600. Again sorry if I offended anyone. If anyone is uncomfortable with answering my questions I will remove myself from the group. Janet S. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2003 Report Share Posted May 16, 2003 <<My husband died of acute pancreatitis. I'm trying to find out all the information I can about it. What it came from was hypertriglyceridemia. Janet S. Dear Janet, Please accept my sincere condolences for the loss of your husband. It certainly it must have come as a tremendous shock and mystery for you to have lost him under such unexpected circumstances. There are attacks of acute pancreatitis that result in tremendous shock and total organ failure which can become fatal for the patient. This is one of the serious consequences of an acute attack that we all need to be aware of and try to avoid. I am so sorry that your husband was a victim of this. There are some folks here with high triglyceride problems, that may be able to answer any specific questions. Feel free to ask any questions that you think may help you. With hope and prayers, Heidi Heidi H. Griffeth Bluffton, SC State and Regional Representative Pancreatitis Association, International Note: All comments are personal opinion only, and should not be a substitute for professional medical consultation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2003 Report Share Posted May 17, 2003 Janet, my name is Jeannine. I was diagnosed with acute pancreatitis for the first time in 1994. I went to the ER telling them I thought I was having a heart attack as I had all the classical symptoms... severe chest pressure, pain in my left shoulder blade and down my left arm, difficulty breathing well, nausea...intense belly pain... bloated belly was the only unusual symptom....I looked at least 6 months pregnant and felt as though I would feel a whole lot better if my belly would just " pop " . They ran all the usual cardiac tests (labs, xray, EKG) and everything turned up negative but my pain wasn't going away. The tested my pancreas enzymes (amylase and lipase) and they were normal but my cholesterol was over 500 and the triglycerides were over 5000. They decided I was having gallbladder pain after doing the belly exam and wanted an ultrasound but the tech had already gone home. They sent me home with demerol and a medicine for nausea (by this time it was nearly midnight) and told me to return in the early a.m. I had my blood drawn once again...my A/L levels doubled overnight and still they were only a teeny bit over the high end of normal so they still haven't clued in to the fact I am suffering with pancreatitis. They did the ultrasound (most docs question this as this is NOT a good test for the pancreas, doesn't show much)..but then I remind them that these docs were looking for gallstones and gallbladder disease...and what they found instead was pancreatitis. I was admitted to the hospital for 4 days...my triglycerides even went up to 7000 at one point (and the chol over 700)even though I was not eating anything! It took four days for my A/L levels to return to normal (they finally did elevate) before I was discharged from the hospital. NOW....it is many years later and I come to find out that elevated triglycerides HIDE the fact that your A/L levels are out of whack... it makes them *appear* normal so the docs think things are just hunky dory in that department ! To make things even worse.....when I started my care at the facility where I am now, they changed my lipid meds...to save money...this change made my lipids go up ! Additionally, when I asked for a trial of estrogen to see if I was going into menopause and would it make me feel better, they should have KNOWN not to give estrogen pills to me BECAUSE of my history of severely elevated lipids...these two factors *combined* to elevate my lipids to the levels that CAUSED my first case of pancreatitis ! But since my husband and I both WORK at this facility and we are dependent on our income, I never filed a lawsuit ....but you can bet the pharmacy does NOT qustion the meds my provider wants to put me on now ! We get just about anything we want now including the newer more expensive drugs....I sometimes wonder if my record is permanently marked " we screwed up...give her what she wants, keep her happy " !!! I don't really know this for a fact, but it's fun to imagine it ! Anyway...go into your favorite search engine and type pancreatitis + triglycerides and you shoud find several really good articles on this phenomenon. Also, type merck manual in the search engine, then " gastro " once you get to the merck site should be enough to bring up the abdominal illnesses in the manual and then find pancreatitis and then look for hypertriglyceridemia.... Good luck in your search...the information is out there... My sympathies to you also for losing your husband to this illness. This is an insidious condition and it affects every member of the family of the one who is diagnosed with it....it's not one to be taken lightly and I am SO SORRY they did not discover your husband's early