Pancreatic insufficiency

The Pancreatic insufficiency is a disease that plays a major role in internal medicine. Insufficiency always conceals a limitation of the functionality of an organ or an organ system.

What is pancreatic insufficiency?

The exocrine pancreatic insufficiency only becomes noticeable when the organ performance has already dropped to around ten percent. The first symptoms are often nausea and vomiting after eating fatty foods, as fat can no longer be digested properly.
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The pancreas, as its name suggests, is a large gland which is of very important importance in connection with the human metabolism. In this context, the Langerhans islands responsible for the production of the vital insulin are well known.

At a Pancreatic insufficiency there is a complete loss of functionality as the progress progresses. In this context, pancreatic insufficiency is about the fact that the production and release of the enzymes that are important for healthy human digestion are reduced or completely stopped. The provision of hormones is also classic in pancreatic insufficiency.

causes

The Pancreatic insufficiency can have different causes. Overall, these lead to damage to the glandular tissue.

Pancreatic insufficiency is usually the result of a previous illness such as persistent and constantly recurring inflammation, a tumor disease, the growth of a cyst or cystic fibrosis.

In addition, pancreatic insufficiency can be caused by gastrointestinal diseases, gastric ulcers, diseases of the bile and the biliary tract, and so-called autoimmune diseases.

The pancreas is a sensitive and very complex organ, which can be difficult to treat if there is insufficient or no treatment. If pancreatic insufficiency occurs, this can also have serious dimensions in other organs.

Symptoms, ailments & signs

The exocrine pancreatic insufficiency only becomes noticeable when the organ performance has already dropped to around ten percent. The first symptoms are often nausea and vomiting after eating fatty foods, as fat can no longer be digested properly. In the further course, greasy, shiny, foul-smelling diarrhea occurs, and the stool is usually very light-colored.

Due to the insufficient absorption of nutrients, those affected lose a lot of weight, although they eat enough food. Vitamin deficiencies can also occur: A deficiency in vitamin K can, for example, lead to an increased tendency to bleed, too little vitamin A affects the eyesight.

If too much undigested food gets into the large intestine, the result is strong gas formation, which causes painful flatulence. An inflammation of the pancreas associated with pancreatic insufficiency is noticeable through upper abdominal pain radiating to the back.

Endogenous pancreatic insufficiency primarily affects the sugar metabolism: Characteristic signs are excessive thirst, increased urination and a decline in physical and mental performance.

The excessively high rise in blood sugar can lead to a metabolic imbalance (ketoacidosis), which manifests itself in increasing apathy, abdominal pain, nausea and vomiting. The fruit or acetone-like halitosis is typical. Hypoglycaemia is also possible: Signs of this are cold sweat, tremors and clouding of consciousness.

Diagnosis & course

The focus of diagnostics in a Pancreatic insufficiency The laboratory tests for various enzymes in urine and serum as well as stool examinations are available.

Clear conclusions about pancreatic insufficiency can be drawn from the determination of the enzyme elastase. The laboratory examinations are expanded to include imaging methods such as ultrasound examinations, computer or magnetic resonance tomography. It is also important to examine the patient with regard to his or her condition.

In addition to painful complaints, extreme nausea and prolonged vomiting occur with pancreatic insufficiency. A pale “fatty stool” or diarrhea are typical of what is known as exocrine pancreatic insufficiency. In the case of pancreatic insufficiency, this condition of the stool is based on a disruption of the metabolism of the fats and proteins contained in food.

The pain that occurs can occur at different times of the day and vary in severity, depending on the type of pancreatic insufficiency. There is pressure pain in the upper abdomen. The patients also lose their appetite and generally feel uncomfortable when pancreatic insufficiency occurs.

Complications

Since excessive alcohol consumption can trigger pancreatic insufficiency via inflammatory processes, if it is not stopped immediately, it leads to further impairment of the pancreas. Therapeutically, no improvement can be achieved with continued alcohol abuse, so that accompanying alcohol therapy is urgently recommended.

If alcohol continues to be consumed, severe epigastric pain, flatulence and diarrhea occur regularly; Weight loss and malnutrition due to inadequate fat digestion and diabetic symptoms such as unbearable thirst, frequent urination and dizziness up to coma. Constrictions caused by stones, pancreatic cysts and malignant tumors of the pancreas are common.

A yellowish discoloration of the skin called jaundice indicates the occurrence of complications such as insufficient drainage of the bile. This also applies to a fifth of the patients who have the insufficiency of the pancreas due to a genetic defect or for reasons that cannot be identified. Lifelong abstinence from alcohol is essential for all pancreas patients.

Pancreatic insufficiency is incurable; it usually leads to lifelong digestive disorders and insulin-dependent diabetes. Complications can also occur if the therapeutic instructions are followed, but in this case they are significantly less common.

When should you go to the doctor?

If irregularities or malaise occur after eating fatty food, developments should be monitored further. If the symptoms persist or if they continuously increase in intensity, a doctor's visit is advisable. A doctor is needed in the event of nausea and vomiting as well as loss of appetite. If there is unwanted weight loss, uncomfortable and painful gas, or a feeling of fullness, there is cause for concern.

