tag:blogger.com,1999:blog-28812673282928126122024-03-13T11:18:25.084-07:00PancreatitisThe pancreas secretes digestive enzymes into the small intestine that help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.
Diseases of the pancreas are serious.pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-2881267328292812612.post-58091105242697637782007-05-04T13:45:00.000-07:002007-05-04T13:48:15.860-07:00Acute Pancreatitis Signs and Symptoms<span style="font-family:georgia;"><strong><span style="font-size:130%;">These are signs and symptoms of Acute pancreatitis: </span></strong>Acute pancreatitis comes on suddenly, usually with mild to severe pain in your upper abdomen that may radiate to your back and occasionally to your chest. The pain may be nearly constant for hours or even days and is likely to become worse when you drink alcohol or eat. Bending forward or curling into a fetal position may provide temporary relief.</span><br /><br /><br /><div align="left"><br /><span style="font-family:georgia;"><strong><span style="font-size:130%;">Other signs and symptoms of acute pancreatitis include:</span></strong><br /></span></div><ol><li><div align="left"><span style="font-family:georgia;">Nausea;</span></div></li><li><div align="left"><span style="font-family:georgia;">Vomiting; </span></div></li><li><div align="left"><span style="font-family:georgia;">Fever; </span></div></li><li><div align="left"><span style="font-family:georgia;">Rapid pulse; </span></div></li><li><div align="left"><span style="font-family:georgia;">Swollen, tender abdomen.</span></div></li></ol><div align="left"><strong><span style="font-family:georgia;font-size:130%;">In severe cases:</span></strong></div><ol><li><div align="left"><span style="font-family:georgia;">Dehydration;</span></div></li><li><div align="left"><span style="font-family:georgia;">Low blood pressure;</span></div></li><li><div align="left"><span style="font-family:georgia;">Internal bleeding; and</span></div></li><li><div align="left"><span style="font-family:georgia;">Shock.</span></div></li></ol><div align="left"><span style="font-family:georgia;">You may have repeated episodes of acute pancreatitis and recover fully from each one. Nevertheless, every attack is a serious illness that can damage your pancreas and cause life-threatening complications.</span></div><div align="left"></div><br /><p align="center"><span style="color:#ffffcc;"><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span><br /></span><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /><br /></span><span style="color:#ffffcc;"></span><span style="color:#ffffcc;"></span></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com2tag:blogger.com,1999:blog-2881267328292812612.post-70936404560644704852007-05-04T13:40:00.000-07:002007-05-04T13:44:46.354-07:00Chronic Pancreatitis Signs and Symptoms<div align="left"><span style="font-family:georgia;"><strong><span style="font-size:130%;">These are signs and symptoms of Chronic pancreatitis:</span></strong> Ongoing damage to your pancreas can lead to a chronic condition that destroys the pancreas and nearby tissues, although it may be years before signs and symptoms appear. A few people with chronic pancreatitis never experience discomfort, but most have intermittent bouts of abdominal pain that can be severe. The pain may last anywhere from a few hours to weeks or even years. Drinking alcohol, smoking tobacco, or eating often makes symptoms worse.<br /><strong>In addition to pain, chronic pancreatitis can cause:</strong></span></div><ol><li><div align="left"><span style="font-family:georgia;">Nausea;</span></div></li><li><div align="left"><span style="font-family:georgia;">Vomiting; </span></div></li><li><div align="left"><span style="font-family:georgia;">Fever; </span></div></li><li><div align="left"><span style="font-family:georgia;">Bloating and gas; </span></div></li><li><div align="left"><span style="font-family:georgia;">Weight loss, even when your appetite and eating habits are normal;</span></div></li><li><div align="left"><span style="font-family:georgia;">Steatorrhea: Oily, malodorous stools resulting from poor digestion and malabsorption of nutrients, particularly fats;</span></div></li><li><div align="left"><span style="font-family:georgia;">Diabetes; </span></div></li><li><div align="left"><span style="font-family:georgia;">Sometimes, jaundice. </span><br /></div></li></ol><p><span style="font-family:georgia;"></span></p><p align="center"><span style="color:#ffffcc;"><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span><br /></span><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /><br /></span><span style="color:#ffffcc;"></span><span style="color:#ffffcc;"></span></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-80934101144922803132007-05-04T13:35:00.000-07:002007-05-04T13:39:13.548-07:00Causes<span style="font-family:georgia;"><span style="font-size:130%;"><span style="font-size:180%;"><strong>Causes</strong><br /></span><a id="Most_common_causes" name="Most_common_causes"></a><br /><br /></span></span><span style="font-family:georgia;"><span style="font-size:130%;"><p></p><span style="font-size:100%;"><span style="font-size:130%;"></span></span></span></span><ul><li><span style="font-family:georgia;"><span style="font-size:130%;"><span style="font-size:100%;"><span style="font-size:130%;">Most common causes: </span></span></span></span><span style="font-family:georgia;"><span style="font-size:130%;"><span style="font-size:100%;">A common </span><span style="font-size:100%;">mnemonic</span><span style="font-size:100%;"> for the causes of pancreatitis is:<br /><span style="color:#ffffcc;">........</span>1. I -<strong> </strong></span><span style="font-size:100%;"><strong>idiopathic</strong></span><span style="font-size:100%;"><br /><span style="color:#ffffcc;">........</span>2. G - </span><span style="font-size:100%;"><strong>gallstone</strong></span><span style="font-size:100%;"><strong>.</strong> Gallstones that travel down the common </span><span style="font-size:100%;">bile duct</span><span style="font-size:100%;"> and which subsequently get stuck in the </span><span style="font-size:100%;">Ampulla of Vater</span><span style="font-size:100%;"> can cause obstruction in the outflow of pancreatic juices from the pancreas into the </span><span style="font-size:100%;">duodenum</span><span style="font-size:100%;">. The backflow of these digestive juices causes </span><span style="font-size:100%;">lysis</span><span style="font-size:100%;"> (dissolving) of pancreatic cells and subsequent pancreatitis.<br /><span style="color:#ffffcc;">........</span>3. E - </span><strong><span style="font-size:100%;">ethanol</span><span style="font-size:100%;"> (</span><span style="font-size:100%;">alcohol</span></strong><span style="font-size:100%;"><strong>)</strong><br /><span style="color:#ffffcc;">........</span>4. T - </span><span style="font-size:100%;"><strong>trauma</strong></span><span style="font-size:100%;"><br /><span style="color:#ffffcc;">........</span>5. S - </span><span style="font-size:100%;"><strong>steroids</strong></span><span style="font-size:100%;"><br /><span style="color:#ffffcc;">........</span>6. M- </span><strong><span style="font-size:100%;">mumps</span><span style="font-size:100%;"> (</span><span style="font-size:100%;">paramyxovirus</span></strong><span style="font-size:100%;"><strong>) and other viruses</strong> (</span><span style="font-size:100%;">Epstein-Barr virus</span><span style="font-size:100%;">, </span><span style="font-size:100%;">Cytomegalovirus</span><span style="font-size:100%;">)<br /><span style="color:#ffffcc;">........