enough to be able to treat him...we " can " go on and live with this, but sometimes the pain is such it's hardly living....I am fortunate anough that my attacks, while awful for me, are still milder than some of what you will read here...I have not had any of the invasive tests you may come across in your readings here. Oh...I just thought of something else...if you go to the yahoogroups website, look for the search engine once you get into this pancreatitis site and type in " triglyceride " , leave off the " s " , it should then bring up all the posts where we have typed about [triglyceride]s, hyper[triglyceride]mia, and the like if you can see what I'm getting at... Ask away if I haven't given you the answers you are looking for.... Take care Janet...and welcome to the group...I hope you find us warm and welcoming. Jeannine > Hello Everyone, I'm new to the group. I was hoping to find some > information about causes of pancreatitis. Does anyone have high fat > levels in the blood and is that the cause of the pancreatitis? > Thanks for all your help > > Janet S from Ohio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2003 Report Share Posted May 17, 2003 here is the URL for the merck manual inof on pancreatitis... http://www.merck.com/mrkshared/mmanual_home/sec9/104.jsp Jeannine > > Hello Everyone, I'm new to the group. I was hoping to find some > > information about causes of pancreatitis. Does anyone have high fat > > levels in the blood and is that the cause of the pancreatitis? > > Thanks for all your help> > Janet S from Ohio Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2003 Report Share Posted May 17, 2003 Hi Jeannine May I ask when you went in with acute pancreatitis what they did to help you get over it? Were you admitted? It seems like you were in the same boat my husband was in. I want to know what kind of care he should of gotten. Janet Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2003 Report Share Posted May 17, 2003 My first attack was in 1994. I was not admitted the first day I went in (Saturday around 8pm), but when I was told to return the next morning for an US (looking for Gallbladder problems) instead they found the pancreatitis (I have been told this is NOT a good test looking for panc, as the pancreas is hidden by other organs,but I guess they could see enough to know...) and my enzymes doubled overnight, so even though they were pretty close to normal still, I guess they focused on the normal GB, no GB stones in the panc duct, the doubling enzymes and the pain and bloating I had...the demerol they gave me did reduce the pain but not take all of it away. They admitted me Sunday after 1pm...I was on the pain pump I was able to control and on IV solutions, not allowed even sips of water...that was the most torturous part for me since I'm a heavy water drinker... I was finally allowed clear liquids the third evening and discharged the next morning.... I went four years before I had another attack (1998)...then three years (2001), then this year I have had three attacks within ten weeks (Feb-April)! I have had many " minor " attacks in between these heavy duty attacks...I would feel them coming on and could stop eating to keep it from progressing...I found the Nurse practitioner's comment two weeks ago rather interesting ... she found it interesting that I am " that in tune " with my body as to feel one coming on...I then told her that was until this morning as this one came out of absolutely nowhere...I had no pain, no buildup in nausea...just had to run for the bathroom and then all the excitement began....I was flabbergasted... Hope this helps... Jeannine > Hi Jeannine > > May I ask when you went in with acute pancreatitis > what they did to help you get over it? Were you > admitted? It seems like you were in the same boat my > husband was in. I want to know what kind of care he > should of gotten. > > Janet Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2003 Report Share Posted May 17, 2003 My first attack was in 1994. I was not admitted the first day I went in (Saturday around 8pm), but when I was told to return the next morning for an US (looking for Gallbladder problems) instead they found the pancreatitis (I have been told this is NOT a good test looking for panc, as the pancreas is hidden by other organs,but I guess they could see enough to know...) and my enzymes doubled overnight, so even though they were pretty close to normal still, I guess they focused on the normal GB, no GB stones in the panc duct, the doubling enzymes and the pain and bloating I had...the demerol they gave me did reduce the pain but not take all of it away. They admitted me Sunday after 1pm...I was on the pain pump I was able to control and on IV solutions, not allowed even sips of water...that was the most torturous part for me since I'm a heavy water drinker... I was finally allowed clear liquids the third evening and discharged the next morning.... I went four years before I had another attack (1998)...then three years (2001), then this year I have had three attacks within ten