There are two types of pancreatitis: acute pancreatitis and chronic pancreatitis. According to the Canadian Digestive Health Foundation (CDHF), pancreatitis is a digestive disorder affecting one million Canadians. Among them, more than 300,000 are affected by chronic pancreatitis and more than 600,000 are affected by acute pancreatitis. Let's learn more about the most common form of pancreatitis in Canada, acute pancreatitis.
Definition of acute pancreatitis
Acute pancreatitis is a gastrointestinal disorder characterized by sudden inflammation of the pancreas, an organ located in the upper abdomen that produces digestive juices and insulin. The process behind the development of this disease is the self-digestion of the pancreas by its own enzymes.
Causes of acute pancreatitis
The main causes of acute pancreatitis, responsible for more than 70% of cases, are gallstones, about 40% of cases, and alcohol consumption, about 30% of cases. Other causes include, among others, genetic predispositions, the use of certain medications, and pancreatic cancer.
Classification of acute pancreatitis
Acute pancreatitis can be classified as mild, moderately severe, or severe depending on its severity.
Symptoms of acute pancreatitis
The main symptom of acute pancreatitis is intense pain in the upper abdomen. Individuals may also experience nausea, vomiting, sweating, abdominal distension, low blood pressure, difficulty breathing, and increased heart rate. In cases of severe acute pancreatitis, damage to other organs (e.g., lungs, kidneys) and infection of the pancreas may also occur.
Diagnosis of acute pancreatitis
The diagnosis of acute pancreatitis is established through blood tests and imaging exams, such as computed tomography (CT) or ultrasound.
Treatment of acute pancreatitis
Treatment of acute pancreatitis requires hospitalization and generally includes intravenous fluid administration, medications to treat pain, and nutritional support. Antiemetic medications may also be given in case of nausea and vomiting. Finally, in some more severe cases, antibiotics and surgery may also be necessary.
Nutritional approach for acute pancreatitis
The three main goals of nutritional intervention are to maintain or improve nutritional status, reduce symptoms, and decrease stimulation of the pancreas to rest it and minimize its destruction.
Dietary recommendations for acute pancreatitis
- Initially, no oral feeding.
- Then, in mild cases, oral feeding is gradually introduced as soon as it can be tolerated. The gradual reintroduction usually starts with a liquid or semi-liquid diet, before progressing to a solid diet, divided into several small daily meals according to each individual's tolerance. During the reintroduction of food, a low-fat diet is generally recommended for a few weeks to a few months or until there are no signs of inflammation. Finally, it is also advised to avoid any alcohol consumption.
- In more severe cases, enteral feeding (whichconsists of providing a nutritional mixture directly into the digestive tract through a tube)is generally used. If enteral feeding is not possible, parenteral feeding (whichconsists of intravenous infusion of a nutritional mixture)is used. Then, when it can be tolerated, oral feeding is gradually resumed as in mild cases.
References
- St-Denis, Louise. November 2018. "Nutrition, pancreas and biliary tract." NUT 3047 – Clinical Nutrition and Chronic Diseases 1. Montreal: University of Montreal.
- https://www.merckmanuals.com/fr-ca/accueil/troubles-digestifs/pancr%C3%A9atite/pancr%C3%A9atite-aigu%C3%AB
- https://www.merckmanuals.com/fr-ca/professional/troubles-gastro-intestinaux/pancr%C3%A9atite/pancr%C3%A9atite-aigu%C3%AB
- https://www.merckmanuals.com/fr-ca/accueil/les-faits-en-bref-troubles-digestifs/pancr%C3%A9atite/pancr%C3%A9atite-aigu%C3%AB
- https://cdhf.ca/fr/digestive-disorders/pancreatite/quest-ce-que-la-pancreatite/