</span>7. A - </span><span style="font-size:100%;"><strong>autoimmune disease</strong></span><span style="font-size:100%;"> (</span><span style="font-size:100%;">Polyarteritis nodosa</span><span style="font-size:100%;">, </span><span style="font-size:100%;">Systemic lupus erythematosus</span><span style="font-size:100%;">)<br /><span style="color:#ffffcc;">........</span>8. S - </span><span style="font-size:100%;"><strong>scorpion</strong></span><span style="font-size:100%;"><strong> sting</strong> - Tityus Trinitatis - Trinidad/ </span><span style="font-size:100%;">snake bite</span><span style="font-size:100%;"><br /><span style="color:#ffffcc;">........</span>9. H - </span><span style="font-size:100%;"><strong>hypercalcemia</strong></span><span style="font-size:100%;"><strong>,</strong> </span><span style="font-size:100%;">hyperlipidemia</span><span style="font-size:100%;">/</span><span style="font-size:100%;">hypertriglyceridemia</span><span style="font-size:100%;"> and </span><span style="font-size:100%;">hypothermia</span><span style="font-size:100%;"><br /><span style="color:#ffffcc;">......</span>10. E - </span><span style="font-size:100%;"><strong>ERCP</strong></span><span style="font-size:100%;"> (Endoscopic Retrograde Cholangio-Pancreatography - a form of </span><span style="font-size:100%;">endoscopy</span><span style="font-size:100%;">)<br /><span style="color:#ffffcc;">.......</span>11. D-</span><a title="Medication" style="COLOR: #ffffcc">.</span><span style="color:#000000;"><strong>Drugs</strong></span></span></a> (SAND) And Duodenal Ulcers<br /><span style="color:#ffffcc;">......</span><span style="color:#ffffcc;">............ </span><span style="color:#000000;">a. </span>S -Steroids and Sulphonamides<br /><span style="color:#ffffcc;">...................</span>b. A- Azathiopine<br /><span style="color:#ffffcc;">...................</span>c. N - NSAIDS<br /><span style="color:#ffffcc;">...................</span>d. D - Diuretics such as:<br /><span style="color:#ffffcc;">..............................</span>1. Furosemide<br /><span style="color:#ffffcc;">..............................</span>2. Thiazides<br /><span style="color:#ffffcc;">..............................</span>3. Didanosine </li><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">Less common causes</span></strong><br /><span style="color:#ffffcc;">.......,</span>1. <strong>pancreas divisum</strong><br /><span style="color:#ffffcc;">........</span>2. <strong>long common duct</strong><br /><span style="color:#000000;"><span style="color:#ffffcc;">........</span>3. </span><strong>carcinoma of the head of pancreas, and other cancer<br /></strong><span style="color:#ffffcc;">........</span>4. <strong>ascaris blocking pancreatic outflow</strong><br /><span style="color:#ffffcc;">........</span>5. <strong>ischemia from bypass surgery</strong><br /><span style="color:#ffffcc;">........</span>6. <strong>fatty necrosis</strong><br /><span style="color:#ffffcc;">........</span>7. <strong>pregnancy</strong><br /><span style="color:#ffffcc;">........</span>8. <strong>infections other than mumps,</strong> including varicella zoster<br /><span style="color:#ffffcc;">........</span>9. <strong>repeated marathon running.</strong> </span></li><li><span style="font-family:georgia;"><span style="font-size:130%;"><span style="font-size:100%;"><span style="font-size:130%;">Causes by demographic:</span><br /><span style="color:#ffffcc;">........</span>1. <strong>Western countries</strong> - chronic alcoholism and gallstones accounting for more than 85% of all cases<br /><span style="color:#ffffcc;">........</span>2. <strong>Eastern countries</strong> - gallstones<br /><span style="color:#ffffcc;">........</span>3. <strong>Children</strong> - trauma<br /><span style="color:#ffffcc;">........</span>4. <strong>Adolescents and young adults</strong> - mumps</span></span></span><br /><span style="color:#ffffcc;"><strong><span style="font-family:georgia;color:#000000;"></span></strong></span></li></ul><p align="center"><span style="color:#ffffcc;"><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span><br /></span><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /><br /></span><span style="color:#ffffcc;"></span><span style="color:#ffffcc;"></span></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-25794341642903272722007-05-04T13:18:00.000-07:002007-05-04T13:39:52.056-07:00Screening and Diagnosis</span><strong><span style="font-size:130%;"><span style="font-size:180%;">Screening and diagnosis of Pancreatitis:</span> </span></strong>Because diagnosing pancreatitis can be difficult, you're likely to have several tests to help pinpoint the problem. The type of test may depend on whether your pancreatitis is acute or chronic.</span><br /><div align="left"><span style="color:#ffffcc;">...<br /></span><span style="font-family:georgia;"><strong>Acute pancreatitis: </strong>If your doctor suspects that you have acute pancreatitis, a sample of your blood may be analyzed for abnormalities such as:<br /></span></div><ol><li><div align="left"><span style="font-family:georgia;"><strong>Elevated levels of the pancreatic enzymes, amylase and lipase;</strong> </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>Elevated white blood cell count;</strong> </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>Elevated liver enzymes and bilirubin, a substance that results from breakdown of red blood cells;</strong></span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>High blood sugar (hyperglycemia);</strong> </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>Low calcium level — high calcium levels can cause pancreatitis, but low levels of calcium in the blood, called hypocalcemia, are a common result;</strong> </span></div></li></ol><div align="left"><span style="font-family:georgia;">Because laboratory tests can't confirm a diagnosis of acute pancreatitis, your doctor may request an ultrasound or computerized tomography (CT) scan of your abdomen to examine your pancreas and to check for gallstones, a duct problem, or destruction of the gland. You may also have X-rays of your abdomen and chest to rule out other reasons for your symptoms. </span></div><div align="left"><span style="font-family:georgia;color:#ffffcc;">..<br /></span></div><div align="left"><strong><span style="font-family:georgia;font-size:130%;">Diagnosing Chronic pancreatitis:</span></strong></div><div align="left"><span style="font-family:georgia;"></span></div><div align="left"><span style="font-family:georgia;">Once there is damage in the pancreas, it is considered Chronic Pancreatitis. Chronic Pancreatitis is an ongoing progressive disease. There is no cure, but there is hope in research.</span></div><div align="left"><span style="font-family:georgia;color:#ffffcc;">..</span></div><div align="left"><span style="font-family:georgia;">Diagnosing chronic pancreatitis can be challenging because some tests may yield normal results, even though you have the disease. It can also be difficult to distinguish acute from chronic pancreatitis. Even so, certain tests can help rule out other problems and aid in the diagnosis. These include:<br /></span></div><ul><li><div align="left"><span style="font-family:georgia;"><strong>Blood tests.</strong> These tests can identify abnormalities associated with chronic pancreatitis and help rule out acute inflammation. </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>Stool test.