weeks (Feb-April)! I have had many " minor " attacks in between these heavy duty attacks...I would feel them coming on and could stop eating to keep it from progressing...I found the Nurse practitioner's comment two weeks ago rather interesting ... she found it interesting that I am " that in tune " with my body as to feel one coming on...I then told her that was until this morning as this one came out of absolutely nowhere...I had no pain, no buildup in nausea...just had to run for the bathroom and then all the excitement began....I was flabbergasted... Hope this helps... Jeannine > Hi Jeannine > > May I ask when you went in with acute pancreatitis > what they did to help you get over it? Were you > admitted? It seems like you were in the same boat my > husband was in. I want to know what kind of care he > should of gotten. > > Janet Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2003 Report Share Posted September 16, 2003 You will never be able to drink again. Of course if you do choose to drink, that is your choice. You will pay for that choice if you choose not to heed this message. You will have to change your life around...no more drinking and eating a low fat diet. That will help you prevent from having other attacks and hopefully you will not develop chronic pancreatitis, like many of us have. Many of us have Acute episodes during our chronic disease. Hopefully you won't ever have to deal with this. You could also be having gall bladder pain or liver pain. You will have to be diagnosed by a Dr first. The no alcohol and low fat eating is something you will have to deal with though if you have pancreatitis. I hope this finds you and yours well. Below is some info on acute panc..........Mark This is a medical emergency marked by acute abdominal stress. Symptoms are caused by spillage of pancreatic fluids into the abdominal cavity. These fluids contain enzymes which begin to digest and destroy the lining of the intestine and the intestinal wall itself as well as any internal organs it encounters. Pain typically radiates from the pit of the abdomen through to the back with nausea, vomiting, low-grade fever, and shock. Some patients exhibit none of these save shock. There may be evidence of intra-abdominal bleeding. Causes include direct trauma, overindulgence in alcoholic beverages, viral and bacterial infections, duodenal ulcer perforation into the pancreas, certain metabolic insults, and toxicity from some pharmacological drugs. The diagnosis is made by ultrasound with supporting evidence from elevated pancreatic enzyme levels (amylase and lipase). These people usually have elevated white cell counts. Acute pancreatitis is a medical emergency and must be treated in a hospital setting. In addition to the usual management doctors in nutritional medicine have noted that intramuscular selenium followed by repeat doses 24 hours later, then daily doses are useful in the management of this disorder. Only doctors who practice nutritional medicine have a clue about the use of selenium for this indication. In the acute stage of acute pancreatitis the patient should have nothing by mouth, intravenous feeding should be instituted, calcium and magnesium levels maintained, pain managed, and the cause of the disorder treated. This may involve surgery. Chronic pancreatitis may result from one or more bouts of acute pancreatitis and this condition is marked by radiologic evidence of calcification of the pancreas, passage of undigested fat in the stool, diabetes, vitamin B12 deficiency, and poor digestion due to loss of pancreatic enzymes. Also a cyst-like condition may develop requiring surgery. The most important aspect in the treatment of acute pancreatitis is supportive care. This includes replacement of fluid and electrolytes, correction of metabolic abnormalities such as symptomatic hypercalcemiaand nutritional support. Other measures such as the use of nasogastric suction and antibiotics should be decided on a case-by-case basis. Agents that have been used to inhibit pancreatic secretion have not been found to be useful in altering the course in acute pancreatitis. These include somatostatin and glucagon. Protease inhibitors, which are effective in laboratory studies, have not been shown to be useful in clinical pancreatitis. Emergency surgery is not indicated in mild acute pancreatitis. Some surgical procedures such as resection of necrotictissue and peritoneal lavagemay have a role in select patients with severe, progressive necrotizing pancreatitis or pancreatic abscess. Cholecystectomy has been demonstrated to be effective in patients with recurrent acute pancreatitis and microlithiasis (Figure 17). Surgical sphincteroplasty of the pancreatic sphincter is an alternative approach to endoscopic pancreatic sphincterotomy in patients with pancreatic sphincter dysfunction. Although the patient outcome is the same as for the endoscopic approach, it is more invasive, requiring laparotomy and . duodenotomy Sphincteroplasty of the minor papilla is indicated for unsuccessful or failed endoscopic minor papilla