Introduction
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 human body processes sugar (glucose). Pancreatitis is inflammation in the pancreas. Pancreatitis can occur as acute — meaning it appears suddenly and lasts for days, or as chronic, 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.
Signs & symptoms
Signs and symptoms of pancreatitis may vary, depending on which type:
Acute pancreatitis
- Upper abdominal pain
- Abdominal pain that radiating to back
- Abdominal pain that feels worse after eating
- Fever
- Rapid pulse
- Nausea
- Vomiting
- Tenderness of abdomen
Chronic pancreatitis
- Upper abdominal pain
- Losing weight without trying
- Oily, smelly stools (steatorrhea)
Causes
Pancreatitis occurs when digestive enzymes become activated while still in the pancreas, irritating the cells of pancreas and causing inflammation. With repeated bouts of acute pancreatitis, damage to the pancreas can occur and lead to chronic pancreatitis. Scar tissue may form in the pancreas, causing loss of function. A poorly functioning pancreas can cause digestion problems and diabetes.
Sometimes, a cause for pancreatitis is never found.
Conditions that can lead to pancreatitis include:
- Abdominal surgery
- Alcoholism
- Certain medications
- Cystic fibrosis
- Gallstones
- High calcium levels in the blood (hypercalcemia), which may be caused by an overactive parathyroid gland (hyperparathyroidism)
- High triglyceride levels in the blood (hypertriglyceridemia)
- Infection
- Injury to the abdomen
- Obesity
- Pancreatic cancer
- Endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to treat gallstones, also can lead to pancreatitis.
Risk factors
Excessive alcohol consumption
Cigarette smoking
Obesity
Family history of pancreatitis
Pathophysiology
Acute pancreatitis is an inflammatory disease, which varies in severity from mild to severe. Factors determining the severity of pancreatitis are not known. It is generally believed that the earliest events in the evolution of acute pancreatitis lead to premature intra-acinar cell activation of digestive zymogens and that those enzymes, once activated cause acinar cell injury. Recent studies have suggested that the ultimate severity of resulting pancreatitis may be determined by events which occur subsequent to acinar cell injury. These include inflammatory cell recruitment and activation as well as the generation and release of cytokines and other chemical mediators of inflammation. Recently, we have undertaken studies to elucidate the role of various inflammatory agents in determining the severity of pancreatitis. Results from these ongoing studies indicate that substance P acting via neurokinin-1 (NK1) receptors, chemokines interacting with CCR1 receptors and platelet activating factor play an important pro-inflammatory role in regulating the severity of pancreatitis and associated lung injury. On the other hand, complement factor 5a (C5a) acts as an anti-inflammatory agent during the development of pancreatitis.
Diagnosis
Blood tests to look for elevated levels of pancreatic enzymes
Faecal examination
Computerized tomography (CT) scan
Abdominal ultrasound
Endoscopy
Magnetic resonance imaging (MRI)
Treatments
Fasting, followed by drinking clear liquids and eating bland foods. With time, slowly back to normal diet
Pain medications
Intravenous (IV) fluids
Depending on the cause of pancreatitis, treatment may include:
Endoscopic retrograde cholangiopancreatography (ERCP)
Gallbladder surgery (cholecystectomy).
Pancreas surgery
Treatment for alcohol dependence.
Additional treatments for chronic pancreatitis
Pain management.
Enzymes to improve digestion.
Changes in diet.
Prognosis
Acute pancreatitis show better prognosis than chronic. In the chronic form, episodes of pancreatitis tend to become more severe over time and the overall 10-year and 20-year survival rates are estimated to be about 70% and 45%, respectively.
Complications
Pseudocyst
Infection
Kidney failure
Breathing problems
Diabetes
Malnutrition
Pancreatic cancer
Disease & Ayurveda
There is no exact correlated name for the disease pancreatitis in Ayurveda. The organ pancreas is known as Agnyasaya in Ayurveda, meaning the seat of digestive fire, as pancreas secretes many enzymes. Shotha denotes the inflammatory condition.
Nidana
Causative factors for the vitiation of all three doshas, Kapha, Pitta and Vaata
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors, three doshas get vitiated. Due to some block or derangement in the corresponding channel or site, when they get lodged in Agnyasaya and produce sotha the diseases manifests.
Lakshana
Sharp abdominal pain
Indigestion
Heartburn
Bloating
Vomiting & nausea
Diarrhoea
Divisions
Not mentioned
Prognosis
Kricchrasadhya in new cases in healthy young individuals. Asadhya in others.
Chikithsa
The treatment of Pancreatitis depends upon many factors like the age, constitution, physical & mental health of the patient and how severe is the inflammation. As all the three doshas are involved, it is important to know which dosha imbalance is the predominant and leading, to control it in the beginning. In most of the cases, pacifying pitta along with removing aama (undigested toxic metabolic wastes in the body) is the first line of treatment.
Samana
Aamapaachana
Agnideepana without causing aggravated Pitta state
Sothaharachikithsa
Sodhana
Virechana is the main sodahana therapy in agnyasaya sotha. It can be done as a sadyovirechana or after a course of Sneha-sweda as per the condition.
Vamana in needed cases
Asthapana vasti and anuvasana vasti are done only if Vaata is involved.
Commonly used medicines
Vaasaguduchyadi kashayam
Daadimaadi ghrutam
Daadimaashtaka choornam
Sukumaram kashayam
Jeevaraksha Gulika
Malla Sindhoor
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
After taking treatment, life style changes can help prevent further problems, like
- Stop drinking alcohol
- Stop smoking.
- Choose a low-fat diet.
- Drink more fluids.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme climate changes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
Regular stretching and mild cardio exercises are advised in cases which are not complicated. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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