</strong> This measures the fat content in your feces. Chronic pancreatitis often causes excess fat in your stool because the fat isn't digested and absorbed normally by your small intestine. </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>Ultrasound.</strong> In standard (external) ultrasound, a wand-like device (transducer) is placed on your body. It emits inaudible sound waves that are reflected to the transducer and then translated into a moving image by a computer. Endoscopic ultrasound may provide images of your pancreas and bile and pancreatic ducts that are superior to those produced by standard ultrasound.</span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>EUS.</strong> In endoscopic ultrasound, your doctor uses a thin, flexible tube with a light (endoscope) to thread a small ultrasound device through your stomach. The device then generates a detailed image on a computer screen. </span></div></li><li><div align="left"><span style="font-family:georgia;"><strong>ERCP</strong>. X-ray of bile and pancreatic ducts. In a procedure called endoscopic retrograde cholangiopancreatography, your doctor gently threads an endoscope down your throat and through your stomach to the opening of the bile and pancreatic ducts in your duodenum. A dye passed through a thin, flexible tube (catheter) inside the endoscope allows for X-ray images of the ducts.<br /></span></div></li></ul><p align="left"><span style="font-family:georgia;color:#ffffcc;">..<br /></span><a href="http://photos1.blogger.com/blogger/23/3875/1600/shared_1251_CP-18.jpg"><span style="font-family:georgia;"><img style="MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://photos1.blogger.com/blogger/23/3875/400/shared_1251_CP-18.jpg" border="0" /></span></a><span style="font-family:georgia;"><br /></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="center"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;">Fig. 1. Pancreas with no dialation of Main Pancreatic Duct and no clubbing of side branches.<br /><span style="color:#ffffcc;">....</span><br /><br /></span><a href="http://photos1.blogger.com/blogger/23/3875/1600/shared_1254_CP-19.jpg"><span style="font-family:georgia;"><img style="MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://photos1.blogger.com/blogger/23/3875/400/shared_1254_CP-19.jpg" border="0" /></span></a><span style="font-family:georgia;"><br /></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="center"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="center"><span style="font-family:georgia;">Fig. 2. Pancreas with main pancreatic duct dialated to 1.5x normal width and some clubbing of side branches. </span></p><p align="left"><span style="font-family:georgia;color:#ffffcc;">..<br /></span><a href="http://photos1.blogger.com/blogger/23/3875/1600/shared_1257_CP-20.jpg"><span style="font-family:georgia;"><img style="MARGIN: 0px 10px 10px 0px; CURSOR: hand" alt="" src="http://photos1.blogger.com/blogger/23/3875/400/shared_1257_CP-20.jpg" border="0" /></span></a><span style="font-family:georgia;"><br /></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="left"><span style="font-family:georgia;"></span></p><p align="center"><span style="font-family:georgia;">Fig. 3. Pancreas with main pancreatic duct dialated to > 1.5x normal width and clubbing of side branches. </span></p><p align="left"><strong><span style="font-family:georgia;color:#ffffcc;">...</span></strong></p><ul><li><div align="left"><span style="font-family:georgia;"><strong>Pancreatic function test.</strong> If you've lost weight or your doctor suspects a malabsorption problem, you may have a pancreatic function test. Several tests exist, but all measure the ability of your pancreas to secrete enzymes or other substances necessary for digestion. </span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>SSMRC.</strong> MRCP With Secretion Stimulation. IV injection of synthetic secretin, a gut hormone, causes a rapid outpouring of bicarbonate-rich fluid from the exocrine pancreas. SSMRCP provides significantly improved visualization not only of the main PD, but also of its side branches, when compared to nonstimulated imaging. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>You may need additional tests</strong> if your doctor is concerned about the possibility of other diseases, such as pancreatic cancer. Chronic pancreatitis puts you at a slightly higher risk of pancreatic cancer.</span></span></div></li></ul><br /><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong><span style="font-size:130%;">Complications: </span></strong>Severe cases of acute pancreatitis may lead to a number of complications:</span></span></div><div align="left"><span style="font-family:georgia;color:#000000;"></span></div><ol><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Infection.</strong> A damaged pancreas may become infected with bacteria that spread from the small intestine into the pancreas. Signs of infection include fever, an elevated white blood cell count and, in severe cases, organ failure. A fluid sample from the pancreas may be tested for bacterial infection. Pancreatic infections can be fatal without intensive treatment, including drainage or surgery to remove the infected tissue. Sometimes multiple operations are necessary. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Pseudocysts.</strong> These are collections of pancreatic fluid and sometimes tissue debris that form within the pancreas or in an obstructed duct. If the cyst is small, no special care may be necessary, but large, infected or bleeding pseudocysts require immediate treatment. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Abscess.</strong> This is a collection of pus in or near your pancreas that may develop about four to six weeks after the onset of acute pancreatitis. Treatment involves drainage of the abscess by catheter or surgery. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Respiratory failure.</strong> Chemical changes in your body can affect your lung function, causing the level of oxygen in your blood to fall to dangerously low levels.</span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Shock.</strong> This life-threatening complication usually occurs when your blood pressure is so low your organs can't carry out their normal functions. Severe shock can cause death within minutes if left untreated.</span></span></div></li></ol><div align="left"><span style="font-family:georgia;color:#000000;"></span></div><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong><span style="font-size:130%;">The complications common to acute pancreatitis can also occur in the chronic form of the disease.</span></strong> In addition, chronic pancreatitis can lead to:</span></span></div><ol><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Bleeding.</strong> Ongoing inflammation and damage to the blood vessels surrounding the pancreas can cause potentially fatal bleeding. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Malnutrition and weight loss.</strong> Lack of digestive enzymes prevents your body from absorbing nutrients from food. The result is often unintended weight loss and malnutrition. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Diabetes.</strong> Damage to insulin-producing cells can lead to diabetes, a disease that affects the way your body uses blood sugar. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Drug dependency</strong>. Because medical treatments for severe pancreatic pain aren't always effective, people with pancreatitis may become dependent on pain medications. </span></span></div></li><li><div align="left"><span style="color:#000000;"><span style="font-family:georgia;"><strong>Pancreatic cancer.</strong> Long-term inflammation of the pancreas increases your risk of pancreatic cancer, one of the most serious of all malignancies.</span></span><br /></div></li></ol><p><span style="font-family:georgia;color:#ffffcc;">..</span> </p><ul></ul><p align="center"><strong><span style="font-family:georgia;font-size:180%;">Why Pain?</span></strong></p><p><span style="font-size:100%;"><strong><span style="font-family:georgia;font-size:130%;">The role of mast cells in the pathogenesis of pain in chronic pancreatitis.</span></strong></span></p><p><span style="font-size:100%;"><span style="font-family:georgia;">BMC Gastroenterol. 2005; 5:8</span><span style="font-family:georgia;"> (ISSN: 1471-230X)<br />Hoogerwerf WA; Gondesen K; Xiao SY; Winston JH; Willis WD; Pasricha PJEnteric Neuromuscular Disorders and Pain Laboratory, Division of Gastroenterology and Hepatology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0764, USA. </span><span style="font-family:georgia;">wahooger@utmb.edu</span></span></p><span style="font-size:100%;"><ul><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">BACKGROUND:</span></strong> <strong>The biological basis of pain in chronic pancreatitis is poorly understood.</strong> <strong>Mast cells</strong> have been implicated in the pathogenesis of pain in other conditions. We hypothesized that mast cells play a role in the pain of chronic pancreatitis.We examined the association of pain with mast cells in autopsy specimens of patients with painful chronic pancreatitis. We explored our hypothesis further using an experimental model of trinitrobenzene sulfonic acid (TNBS) -induced chronic pancreatitis in both wild type (WT) and mast cell deficient mice (MCDM). </span></li><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">METHODS:</span></strong> Archival tissues with histological diagnoses of chronic pancreatitis were identified and clinical records reviewed for presence or absence of reported pain in humans. Mast cells were counted.The presence of pain was assessed using von Frey Filaments (VFF) to measure abdominal withdrawal responses in both WT and MCDM mice with and without chronic pancreatitis. </span></li><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">RESULTS:</span></strong> Humans with painful chronic pancreatitis demonstrated a 3.5-fold increase in pancreatic mast cells as compared with those with painless chronic pancreatitis. WT mice with chronic pancreatitis were significantly more sensitive as assessed by VFF pain testing of the abdomen when compared with MCDM. </span></li><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">CONCLUSION:</span></strong> Humans with painful chronic pancreatitis have an increased number of pancreatic mast cells as compared with those with painless chronic pancreatitis. MCDM are less sensitive to mechanical stimulation of the abdomen after induction of chronic pancreatitis as compared with WT. Mast cells may play an important role in the pathogenesis of pain in chronic pancreatitis. </span></li></ul><p align="center"><span style="color:#ffffcc;"><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span><br /></span><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /><br /></span><span style="color:#ffffcc;"></span><span style="color:#ffffcc;"></span></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-27511013691378909732007-05-04T13:17:00.000-07:002009-06-22T13:44:22.204-07:00Pancreatic Pseudocysts<strong><span style="font-size:180%;">Pancreatic pseudocyst</span></strong><br />From Wikipedia, the free encyclopedia<br /><br /><span style="font-size:180%;"><strong>Classification and external resources</strong><br /></span><a class="mw-redirect" title="ICD" href="http://en.wikipedia.org/wiki/ICD">ICD</a>-<a class="mw-redirect" title="List of ICD-10 codes" href="http://en.wikipedia.org/wiki/List_of_ICD-10_codes">10</a><br /><a class="mw-redirect" title="ICD-10 Chapter K" href="http://en.wikipedia.org/wiki/ICD-10_Chapter_K">K</a><a class="external text" title="http://www.who.int/classifications/apps/icd/icd10online/?gk80.htm+k863" href="http://www.who.int/classifications/apps/icd/icd10online/?gk80.htm+k863" rel="nofollow">86.3</a><br /><a class="mw-redirect" title="ICD" href="http://en.wikipedia.org/wiki/ICD">ICD</a>-<a title="List of ICD-9 codes" href="http://en.wikipedia.org/wiki/List_of_ICD-9_codes">9</a><br /><a class="external text" title="http://www.icd9data.com/getICD9Code.ashx?icd9=" href="http://www.icd9data.com/getICD9Code.ashx?icd9=577.2" rel="nofollow">577.2</a><br /><a title="Diseases Database" href="http://en.wikipedia.org/wiki/Diseases_Database">DiseasesDB</a><br /><a class="external text" title="http://www.diseasesdatabase.com/ddb9530.htm" href="http://www.diseasesdatabase.com/ddb9530.htm" rel="nofollow">9530</a><br /><a title="MedlinePlus" href="http://en.wikipedia.org/wiki/MedlinePlus">MedlinePlus</a><br /><a class="external text" title="http://www.nlm.nih.gov/medlineplus/ency/article/000272.htm" href="http://www.nlm.nih.gov/medlineplus/ency/article/000272.htm" rel="nofollow">000272</a><br /><a title="EMedicine" href="http://en.wikipedia.org/wiki/EMedicine">eMedicine</a><br /><a class="external text" title="http://www.emedicine.com/med/topic2674.htm" href="http://www.emedicine.com/med/topic2674.htm" rel="nofollow">med/2674</a> <a class="external text" title="http://www.emedicine.com/radio/topic576.htm#" href="http://www.emedicine.com/radio/topic576.htm#" rel="nofollow">radio/576</a><br /><a title="Medical Subject Headings" href="http://en.wikipedia.org/wiki/Medical_Subject_Headings">MeSH</a><br /><a class="external text" title="http://www.nlm.nih.gov/cgi/mesh/2009/MB_cgi?field=" href="http://www.nlm.nih.gov/cgi/mesh/2009/MB_cgi?field=uid&term=D010192" rel="nofollow" term="D010192">D010192</a><br /><br />A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue (tissue that has died), typically located in the <a title="Lesser sac" href="http://en.wikipedia.org/wiki/Lesser_sac">lesser sac</a> of the abdomen. Pancreatic pseudocysts are usually complications of pancreatitis, although in children they frequently occur following abdominal trauma. Pancreatic pseudocysts account for approximately 75% of all pancreatic masses. The prefix pseudo- (Greek for "false") distinguishes them from true cysts, which are lined by epithelium; pseudocysts are lined with granulation tissue.<br /><a id="Pathophysiology" name="Pathophysiology"></a><br /><strong><span style="font-size:180%;">Pathophysiology</span></strong><br />Acute pancreatitis results amongst other things in the disruption of pancreatic parenchyma and the ductal system. This results in extravasation of pancreatic enzymes which in turn digest the adjoining tissues. This results in a collection of fluid containing pancreatic enzymes, hemolysed blood and necrotic debris around the pancreas. The <a title="Lesser sac" href="http://en.wikipedia.org/wiki/Lesser_sac">lesser sac</a> being a potential space, the fluid collects here preferentially. This is called an acute pancreatic collection. Some of these collections resolve on their own as the patient recovers from the acute episode. However, others become more organized and get walled-off within a thick wall of granulation tissue and fibrosis. This takes several weeks to occur and results in a pancreatic pseudocyst.