sphincterotomy in patients with . pancreas divisum Endoscopic therapy has a therapeutic role in three specific areas in the management of acute pancreatitis: 1) acute gallstone pancreatitis, 2) recurrent pancreatitis due to pancreatic sphincter dysfunction, and 3) recurrent pancreatitis due to . pancreas divisum The rationale for endoscopic therapy in each area is the relief of obstruction to flow of pancreatic juice. [top] Although it would seem logical that removal of the gallstones from the common bile duct early in acute gallstone pancreatitis would improve the clinical course, there is a lack of a " predictable " good outcome as suggested by propective clinical trials. It appears, however, that the patients with suspected stones who benefit from early ERCP are those with evidence of biliary obstruction such as jaundice or dilation of the bile duct and severe pancreatitis. Further clinical trials are needed before more definitive recommendations can be made. In a subgroup of patients with acute recurrent pancreatitis and ,microlithiasis endoscopic sphincterotomy has been shown to significantly reduce the frequency of attacks (Figure 18). [top] With the advent of manometric studies of the pancreatic sphincter, many cases of so-called idiopathic recurrent pancreatitis are now known to be a result of pancreatic sphincter dysfunction. Endoscopic pancreatic sphincterotomy may be expected to have a good outcome in up to 90% of these patients. There are two techniques for endoscopic pancreatic sphincterotomy; one is with a pull-type sphincterotome followed by stenting of the pancreatic duct and the second is with a needle-knife sphincterotome performed over a pancreatic stent. Following pancreatic sphincterotomy there may be tissue swelling that could result in obstruction to pancreatic outflow. Therefore, short-term pancreatic stenting is indicated when pancreatic sphincterotomy is performed to maintain patency of pancreatic outflow (Figure 19). [top] Endoscopic minor papilla sphincterotomy is effective treatment for patients with recurrent pancreatitis and pancreas divisum (Figure 20). Good long-term results are found in about 70% of patients but may be significantly less if there are changes of chronic pancreatitis. There are two techniques for endoscopic minor papilla sphincterotomy; one is with a pull-type sphincterotome followed by stenting of the pancreatic duct and the second is with a needle-knife sphincterotome performed over a pancreatic stent (Figure 21). Following pancreatic sphincterotomy there may be tissue swelling that could result in obstruction to pancreatic outflow. Therefore short-term pancreatic stenting is indicated when pancreatic sphincterotomy is performed to maintain patency of pancreatic outflow. [top] Acute pancreatitis > Hey everyone!I've read alot of the messages in the message board and > have'nt seen much about acute pancreatitis. Now I'm wondering how bad > really acute pancreatitis is? I really have'nt had much pain since I > had my first symptoms. My symtoms were heavy pain in the right upper > side of my stomach. It stared on a tuesday night and it got worse on > wednensday. I called my doctor on a emergency number that she gave > me,I explained to her that I had a heavy pain in my stomach, after a > five minutes of conversation she told me to go to the hospital rite > away. I could barely drive, I ended up staying in the hospital for > two days. since I left the hospital I have not had a chance to see > the doctor yet, but I have an appointment next week. My question is > how bad is acute pancreatitis? I used to drink alcohol do you think I > will be able to go back to my normal a life? what changes do I have > make in my life style? > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2003 Report Share Posted September 16, 2003 > Hey everyone!I've read alot of the messages in the message board and > have'nt seen much about acute pancreatitis. Now I'm wondering how bad > really acute pancreatitis is? I really have'nt had much pain since I > had my first symptoms. My symtoms were heavy pain in the right upper > side of my stomach. It stared on a tuesday night and it got worse on > wednensday. I called my doctor on a emergency number that she gave > me,I explained to her that I had a heavy pain in my stomach, after a > five minutes of conversation she told me to go to the hospital rite > away. I could barely drive, I ended up staying in the hospital for > two days. since I left the hospital I have not had a chance to see > the doctor yet, but I have an appointment next week. My question is > how bad is acute pancreatitis? I used to drink alcohol do you think I > will be able to go back to my normal a life? what changes do I have > make in my life style? Most of us with chronic pancreatitis have acute episodes. Some people, like me, started their journey with pancreatitis by having an initial acute attack like you have. I had an acute attack on April 30, 2001, and yes, I used to drink alcohol. Within two weeks of my acute attack I was diagnosed with chronic pancreatitis. I've