1. PANCREATITIS
PRESENTED BY-
Shruti Richa
Assistant Professor
Azad Institute of Pharmacy &
Research

2. Pancreatitis is a disease taken from two words-
Pancreas (Pancreas is a large gland
behind the stomach and
next to the small intestine)
Pancreatitis
Itis (means inflammation i. e.
redness, pain & swelling)
Thus, pancreatitis is the inflammation of pancreas (which is
a long, flat gland of about 6 inches (15.24 centimeters) that sits
tucked behind the stomach in the upper abdomen) or it is a
disease in which the pancreas becomes inflamed.

3. Diagrammatic Representation
• Normal pancreas v/s inflamed pancreas

4. • Normally, the pancreas produces enzymes that helps in
digestion and hormones which helps to regulate the way
how body processes sugar (glucose).
• In pancreatitis happens to start when the digestive
enzymes are activated before they are released into the
small intestine and begin attacking the pancreas.
• Mild cases of pancreatitis may go away without treatment,
but severe cases can cause life-threatening complications
since pancreatitis is an inflammatory process in which
pancreatic enzymes auto digest the gland.

5. Types of pancreatitis
• Pancreatitis is of two types :
Acute (The pancreas can sometimes heal
without any impairment of function
or any morphologic changes).
Panacreatitis
Chronic (It can recur intermittently,
contributing to the functional
and morphologic loss of the
gland).

6. Acute pancreatitis
• Acute pancreatitis is a sudden inflammation that lasts for
a short time.
• It may range from mild discomfort to a severe, life-
threatening illness.
• Most people with acute pancreatitis recover completely
after getting the right treatment. But in severe cases, acute
pancreatitis can result in bleeding into the gland, serious
tissue damage, infection, and cyst formation.
• Severe pancreatitis can also harm other vital organs such
as the heart, lungs, and kidneys.

7. Severity of acute pancreatitis

8. Chronic pancreatitis
• With repeated bouts of acute pancreatitis, damage to the
pancreas can occur and lead to chronic pancreatitis.
• Chronic pancreatitis is long-lasting inflammation of the
pancreas. It most often happens after an episode of acute
pancreatitis. Heavy alcohol drinking is another big cause.
Damage to the pancreas from heavy alcohol use may not
cause symptoms for many years, but then the person may
suddenly develop severe pancreatitis symptoms.

10. Causes/ Etiology
0-2 Very rare
3-5 Very rare
6-13 Rare
14-18 Rare
19-40 Rare
41-60 Common
60+ Rare
• Age factor
• Alcoholism
• Cigarette smoking
• Gallstones

11. • Abdominal surgery
• Certain medications (azathioprine, corticosteroids,
sulfonamides, thiazides, furosemides, nonsteroidal anti-
inflammatory drugs (NSAIDs), mercaptopurine,
methyldopa, and tetracyclines)
• Cystic fibrosis
• Family history of pancreatitis
• High calcium levels in the blood i. e. hypercalcemia, which may
be caused by an overactive parathyroid gland
(hyperparathyroidism)
• High triglyceride levels in the blood
(hypertriglyceridemia)
• Infection (a number of infectious agents have been
recognized as causes of pancreatitis, e.g. Hepatitis B).
• Injury to the abdomen
• Pancreatic cancer
• Scar tissue may form in the pancreas, causing loss of
function.

12. • Intestinal parasites, such as Ascaris, which can block the
pancreatic outflow
• A poorly functioning pancreas can cause digestion
problems and diabetes.
• Pancreas divisum
• Scorpion and snake bites
• Vascular factors, such as ischemia or vasculitis
• Autoimmune pancreatitis
• Endoscopic retrograde cholangiopancreatography (ERCP),
a procedure used to treat gallstones, can also lead to
pancreatitis.
• Sometimes, a cause for pancreatitis is never found.

13. Symptoms
Symptoms of acute pancreatitis:
• Upper abdominal pain that radiates into the back; it may
be aggravated by eating, especially foods high in fat.
• Swollen and tender abdomen
• Nausea and vomiting
• Fever
• Increased heart rate (tachycardia)
• Mild jaundice
• Diminished or absent bowel sounds

14. Symptoms of chronic pancreatitis:
• Frequently constant pain in the upper abdomen that
radiates to the back.
• In some patients, the pain may be disabling
• Diarrhea
• Tachypnea
• Hypotension
• Weight loss caused by poor absorption (malabsorption) of
food. This malabsorption happens because the gland is not
releasing enough enzymes to break down food.
• Diabetes may develop if the insulin-producing cells of the
pancreas are damaged.

15. Diagnosis
• Blood Test for estimation of pancreatic function-
• Blood Sugar levels
• Serum Amylase
• Serum Lipase
• Serum calcium levels
• Lipid profile
• Complete Blood Count
• ESR (Erythrocyte Sedimentation Rate)
• Stool Routine
• CT scan
• MRI, abdominal ultrasound or ERCP, an endoscopic
ultrasound can be used for diagnosis.
• Amylase and lipase are 2 enzymes produced by the
pancreas. Elevations in lipase are generally considered a
better indicator for pancreatitis.