<br /><a id="Investigations" name="Investigations"></a><br /><strong><span style="font-size:180%;">Investigations<br /></span></strong>The questions that need to be answered are:<br /><ol><li>Where, how big and how many? </li><li>Is there a communication with the pancreatic ductal system? Draining such a pseudocyst carries an increased risk of pancreatic fistula. </li></ol><br /><strong><span style="font-size:130%;">The most useful imaging tools are:</span></strong><br /><ol><li><a class="mw-redirect" title="Ultrasonography" href="http://en.wikipedia.org/wiki/Ultrasonography">Ultrasonography</a> - The role of ultrasonography in imaging the pancreas is limited by patient habitus, operator experience and the fact that the pancreas lies behind the stomach (and so a gas-filled stomach will obscure the pancreas). </li><li><a class="mw-redirect" title="Computerized tomography" href="http://en.wikipedia.org/wiki/Computerized_tomography">Computerized tomography</a> - This is the gold standard for initial assessment and follow-up </li><li><a title="Magnetic resonance cholangiopancreatography" href="http://en.wikipedia.org/wiki/Magnetic_resonance_cholangiopancreatography">Magnetic resonance cholangiopancreatography</a> (MRCP) - to establish the relationship of the pseudocyst to the pancreatic ducts </li></ol><p><span style="font-size:180%;"><strong>Treatment<br /></strong></span>A small pseudocyst that is not causing any symptoms may be managed conservatively. However, a large proportion of them will need some form of treatment, The interventions available are:</p><ol><li><a class="mw-redirect" title="Gastroscopy" href="http://en.wikipedia.org/wiki/Gastroscopy">Endoscopic</a> trans-gastric drainage </li><li>Imaging guided percutaneous drainage </li><li>Laparoscopic/open cystogastrostomy </li></ol><p align="center"><strong>To view information on another disease, click on Pancreatitis SOD Library.!<br /></strong><a href="http://pancsod-library.blogspot.com/"><strong>Pancreatitis SOD Library</strong></a></p><p></p>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-79513934046531362252007-05-04T13:04:00.000-07:002007-05-04T13:18:25.856-07:00Treatment<span style="font-family:georgia;"><strong><span style="font-size:180%;">Treatment</span></strong><br /><br /><br /></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><span style="font-family:georgia;"></span><p></p><ol><li><span style="font-family:georgia;"><strong><span style="font-size:100%;">Relieving pain</span></strong> is the first step in treating chronic pancreatitis. </span></li><li><span style="font-family:georgia;">The next step is to plan a <strong>diet</strong> that is high in carbohydrates and low in fat. </span></li><li><span style="font-family:georgia;">A doctor may prescribe <strong>pancreatic enzymes</strong> to take with meals if the pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the body digest food and regain some weight. </span></li><li><span style="font-family:georgia;">In some cases, <strong>surgery</strong> is needed to relieve pain. The surgery may involve draining an enlarged pancreatic duct or removing part of the pancreas. </span></li><li><span style="font-family:georgia;">For fewer and milder attacks, people with pancreatitis <strong>must stop drinking alcohol</strong>, if they do drink, <strong>stop smoking tobacco</strong>, if they do smoke, <strong>stick to their prescribed diet</strong>, and <strong>take the proper medications</strong>. </span></li><li><span style="font-family:georgia;"><span style="font-size:130%;"><span style="font-size:100%;">Sometimes <strong>insulin or other drugs</strong></span> </span><span style="font-size:100%;">are needed to control blood glucose. </span></span></li><li><span style="font-family:georgia;"><span style="font-size:100%;"><strong>Complications</strong> will be treated if or as they arise (infections, pseudocysts, abscess, respiratory problems, shock, bleeding, malnutritian, weight loss, diabetes, drug dependency, pancreatic cancer.) </span></span></li></ol><p><span style="font-family:georgia;"><strong><span style="font-size:130%;">Emergency Department Care:</span></strong> Most of the cases presenting to the ED are treated conservatively, and approximately 80% respond to such treatment:</span></p><ul><li><span style="font-family:georgia;"><strong>Fluid resuscitation:</strong> </li><ul><li>Monitor accurate intake/output and electrolyte balance of the patient.<br />Crystalloids are used, but other infusions, such as packed red blood cells<br />(PRBCs), are occasionally administered, particularly in the case of hemorrhagic pancreatitis. </li><li>Central lines and Swan-Ganz catheters are used in patients<br />with severe fluid loss and very low blood pressure.</li></ul></span><li><span style="font-family:georgia;"><strong>NPO:</strong> Patients should have nothing by mouth, and a nasogastric tube should be inserted to assure an empty stomach and to keep the GI system at rest.</span></li><li><span style="font-family:georgia;"><strong><span style="font-size:130%;">**</span>Begin parenteral nutrition</strong> if the prognosis is poor and if the patient is going to be kept in the hospital for more than 4 days.</span></li><li><span style="font-family:georgia;"><strong>Analgesics are used to relieve pain.</strong> Meperidine is preferred over morphine because of the greater spastic effect of the latter on the sphincter of Oddi.</span></li><li><span style="font-family:georgia;"><strong>Antibiotics</strong> are used in severe cases associated with septic shock or when the CT scan indicates that a phlegmon of the pancreas has evolved.</span></li><li><span style="font-family:georgia;"><strong>Other conditions</strong>, such as biliary pancreatitis associated with cholangitis, also need antibiotic coverage. The preferred antibiotics are the ones secreted by the biliary system, such as ampicillin and third generation cephalosporins.</span></li><li><span style="font-family:georgia;"><strong>Continuous oxygen saturation</strong> should be monitored by pulse oximetry and acidosis should be corrected. When tachypnea and pending respiratory failure develops, intubation should be performed. </span></li><li><span style="font-family:georgia;"><strong>Perform CT-guided aspiration of necrotic areas</strong>, if necessary. </span></li><li><span style="font-family:georgia;">An <strong>ERCP</strong> may be indicated for common duct stone removal.</span></li><li><span style="font-family:georgia;"><strong>Consultations:</strong> Consult a general surgeon in the following cases: </li><ul><li>For phlegmon of the pancreas, surgery can achieve drainage of any abscess or<br />scooping of necrotic pancreatic tissue. It should be followed by postoperative<br />lavage of the pancreatic bed.<br />In patients with hemorrhagic pancreatitis, surgery is indicated to achieve<br />hemostasis, particularly because major vessels may be eroded in acute<br />pancreatitis. </li><li>Patients who fail to improve despite optimal medical treatment or patients who push the Ranson score even further are taken to the operating room. Surgery in these cases may lead to a better outcome or confirm a different diagnosis.<br />In biliary pancreatitis, a sphincterotomy (ie, surgical emptying of the common bile duct) can relieve the obstruction. A cholecystectomy may be performed to clear the system from any source of biliary stones.