probably had six or eight acute attacks since that time, though I have only gone to the hospital with one. I've handled the remainder of my attacks at home with pain medication and by going to a liquid diet until the attacks subsided. I live what I call a normal life. The only exception to this is that I don't drink and never will, and I followed a low fat diet for my CP until I developed diabetes. Abstainence from alcohol and the low fat diet are the two greatest lifestyle changes to adapt to, yet both are very healthy changes that will, in the end result, improve your overall health. Keep asking questions, we're here to help you however we can. With hope and prayers, Heidi Heidi H. Griffeth South Carolina SC & SE Regional Rep. PAI, Intl. Note: All comments and advice are personal opinion only, and should not be substituted for professional medical consultation. " What lies behind us and what lies before us are tiny matters compared to what lies within us. " - Ralph Waldo Emerson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2003 Report Share Posted September 17, 2003 , I'm going to answer your last two questions first as they are the major issues. 1. Yes there are some significant life changes you are going to have to do a. You are going to have to stop any alcohol. Not even to cook with. The pancreas is very sensitive to alcohol, even if that isn't the cause of the pancreatitis. I have CP due to a birth defect and I can't even cook with it or I amd in a lot of pain. b. You need to go on a low fat diet. 20-30 grams of fat a day (believe me that's not alot. You will have to get used to reading food labels. You'll be amazed how much fat is in thingsl For those iems that don't have the label, you can get books on the approxicmate amount of food that estimates the amount of fat in it. Pay close attention to portion sizes. That's very important. 2. As for going back to your normal life? I can't answer that and I doubt the doctors can either. Pancreatitis is a poorly understood disease. Hopefully, just making those changes will fix the issue, but that's no guarantee and I'm only giving you advice that I was given by my doctor. I'm not a health care profession, so any advice I give you is mainly personal opinion or from stuff Ive read and is not the same as that of a health care professional. However, some people have eventually developed chronic pancreatitis If you want more information on acute pancreatitis, I suggest looking at the Hopkin's GI website. Here is the URL to the Acute Pancreatitis section.: http://www.hopkins-gi.org/pages/latin/templates/index.cfm?pg=disease1 & organ=4 & di\ sease=22 & lang_id=1 The URL link is very long and it may have wrapped to the next line, which makes the link not go to the right place, so you may need to cut and paste the URL into your browser. There is also a section on Chronic Pancreatitis if you are interested in reading up on that too: http://www.hopkins-gi.org/pages/latin/templates/index.cfm?pg=disease1 & organ=4 & di\ sease=24 & lang_id=1 Hope this has been of some help. Kimber -- Kimber Vallejo, CA hominid2@... Note: All advice given is personal opinion, not equal to that of a licensed physician or health care professional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2003 Report Share Posted September 17, 2003 Thanks a lot > , > I'm going to answer your last two questions first as they are the major > issues. > 1. Yes there are some significant life changes you are going to have to do > a. You are going to have to stop any alcohol. Not even to cook with. > The pancreas is very sensitive to alcohol, even if that isn't the cause > of the pancreatitis. I have CP due to a birth defect and I can't even > cook with it or I amd in a lot of pain. > b. You need to go on a low fat diet. 20-30 grams of fat a day > (believe me that's not alot. You will have to get used to reading food > labels. You'll be amazed how much fat is in thingsl For those iems that > don't have the label, you can get books on the approxicmate amount of > food that estimates the amount of fat in it. Pay close attention to > portion sizes. That's very important. > > 2. As for going back to your normal life? I can't answer that and I > doubt the doctors can either. Pancreatitis is a poorly understood > disease. Hopefully, just making those changes will fix the issue, but > that's no guarantee and I'm only giving you advice that I was given by > my doctor. I'm not a health care profession, so any advice I give you is > mainly personal opinion or from stuff Ive read and is not the same as > that of a health care professional. However, some people have eventually > developed chronic pancreatitis > > If you want more information on acute pancreatitis, I suggest looking at > the Hopkin's GI website. Here is the URL to the Acute Pancreatitis > section.: > http://www.hopkins-gi.org/pages/latin/templates/index.cfm? pg=disease1 & organ=4 & disease=22 & lang_id=1 > The URL link is very long and it may have wrapped to the next line, > which makes the link not go to the right place, so you may need