What pathologies comprise the biliopancreatic disorders? What do they consist of?
Biliopancreatic diseases can be divided into two large groups, pathologies of the bile duct and gallbladder and pathologies of the pancreas itself. Generally speaking, each group of diseases can be divided into two large groups: neoplastic or non-neoplastic.
Non-neoplastic diseases are the most frequent and their cause is usually associated with the presence of stones in the gallbladder or in the extrahepatic biliary tract that can cause inflammatory processes such as biliary colic or acute pancreatitis. These inflammatory processes can be complicated by infections such as cholangitis or acute cholecystitis.
What are the symptoms of acute pancreatitis?
The fundamental symptom of acute pancreatitis is abdominal pain associated with an elevation of more than twice the normal value of amylase determined in a blood test. The most frequent causes of acute pancreatitis are either bile duct stones or massive or continuous alcohol intake.
Acute pancreatitis can be complicated by infections of the pancreatic tissue that can cause fever and can affect other vital organs such as the lungs and kidneys, which is why it requires hospital admission for proper treatment, since its severity can range from a mild process that improves in a few days to a severe process that can even have a risk of mortality.
How is it treated?
The fundamental treatment of acute pancreatitis is intestinal rest to prevent the pancreas from working, suspending feeding by mouth and initially establishing serum and later, if necessary, starting enteral nutrition by tube. On the other hand, the Digestive System specialist must control pain with analgesics.
Once the acute phase has passed, if the cause is the presence of stones in the gallbladder, scheduled gallbladder surgery (cholecystectomy) should be considered and if the cause is alcohol, complete abstinence from alcoholic beverages.
Should surgery be performed in all cases?
Generally it is not necessary and surgery is only required in the acute phase of pancreatitis in those patients who present complications such as infection of the pancreatic necrosis secondary to severe inflammation of the pancreas that occurs several days after the onset of the clinical picture.
On other occasions pancreatic collections called pancreatic pseudocysts are formed which require drainage if they become infected or cause symptoms and this approach can be performed either with less invasive endoscopic procedures or with surgery.
Finally, if the cause of pancreatitis is the existence of gallstones in the gallbladder, the gallbladder must be removed once the acute phase has passed on a scheduled basis.
Can it be prevented? What are the risk factors?
To prevent a new episode of acute pancreatitis, the cause of the acute pancreatitis must be identified and eliminated. In the case of gallbladder stones, the gallbladder should be operated on and diets rich in fats that can provoke a new episode should be avoided, and in the case of alcohol, absolute abstinence.
That is why it is essential to make a good diagnosis with imaging tests such as ultrasound and abdominal CT and in cases where it is not clear, to perform a biliopancreatic echoendoscopy to rule out stones not seen in other imaging tests or alterations of the pancreatic gland.
The risk factors for developing acute pancreatitis are alcohol, tobacco, gallbladder stones and diets rich in polyunsaturated fats.
What type of diet should the patient who suffers from pancreatitis follow?
Once the oral diet has been restarted, the patient should eat small amounts of food and avoid fatty foods, reintroducing all foods slowly and progressively.