</li></ul></span><li><span style="font-family:georgia;"><strong>Further Inpatient Care:</strong><br /></li></span><span style="font-family:georgia;"><ul><li><span style="font-family:georgia;">Transfer patients with Ranson scores of 0-2 to a hospital floor. </span></li><li><span style="font-family:georgia;">Transfer patients with Ranson scores 3-5 to an intensive care unit. </span></li><li><span style="font-family:georgia;">Transfer patients with Ranson scores higher than 5 to an intensive care unit with emergency surgery as a possibility. </span></li><li><span style="font-family:georgia;">Two other systems, the<br /><blockquote><li><span style="font-family:georgia;">Acute Physiology and Chronic Health Evaluation (APACHE) and</span></li><li><span style="font-family:georgia;"><span style="font-family:georgia;">the Multiple Organ System Score (MOSS), have been used recently, but these are used more in an ICU setting.</span></span></li></blockquote></li></ul></span></span><li><span style="font-family:georgia;"><strong>Further Outpatient Care:</strong><br />The patient should be followed routinely with physical examination and amylase<br />and lipase assays.</span></li></ul></li></li><br /><strong><span style="font-size:130%;">**</span></strong>A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition.<br /><br /><a href="http://www.ncbi.nlm.nih.gov/">http://www.ncbi.nlm.nih.gov/</a><br />posted by nicola 22 hours ago view profile<br />Dig Surg. 2006;23(5-6):336-44; discussion 344-5.<br />Petrov MS, Kukosh MV, Emelyanov NV.<br />Discuss category: Other (Clinical) tags: APACHE Abscess Acute Disease Adult Aged Analysis of Variance C-Reactive Protein Enteral Nutrition Female Humans Infection Male Middle Aged Necrosis Pancreatitis Parenteral Nutrition Prognosis Treatment Outcome all<br /><br /><br />BACKGROUND: Infectious complications are the main cause of late death in patients with acute pancreatitis. Routine prophylactic antibiotic use following a severe attack has been proposed but remains controversial. On the other hand, nutritional support has recently yielded promising clinical results. The aim of study was to compare enteral vs. parenteral feeding for prevention of infectious complications in patients with predicted severe acute pancreatitis. METHODS: We screened 466 consecutive patients with acute pancreatitis. A total of 70 patients with objectively graded severe acute pancreatitis were randomly allocated to receive either total enteral nutrition (TEN) or total parenteral nutrition (TPN), within 72 h of onset of symptoms. Baseline characteristics were well matched in the two groups. RESULTS: The incidence of pancreatic infectious complications (infected pancreatic necrosis, pancreatic abscess) was significantly lower in the enterally fed group (7 vs. 16, p = 0.02). In the TEN group, 7 patients developed multiple organ failure whereas 17 parenterally fed patients developed multiple organ failure (p = 0.02). Overall mortality was 20% with two deaths in the TEN group and twelve in the TPN <strong><span style="font-family:georgia;"><span style="font-size:130%;">Prognosis:<br /></span></span><span style="font-family:georgia;">Ranson developed a series of different criteria for the severity of acute pancreatitis:</span></strong><br /><br /><br /><p></p><ul><li><span style="font-family:georgia;"><strong>Present on admission</strong></span></li></ul><p><span style="font-family:georgia;"><span style="color:#ffffcc;">..........</span>1. Older than 55 years<br /><span style="color:#ffffcc;">..........</span>2. WBC higher than 16,000 per mcL<br /><span style="color:#ffffcc;">..........</span>3. Blood glucose higher than 200 mg/dL<br /><span style="color:#ffffcc;">..........</span>4. Serum lactate dehydrogenase (LDH) more than 350 IU/L<br /><span style="color:#ffffcc;">..........</span>5. SGOT (ie, aspartate aminotransferase [AST]) ></span><span style="font-family:georgia;"><span style="font-family:georgia;">250 </span><span style="font-family:georgia;"><strong></strong></span></span></p><ul><li><span style="font-family:georgia;"><span style="font-family:georgia;"><strong>Developing during the first 48 hours:</strong></span></span><span style="font-family:georgia;"><span style="font-family:georgia;"> </li></ul></span></span><span style="color:#ffffcc;"></span><p><span style="font-family:georgia;"><span style="font-family:georgia;"><span style="color:#ffffcc;">..........</span>1. Hematocrit fall more than 10%<br /><span style="color:#ffffcc;">..........</span>2. BUN increase more than 8 mg/dL<br /><span style="color:#ffffcc;">..........</span>3. Serum calcium less than 8 mg/dL<br /><span style="color:#ffffcc;">..........</span>4. Arterial oxygen saturation less than 60 mm Hg<br /><span style="color:#ffffcc;">..........</span>5. Base deficit higher than 4 mEq/L<br /><span style="color:#ffffcc;">..........</span>6. Estimated fluid sequestration higher than 600 mL </span></p></span><p></p><ul><li><div align="left"><span style="font-family:georgia;"><strong>What the Score Means:</strong></span></div></li><span style="font-family:georgia;"></span></ul><span style="font-family:georgia;"><blockquote><p><span style="font-family:georgia;">1. A Ranson score of 0-2 has a minimal mortality</span><br /><span style="font-family:georgia;"><span style="color:#ffffcc;">....</span>rate </span><span style="font-family:georgia;">Patient to regular floor.</span></p><p><span style="font-family:georgia;">2. A Ranson score of 3-5 has a 10%-20% mortality</span><br /><span style="font-family:georgia;"><span style="color:#ffffcc;">.....</span>rate. Patient to ICU</span><span style="font-family:georgia;"><br /></span><span style="font-family:georgia;"><span style="font-family:georgia;">3. A Ranson score higher than 5 has a mortality </span><br /><span style="font-family:georgia;"><span style="color:#ffffcc;">.....</span>rate of more than 50% and is associated with </span><br /><span style="font-family:georgia;"><span style="color:#ffffcc;">.....</span>more systemic complications. Patient to ICU </span><br /><span style="font-family:georgia;"><span style="color:#ffffcc;">.....</span>emergency surgery floor.</p></blockquote></span></span><p></p></span><span style="font-family:georgia;"><strong><span style="font-size:130%;"><p align="center"><br /><br />Links to Wikipedia for more information:</span></strong><br /><a href="http://en.wikipedia.org/wiki/Pancreas"><strong>Pancreas</strong></a>: (<a href="http://en.wikipedia.org/wiki/Acute_pancreatitis"><strong>Acute pancreatitis</strong></a>, <a href="http://en.wikipedia.org/wiki/Chronic_pancreatitis"><strong>Chronic pancreatitis</strong></a>, <a href="http://en.wikipedia.org/wiki/Pancreatic_pseudocyst"><strong>Pancreatic pseudocyst</strong></a>,<br /><a href="http://en.wikipedia.org/wiki/Hereditary_pancreatitis"><strong>Hereditary pancreatitis</strong></a>, <a href="http://en.wikipedia.org/wiki/Pancreatic_cancer"><strong>Pancreatic cancer</strong></a>)<br /><br /></p><p align="center"><span style="color:#ffffcc;">.. </p></span><br /><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span><br /></span><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /><br /></span><span style="color:#ffffcc;"></span><span style="color:#ffffcc;"></span></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-31087352240320310282007-05-04T13:00:00.000-07:002007-05-04T13:03:26.164-07:00Pancreatitis Diet<strong><span style="font-size:180%;">Pancreatitis Diet</span></strong><br /><span style="color:#ffffcc;">..</span><br /><strong><span style="font-size:130%;">Always check with your doctor before changing your diet.