to cut > and paste the URL into your browser. > > There is also a section on Chronic Pancreatitis if you are interested in > reading up on that too: > http://www.hopkins-gi.org/pages/latin/templates/index.cfm? pg=disease1 & organ=4 & disease=24 & lang_id=1 > > Hope this has been of some help. > Kimber > -- > Kimber > Vallejo, CA > hominid2@c... > Note: All advice given is personal opinion, not equal to that of a licensed physician or health care professional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2003 Report Share Posted September 17, 2003 Thank you very much. > You will never be able to drink again. Of course if you do choose to drink, > that is your choice. You will pay for that choice if you choose not to heed > this message. You will have to change your life around...no more drinking > and eating a low fat diet. That will help you prevent from having other > attacks and hopefully you will not develop chronic pancreatitis, like many > of us have. Many of us have Acute episodes during our chronic disease. > Hopefully you won't ever have to deal with this. You could also be having > gall bladder pain or liver pain. You will have to be diagnosed by a Dr > first. The no alcohol and low fat eating is something you will have to deal > with though if you have pancreatitis. I hope this finds you and yours well. > Below is some info on acute panc..........Mark > > This is a medical emergency marked by acute abdominal stress. Symptoms are > caused by spillage of pancreatic fluids into the abdominal cavity. These > fluids contain enzymes which begin to digest and destroy the lining of the > intestine and the intestinal wall itself as well as any internal organs it > encounters. > > Pain typically radiates from the pit of the abdomen through to the back with > nausea, vomiting, low-grade fever, and shock. Some patients exhibit none of > these save shock. There may be evidence of intra-abdominal bleeding. > > Causes include direct trauma, overindulgence in alcoholic beverages, viral > and bacterial infections, duodenal ulcer perforation into the pancreas, > certain metabolic insults, and toxicity from some pharmacological drugs. > > The diagnosis is made by ultrasound with supporting evidence from elevated > pancreatic enzyme levels (amylase and lipase). These people usually have > elevated white cell counts. > > Acute pancreatitis is a medical emergency and must be treated in a hospital > setting. In addition to the usual management doctors in nutritional medicine > have noted that intramuscular selenium followed by repeat doses 24 hours > later, then daily doses are useful in the management of this disorder. Only > doctors who practice nutritional medicine have a clue about the use of > selenium for this indication. > > In the acute stage of acute pancreatitis the patient should have nothing by > mouth, intravenous feeding should be instituted, calcium and magnesium > levels maintained, pain managed, and the cause of the disorder treated. This > may involve surgery. > > Chronic pancreatitis may result from one or more bouts of acute pancreatitis > and this condition is marked by radiologic evidence of calcification of the > pancreas, passage of undigested fat in the stool, diabetes, vitamin B12 > deficiency, and poor digestion due to loss of pancreatic enzymes. Also a > cyst-like condition may develop requiring surgery. > > > > > The most important aspect in the treatment of acute pancreatitis is > supportive care. This includes replacement of fluid and electrolytes, > correction of metabolic abnormalities such as symptomatic hypercalcemiaand > nutritional support. Other measures such as the use of nasogastric suction > and antibiotics should be decided on a case-by-case basis. > > > > Agents that have been used to inhibit pancreatic secretion have not been > found to be useful in altering the course in acute pancreatitis. These > include somatostatin and glucagon. Protease inhibitors, which are effective > in laboratory studies, have not been shown to be useful in clinical > pancreatitis. > > > > Emergency surgery is not indicated in mild acute pancreatitis. Some surgical > procedures such as resection of necrotictissue and peritoneal lavagemay have > a role in select patients with severe, progressive necrotizing pancreatitis > or pancreatic abscess. Cholecystectomy has been demonstrated to be effective > in patients with recurrent acute pancreatitis and microlithiasis (Figure > 17). > > > > Surgical sphincteroplasty of the pancreatic sphincter is an alternative > approach to endoscopic pancreatic sphincterotomy in patients with pancreatic > sphincter dysfunction. Although the patient outcome is the same as for the > endoscopic approach, it is more invasive, requiring laparotomy and . > duodenotomy > > Sphincteroplasty of the minor papilla is indicated for unsuccessful or > failed endoscopic minor papilla sphincterotomy in patients with . pancreas > divisum > > > > Endoscopic therapy has a therapeutic role in three specific areas in the > management of acute pancreatitis: 1) acute gallstone