Pain in the upper abdomen or a decrease in physical resilience must be presented to a doctor. Since numerous complications can arise when taking pain medication, this should only take place after consulting a doctor. An increase in the bleeding tendency or disorders of various functional abilities must be examined and clarified by a doctor. Excessive thirst, apathy, or withdrawal from social life are other signs of a health disorder.

Diffuse deficiency symptoms, diarrhea or foul-smelling discharges should be examined more closely by a doctor. In these cases, there is an illness that needs treatment. If there is a decrease in the ability to concentrate, problems coping with everyday life and a clouding of consciousness, action is required. A doctor must be consulted, as the quality of life is already severely restricted in these cases.

Treatment & Therapy

Since there is both the endo- and exocrine form of the Pancreatic insufficiency there are also varying treatment methods. These are also based on the triggers of the disease and the extent as well as the existing symptoms of pancreatic insufficiency.

In principle, a pancreatic insufficiency that occurs cannot be cured retrospectively. The basis for the therapy of pancreatic insufficiency, which should alleviate the symptoms and make life with this disease possible, consists on the one hand on a healthy lifestyle and on the other hand on the intake of specially developed active ingredients. With regard to a gentle diet in the case of pancreatic insufficiency, it is important not to consume alcoholic beverages and to ensure that the food is rich in vitamins and minerals.

These measures are usually supplemented by a dietary choice of food, in which diet margarines are predominantly recommended in the context of pancreatic insufficiency.

Drug therapy for pancreatic insufficiency is mainly about taking pancreas-relevant enzymes to support the function. The treatment of pre-existing or concomitant diseases should also be considered in the case of pancreatic insufficiency.

Outlook & forecast

Insufficiency of the pancreas is considered irreversible. This means that the suffering cannot be cured. However, there is definitely the possibility of using appropriate treatment measures to achieve a more favorable course of pancreatic insufficiency so that the symptoms are tolerable.

The prognosis of the disease also depends on various factors. It plays an important role whether only one function of the pancreas, such as the endocrine or exocrine function, is affected, or several. The cause of the pancreatic insufficiency is also important.

Pancreatic insufficiency reduces the life expectancy of those affected, because the weakness of the pancreas is often associated with other serious diseases. The prognosis is particularly negative if the suffering is caused by constant excessive consumption of alcohol. On the other hand, however, the consistent avoidance of alcoholic beverages can improve the outlook.

Basically, about half of all patients with pancreatic insufficiency die after ten years. With drug therapy, renouncing tobacco products as well as a healthy diet and lifestyle adjustment, at least a longer life expectancy can be achieved.

Many patients fear the large number of medications they need to treat them. But the drugs are absolutely necessary to stabilize fat digestion as much as possible, which in turn has a positive effect on the prognosis.

prevention

A prevention against that Pancreatic insufficiency is only possible indirectly by avoiding harmful stimulants such as alcohol and following a balanced diet. In the event of symptoms of the gastrointestinal tract, the bile or the duodenum or the liver, a specialist should be consulted in order to eliminate the risk of secondary diseases of the pancreas in good time.

When taking any medication, it is important to be aware of their side effects in relation to the risk of pancreatic insufficiency. Persistent malnutrition should also be avoided in order to prevent pancreatic insufficiency.

Aftercare

In the case of pancreatic insufficiency, the person affected has only a few special follow-up measures available. They are often severely limited, so that the person affected with this disease is primarily dependent on a quick diagnosis and treatment so that there are no major complications. A doctor should therefore be contacted at the first symptoms and signs of the disease in order to prevent further complications or complaints from occurring.

Most patients with this disease are dependent on the intake of various medications and drugs in order to permanently relieve the symptoms. The person concerned should always observe the correct dosage and regular intake. If anything is unclear or if you have any questions, consult a doctor first.

Furthermore, a healthy lifestyle with a healthy diet generally has a positive effect on the course of pancreatic insufficiency and can alleviate the symptoms. Most patients rely on the help and support of friends and family in their everyday lives. Contact with other affected persons can be very useful, as this can often lead to an exchange of information.

You can do that yourself

People with pancreatic insufficiency can review and optimize their lifestyle. The consumption of harmful substances is fundamentally prohibited. In particular, the consumption of alcohol should be completely stopped as soon as possible in the case of pancreatic insufficiency.

Self-help measures in the case of pancreatic insufficiency depend on the cause of the disease. In the case of alcohol abuse, the person concerned needs help and support to cope with the symptoms. If withdrawal symptoms occur in everyday life without the consumption of alcohol, an addiction counseling center should be visited. The diet must also be optimized and adapted to the needs of the organism. The food should be rich in vitamins and balanced. Together with the doctor, a diet is worked out that is useful in relieving symptoms. Fatty meals or hot spices lead to an increase in the existing complaints.

If a tumor is present, the immune system can be supported by a healthy intake of food. According to the latest research, cruciferous foods are said to be helpful in the fight against cancer. Food intake should be split into several meals per day. Doctors recommend a division into five to seven dishes a day. It is important to ensure that the amount consumed per meal is not excessive. The procedure reduces the complaints in the gastrointestinal tract and has a relieving effect on the human digestion.