</span></strong><strong><span style="font-size:130%;"></span></strong><strong><span style="font-size:130%;"></span></strong><br /><div align="center"><span style="color:#ffffcc;">..<strong><span style="font-size:130%;">..</span></strong></span></div><div align="left"><strong><span style="font-size:130%;">If you have vomiting, pain, and nausea: go to hospital. You should be kept well hydrated and nourished by use of IV.</span></strong><br /><span style="font-size:130%;"><strong>Bowel sounds returning, pain subsiding, nausea lessening: Clear liquid diet </strong></span></div><ol><li><div align="left">Water</div></li><li><div align="left">Clear juices like apple juice</div></li><li><div align="left">Popcycles (not red or grape)</div></li><li><div align="left">Jello (not red or grape)</div></li><li><div align="left">Clear fat free broth (chicken, vegetable or beef</div></li></ol><div align="left"><strong><span style="font-size:130%;">If you tolerate the clear liquid diet well, and bowel sounds are good, and things tend to be moving, you could move to the solid liquid diet:</span></strong> </div><ol><li><div align="left">Everything on the clear liquid diet</div></li><li><div align="left">Cottage cheese</div></li><li><div align="left">Ice cream</div></li><li><div align="left">Pudding</div></li></ol><div align="left"><strong><span style="font-size:130%;">If that is well tolerated for a day or two, and bowels are still moving well, you may move to soft diet:</span></strong></div><ol><li><div align="left">Everything on the solid liquid diet</div></li><li><div align="left">Extremely well cooked veggies, not of the **cruciferous family</div></li><li><div align="left">Canned fruits (not raw)</div></li><li><div align="left">A small piece of very lean meat, usually boiled and patted dry </div></li></ol><div align="left"></div><div align="left"><strong><span style="font-size:130%;">If that is well tolerated for a day or two, and bowels are still working well, you might move to a bland diet:</span></strong></div><ol><li><div align="left">Everything on the soft diet</div></li><li><div align="left">Toast/bread</div></li><li><div align="left">Jellies</div></li><li><div align="left">Bananas</div></li><li><div align="left">White rice, no fat</div></li><li><div align="left">Melon<span style="color:#ffffcc;">..</span></div></li></ol><div align="left"><strong><span style="font-size:130%;">If that is well tolerated, and the bowels are working well, you might move to the Pancreatitis diet: Low Fat, Low Protein, High Carbohydrate Diet</span></strong><span style="color:#ffffcc;">..</span></div><div align="left">You can eat what you want that is basically low fat. </div><div align="left"></div><div align="left"><span style="color:#ffffcc;">..</span></div><ol><li><div align="left"><strong><span style="font-size:130%;">Fats:</span></strong> Your diet should contain 30g fat per day. Your doctor may advise you to take MCT oil (to prevent fat malabsorption). </div></li><li><div align="left"><strong><span style="font-size:130%;">Saturated fat</span></strong> is most often found in animal products, such as red meat, poultry, butter and whole milk. Other foods high in saturated fat include coconut, palm and other tropical oils. Saturated fat is the main dietary culprit in raising your blood cholesterol and increasing your risk of coronary artery disease. Limit your daily intake of saturated fat to no more than 10 percent of your total calories. For most women, this means no more than 20 grams a day, and for most men this means no more than 24 grams a day.</div></li><li><div align="left"><strong><span style="font-size:130%;">Carbohydrates:</span></strong> Get 45 percent to 65 percent of your daily calories — at least 130 grams a day — from carbohydrates. Emphasize complex carbohydrates, especially from whole grains and beans, and nutrient-rich fruits and milk. Limit sugars from candy and other sweets.</div></li><li><div align="left"><strong><span style="font-size:130%;">Cholesterol</span></strong> is vital to the structure and function of all your cells, but it's also the main substance in fatty deposits (plaques) that can develop in your arteries. Your body makes all of the cholesterol it needs for cell function. You get additional cholesterol by eating animal foods, such as meat, poultry, seafood, eggs, dairy products and butter. Limit your intake of cholesterol to no more than 300 milligrams a day.</div></li><li><div align="left"><strong><span style="font-size:130%;">Fiber</span></strong> is the part of plant foods that your body doesn't digest and absorb. There are two basic types: soluble and insoluble. <strong>Insoluble fiber</strong> adds bulk to your stool and can help prevent constipation. Vegetables, wheat bran and other whole grains are good sources of insoluble fiber. <strong>Soluble fiber</strong> may help improve your cholesterol and blood sugar levels. Oats, dried beans and some fruits, such as apples and oranges, are good sources of soluble fiber. Women need 21 to 25 grams of fiber a day, and men need 30 to 38 grams of fiber a day.</div></li><li><div align="left"><strong><span style="font-size:130%;">Protein</span></strong> is essential to human life. Your skin, bones, muscles and organ tissue all contain protein. It's found in your blood, hormones and enzymes too. Protein is found in many plant foods. It comes from animal sources as well. Legumes, poultry, seafood, meat, dairy products, nuts and seeds are your richest sources of protein. Between 10 percent and 35 percent of your total daily calories — at least 46 grams a day for women and 56 grams a day for men — can come from protein.</div></li></ol><div align="left"><strong><span style="font-size:130%;">Each person is different! Stay away from foods that disrupt your digestion!</span></strong> If you choose foods that are low fat, low protein, high carbohydrate, it will be easier on your pancreas. It won't have to work so hard to digest foods. Some people can't tolerate dairy products. They don't bother me at all, so I eat them! Some people don't tolerate wheat products, or products made from corn, but I have no problem with them! Once you on the Pancreatitis Diet, start a food log or diary. Start periodically adding a new food (just one at a time) and after a while, you will be able to tell whether or not this food agrees with you. As you find foods that you tolerate well, move them to your "Foods to eat" category. If you find a food that you don't tolerate well, move it to your "Foods to stay away from" category. After a while, you will see that you have a myriad of foods from which to choose!</div><div align="left"><span style="color:#ffffcc;">..</span></div><div align="left"><strong>**Cruciferous family:</strong></div><ol><li>Broccoli</li><li>Cabbage</li><li>Cauliflower</li><li>Brussels sprouts</li></ol><div align="left">These are hard to digest and may cause gas and tummy problems.</div><div align="left"></div><div align="left"><strong>Other possible tummy troublers:</strong></div><ol><li>Carrots</li><li>Raisons!</li></ol><div align="left">These are not from the cruciferous family, but none-the-less are hard to digest and may cause gas and tummy problems. </div><div align="left"><span style="color:#ffffcc;">..</span></div><div align="left"></div><div align="left"><strong><span style="font-size:130%;">Here is a list of difficiencies and symptoms of dificiency:</span></strong></div><div align="left"></div><div align="left"><strong><span style="color:#ffffcc;">..</span></strong></div><div align="left"><strong>Deficiency</strong><span style="color:#ffffcc;">.