16. Prognosis
• Severe acute pancreatitis has mortality rates around 2–9%,
• It happens at the age > 55 years
• Blood levels result in:
• PO2 oxygen < 60mmHg or 7.9kPa
• Neutrophilia White blood cells > 15
• Calcium< 2 mmol/L
• Renal Urea > 16 mmol/L
• Enzyme Lactate dehydrogenase (LDH) > 600iu/L
• Enzyme Aspartate transaminase (AST) > 200iu/L
• Albumin < 32g/L
• Sugar Glucose > 10 mmol/L

17. Treatment
• Goals of treatment-
• To give maximum therapeutic effect with using
minimum dose of the medicine.
• To provide symptomatic treatment
• To minimize the pain
• To give relief

18. • The treatment can be of two types-
Non- medicinal treatment (Life-style
modification)
Treatment
Medical treatment (involves medicines)

19. • Non medical treatment- It involves general life style
changes and modifications-
• To stop drinking alcohol.
• To stop smoking
• Meditation
• Relaxation exercises
• Yoga
• Acupuncture

20. • By choosing a low-fat diet. Choose a diet that limits fat
and emphasizes fresh fruits and vegetables, whole
grains, and lean protein.
• By drinking more fluids. Pancreatitis can cause
dehydration, so drink more fluids throughout the day.
• Rather than three large meals a day, patients should be
advised to change to six small meals. It is also better to
avoid fatty meal.

21. • Medical treatment (Allopathy)-
• Analgesics & others
• Tramadol (analgesic)
• Meperidine (opioid narcotic analgesic)
• Acetaminophen (peripherally acting drug of choice for
mild to moderate pain and elevation of body
temperature)
• Antibiotics
• Ampicillin
• Ceftriaxone
• Nonsteroidal Anti-Inflammatory Drugs
• Naproxen
• Ketorolac
• Diclofenac
• Ibuprofen

22. • Medical treatment (homeopathy)-
• Iris Versicolor
• Iodum
• Phosphorous
• Belladonna
• Conium
• Kali-Iodum
• Mercurius
• Arsenic album
• Surgery

24. Complications
• Pseudocyst (acute pancreatitis can cause fluid
and debris to collect in cyst like pockets in the
pancreas. A large pseudocyst that ruptures can
cause complications such as internal bleeding and
infection).
• Infection (It makes pancreas more vulnerable to
bacteria and infection. Pancreatic infections are
serious and require intensive treatment, such as
surgery to remove the infected tissue).
• Kidney failure
• Breathing problems (due to chemical changes in
the body that affects the lung function, causing
the level of oxygen in blood to fall to dangerously
low levels).

25. • Diabetes (damage to insulin-producing cells in pancreas
leads to diabetes, a disease that affects the way your body
uses blood sugar).
• Malnutrition (pancreatitis causes pancreas to produce
fewer of the enzymes that are needed to break down and
process nutrients from the food we eat. This can lead to
malnutrition, diarrhea and weight loss)
• Pancreatic cancer (long-standing inflammation develops
pancreatic cancer).

26. Epidemiology
• Globally the incidence of acute pancreatitis is 5 to 35 cases
per 100,000 people.
• While the incidence of chronic pancreatitis is 4–8 per
100,000 with a prevalence of 26–42 cases per 100,000.
• In 2013 pancreatitis resulted in 123,000 deaths up from
83,000 deaths in 1990.

27. References
• ‘Waugh Anne’, ‘Grant Allison’; “Anatomy & Physiology in Health &
Illness”, IX edition, Ross & Willson, 2001, reprinted- 2005, page no.-
332-333.
• ‘Phate Rahul P.’ “Anatomy Physiology & Health Education” III edition,
Career Publication, 2004, page no-23-24.
• https://www.mayoclinic.org/diseasesconditions/pancreatitis/symptom
s-causes/syc-20360227https://www.mayoclinic.org/diseases-
conditions/pancreatitis/symptoms-causes/syc-20360227.
• https://www.google.co.in/search?q=PANCREATITIS+IMAGE&client=fire
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bPQ%3D&sa=X&ved=0ahUKEwja8ZuNvJ3ZAhWLpo8KHTQuCEwQ9QEI
NzAI#imgrc=_BPr7vBeMUbX5M:

28. • https://www.medicinenet.com/pancreatitis/article.htm#pancreatitis_
definition_and_facts
• http://www.mindheal.org/pancreatitis.html
• https://en.wikipedia.org/wiki/Pancreatitis.
• https://www.webmd.com/digestive-disorders/digestive-diseases-
pancreatitis
• https://treatment.hpathy.com/

29. ANY QUERY????