pancreatitis, 2) > recurrent pancreatitis due to pancreatic sphincter dysfunction, and 3) > recurrent pancreatitis due to . pancreas divisum The rationale for > endoscopic therapy in each area is the relief of obstruction to flow of > pancreatic juice. > > [top] > > > > Although it would seem logical that removal of the gallstones from the > common bile duct early in acute gallstone pancreatitis would improve the > clinical course, there is a lack of a " predictable " good outcome as > suggested by propective clinical trials. It appears, however, that the > patients with suspected stones who benefit from early ERCP are those with > evidence of biliary obstruction such as jaundice or dilation of the bile > duct and severe pancreatitis. Further clinical trials are needed before more > definitive recommendations can be made. In a subgroup of patients with acute > recurrent pancreatitis and ,microlithiasis endoscopic sphincterotomy has > been shown to significantly reduce the frequency of attacks (Figure 18). > > > > [top] > > > > With the advent of manometric studies of the pancreatic sphincter, many > cases of so-called idiopathic recurrent pancreatitis are now known to be a > result of pancreatic sphincter dysfunction. Endoscopic pancreatic > sphincterotomy may be expected to have a good outcome in up to 90% of these > patients. There are two techniques for endoscopic pancreatic sphincterotomy; > one is with a pull-type sphincterotome followed by stenting of the > pancreatic duct and the second is with a needle-knife sphincterotome > performed over a pancreatic stent. Following pancreatic sphincterotomy there > may be tissue swelling that could result in obstruction to pancreatic > outflow. Therefore, short-term pancreatic stenting is indicated when > pancreatic sphincterotomy is performed to maintain patency of pancreatic > outflow (Figure 19). > > > > > [top] > > > > Endoscopic minor papilla sphincterotomy is effective treatment for patients > with recurrent pancreatitis and pancreas divisum (Figure 20). Good long-term > results are found in about 70% of patients but may be significantly less if > there are changes of chronic pancreatitis. > > > > There are two techniques for endoscopic minor papilla sphincterotomy; one is > with a pull-type sphincterotome followed by stenting of the pancreatic duct > and the second is with a needle-knife sphincterotome performed over a > pancreatic stent (Figure 21). Following pancreatic sphincterotomy there may > be tissue swelling that could result in obstruction to pancreatic outflow. > Therefore short-term pancreatic stenting is indicated when pancreatic > sphincterotomy is performed to maintain patency of pancreatic outflow. > > > > [top] > > > > > > > > > > Acute pancreatitis > > > > Hey everyone!I've read alot of the messages in the message board and > > have'nt seen much about acute pancreatitis. Now I'm wondering how bad > > really acute pancreatitis is? I really have'nt had much pain since I > > had my first symptoms. My symtoms were heavy pain in the right upper > > side of my stomach. It stared on a tuesday night and it got worse on > > wednensday. I called my doctor on a emergency number that she gave > > me,I explained to her that I had a heavy pain in my stomach, after a > > five minutes of conversation she told me to go to the hospital rite > > away. I could barely drive, I ended up staying in the hospital for > > two days. since I left the hospital I have not had a chance to see > > the doctor yet, but I have an appointment next week. My question is > > how bad is acute pancreatitis? I used to drink alcohol do you think I > > will be able to go back to my normal a life? what changes do I have > > make in my life style? > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2003 Report Share Posted September 17, 2003 Your very welcome . If I can ever help you in anyway, please let me know I hope this finds you and yours well Mark Acute pancreatitis > > > > > > > Hey everyone!I've read alot of the messages in the message board > and > > > have'nt seen much about acute pancreatitis. Now I'm wondering how > bad > > > really acute pancreatitis is? I really have'nt had much pain > since I > > > had my first symptoms. My symtoms were heavy pain in the right > upper > > > side of my stomach. It stared on a tuesday night and it got worse > on > > > wednensday. I called my doctor on a emergency number that she gave > > > me,I explained to her that I had a heavy pain in my stomach, > after a > > > five minutes of conversation she told me to go to the hospital > rite > > > away. I could barely drive, I ended up staying in the hospital for > > > two days. since I left the hospital I have not had a chance to see > > > the doctor yet, but I have an appointment next week. My question > is > > > how bad is acute pancreatitis? I used to drink alcohol do you > think I > > > will be able to go back to my normal a life? what changes do I > have > > > make in my life style? > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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