</span> / <strong>Symptom</strong></div><div align="left">Protein-<span style="color:#ffffcc;">............</span><span style="color:#000000;">low </span>energy- apathy, fretfulness, low interest in food</div><div align="left">Thiamin- <span style="color:#ffffcc;">.......</span><span style="color:#ffffcc;">..</span>confusion, irritability, memory loss, depression</div><div align="left">Riboflavin- <span style="color:#ffffcc;">......</span>depression, hysteria, psychopathic behavior</div><div align="left">Niacin- <span style="color:#ffffcc;">.............</span>irritability, memory loss, mental confusion</div><div align="left">Vitamin B6-<span style="color:#ffffcc;"> ....</span>irritability, depression, abnormal brainwave patterns</div><div align="left">Folate- <span style="color:#ffffcc;">............</span> mental symptoms of anemia, irritability, depression</div><div align="left">Vitamin B12- <span style="color:#ffffcc;">..</span>degeneration of the peripheral nervous system</div><div align="left">Vitamin C- <span style="color:#ffffcc;">......</span>hysteria, depression, lassitude, social introversion</div><div align="left">Vitamin A- <span style="color:#ffffcc;">......</span>anemia</div><div align="left">Iron- <span style="color:#ffffcc;">................</span>irritability, weakness, headaches</div><div align="left">Magnesium- <span style="color:#ffffcc;">...</span>apathy, personality changes</div><div align="left">Copper- <span style="color:#ffffcc;">...........</span>iron deficiency anemia</div><div align="left">Zinc- <span style="color:#ffffcc;">................</span>iron deficiency anemia, irritability, emotional</div><div align="left"><span style="color:#ffffcc;">..........................</span>disorders </div><div align="left"><span style="color:#ffffcc;">..</span><span style="color:#ffffcc;"><strong><span style="color:#000000;"><br /></div></span></strong></span><div align="center"><div align="center"><span style="color:#ffffcc;">..<br /></span><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span> </div><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /></span><span style="color:#ffffcc;"></span></div>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-4557898103037487942007-05-04T12:47:00.001-07:002007-05-04T12:54:44.721-07:00Coping Skills<div align="center"><strong><span style="font-size:180%;">Coping Skills</span></strong></div>The effects of chronic pancreatitis may persist for years. By avoiding alcohol and smoking tobacco, eating well and working closely with your doctor to find appropriate medications, you have a better chance of managing the condition and living a more active, productive lifestyle.<br />As is true with other chronic diseases, living with pancreatitis can cause emotional ups and downs. Here are tips for dealing with those swings: <ol><li>Maintain normal daily activities as best you can.</li><li>Stay connected with friends and family.</li><li>Continue to pursue hobbies that you enjoy and are able to do.</li><li>Consider joining a support group, especially one for people with chronic pain.</li></ol><p>Keep in mind that <strong>your physical health can impact directly on your mental health</strong>. Denial, anger and frustration are common with chronic illnesses. At times, you may need more tools to deal with your emotions. Professionals such as therapists or behavioral psychologists may be able to help you put things in perspective. They can also teach coping skills, including relaxation techniques, that may help you.<br />In addition, <strong>many chronic illnesses place you at an increased risk of depression</strong>. <strong>This</strong> isn't a failure to cope but <strong>may indicate a disruption in your body's neurochemistry that can be helped with appropriate medical treatment</strong>. Talk with your family, friends and doctor if you're feeling depressed. </p><span style="color:#ffffcc;"></span><br /><div align="center"><span style="color:#ffffcc;">..<br /></span><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span> </div><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /></span><span style="color:#ffffcc;"></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0tag:blogger.com,1999:blog-2881267328292812612.post-62231666641837508892007-05-04T12:23:00.000-07:002007-05-04T12:59:01.694-07:00Self Care<div align="center"><strong><span style="font-size:180%;">Self Care</span></strong></div><br />Chronic pancreatitis may leave you with lifelong signs and symptoms, such as pain and malabsorption of certain nutrients. However, most people with acute pancreatitis recover completely. But even if you experience no lingering symptoms, it's important to take steps to keep your pancreas as healthy as possible: <ol><li><strong><span style="font-size:130%;">Avoid alcohol.</span></strong> If you can't voluntarily stop drinking alcohol, get treatment for alcoholism. Abstaining from alcohol may or may not reduce your pain, but it will reduce your risk of dying of your disease.</li><li><strong><span style="font-size:130%;">Avoid smoking tobacco</span></strong>. Smoking tobacco exacerbates pancreatitis and might cause pancreatic cancer. If you are a patient of CP you already have a higher risk of pancreatic cancer. If you smoke tobacco, your risk for pancreatic cancer is even higher.</li><li><strong><span style="font-size:130%;">Eat smaller meals.</span></strong> The more you eat during a meal, the greater the amount of digestive juices your pancreas must produce. Instead of large meals, eat smaller, more frequent meals.</li><li><strong>Limit fat in your diet</strong>. Limiting fat will help reduce loose and oily stools that result from a lack of pancreatic enzymes. Discuss with your doctor or a dietitian how much fat to eat each day because some fat is essential.</li><li><strong><span style="font-size:130%;">Follow a diet high in carbohydrates</span></strong>. Carbohydrates give you energy to help fight fatigue. They're present in foods made from starches (complex carbohydrates) or sugars (simple carbohydrates). Try to get most of your daily calories from complex carbohydrates found in grains, vegetables and legumes. If you have diabetes, a dietitian can help you plan an appropriate diet.</li><li><strong><span style="font-size:130%;">Drink plenty of liquids</span></strong>. If you have chronic pancreatitis, be sure to drink enough liquids so that you don't become dehydrated. Dehydration may aggravate your pain by further irritating your pancreas.</li><li><strong><span style="font-size:130%;">Find safe ways to control pain</span></strong>. Talk with your doctor about options for controlling your pain, including the benefits and risks of prescription and over-the-counter pain relievers and the use of digestive enzymes.</li></ol><span style="color:#ffffcc;"></span><br /><div align="center"><span style="color:#ffffcc;">..<br /></span><span style="color:#ffffcc;"><strong><span style="color:#000000;"><div align="center"><span style="color:#ffffcc;">..<br /></span><span style="color:#ffffcc;"><strong><span style="color:#000000;">To view information on another disease, click on Pancreatitis SOD Library.</span>!</strong></span> </div><p></p><p align="center"><span style="color:#ffffcc;"><a href="http://pancsod-library.blogspot.com/">Pancreatitis SOD Library</a></span></p><br /><span style="color:#ffffcc;">..<br /><br /></span><span style="color:#ffffcc;"></span></div></span></strong></span>pancsodhttp://www.blogger.com/profile/02662584668454990789noreply@blogger.com0