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Pancreatitis Treatment in Singapore

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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Pancreatitis is an inflammatory condition of the pancreas that can impair its ability to function normally.

 

It can manifest as acute pancreatitis, which appears suddenly and lasts for a short period, or as chronic pancreatitis, where inflammation persists over an extended period. Understanding pancreatitis is key to managing symptoms and preventing potential complications.

Types of Pancreatitis

Pancreatitis can manifest in various forms, each with distinct characteristics and implications for patient care. Types include:

Acute Pancreatitis

Acute pancreatitis is characterised by sudden inflammation that lasts for a short period. It can range from mild discomfort to severe, life-threatening illness but typically resolves with proper medical treatment

Chronic Pancreatitis

Chronic pancreatitis develops over many years and is characterised by persistent inflammation that leads to irreversible damage. This condition often results from prolonged alcohol abuse or genetic disorders and can severely affect the pancreas’s ability to function.

Autoimmune Pancreatitis

This rare form involves the immune system attacking the pancreas, causing inflammation. It can mimic the symptoms of pancreatic cancer, making diagnosis challenging.

Hereditary Pancreatitis

Hereditary pancreatitis is a genetic condition that leads to recurrent episodes of pancreatitis, significantly increasing the risk of developing chronic pancreatitis and pancreatic cancer over time.

Causes of Pancreatitis

Understanding the underlying causes of pancreatitis contributes to its prevention and treatment. Common causes include:

Gallstones

Gallstones can block the bile duct, leading to pancreatitis. This blockage prevents pancreatic enzymes from flowing into the small intestine, causing them to accumulate and damage the pancreas.

Alcohol Consumption

Excessive alcohol consumption is a leading cause of chronic pancreatitis. It can trigger the premature release of digestive enzymes, which can damage pancreatic tissue.

Genetic Factors

Specific genetic mutations may predispose individuals to pancreatitis, indicating a hereditary component to the disease.

Medications

Some medications have been linked to the development of pancreatitis, though this is less common.

High Triglyceride Levels

Severely elevated triglyceride levels can lead to hyperlipidemia-induced pancreatitis by generating high concentrations of toxic free fatty acids that damage pancreatic cells.

Other Causes

Other factors can also contribute to the onset of pancreatitis, including abdominal surgery, cigarette smoking, cystic fibrosis, high levels of calcium in the blood, autoimmune diseases, certain infections, and trauma.

Signs and Symptoms of Pancreatitis

Identifying the symptoms of pancreatitis is crucial for timely diagnosis and treatment at specialist clinics in Singapore. Here are the common signs people may experience during an episode of pancreatitis.

  • Acute Pancreatitis

    Acute pancreatitis is a sudden inflammation of the pancreas that can cause severe symptoms. Its onset is typically abrupt, and while often mild, it can sometimes lead to serious complications. Some of the symptoms a pancreatitis doctor might use to diagnose acute pancreatitis include:

    • Nausea and vomiting
    • Fever and rapid pulse
Woman holding the side of her stomach, with a diagram of her pancreas

  • Chronic Pancreatitis

    Chronic pancreatitis involves long-standing inflammation of the pancreas that leads to permanent damage over time. This progressive deterioration can impair the pancreas's ability to produce digestive enzymes and hormones. Some of the symptoms a pancreatitis specialist will use to diagnose chronic pancreatitis include:

    • Persistent abdominal pain
    • Weight loss
    • Steatorrhea (oily stools)
    • Diabetes mellitus

Diagnosis of Pancreatitis

Diagnosing pancreatitis typically involves a pancreatitis doctor or pancreatitis specialist conducting a comprehensive assessment via a combination of medical history, physical examination, and various diagnostic procedures.

  • Medical History and Physical Examination
    Diagnosis begins with a thorough medical history, where the pancreatitis doctor assesses a patient's reported symptoms and potential risk factors. This is followed by a physical examination to gather initial clinical information.

  • Laboratory Tests

    Blood tests are crucial in diagnosing pancreatitis, as they can reveal key indicators of pancreatic inflammation or damage, which can inform appropriate pancreatitis surgery or treatment options. Key laboratory tests in Singapore include:

  • Serum amylase and lipase levels: Elevated levels of these specific pancreatic enzymes can strongly indicate inflammation of the pancreas.

  • Liver function tests: These tests help identify potential underlying causes such as bile duct obstructions.

  • Imaging Studies

    Imaging tests help to visualise the pancreas's condition and identify potential causes or complications.

  • Ultrasound: Often used as a first step to detect gallstones, which are a common cause of acute pancreatitis.

  • CT Scan: Provides detailed cross-sectional images, assessing the extent of inflammation and identifying complications such as fluid collections or necrosis.

  • MRI/MRCP: Offers even more detailed imaging of the pancreatic ducts and surrounding structures, particularly useful for complex cases or identifying subtle changes.

  • Endoscopic Procedures

    In some instances, more advanced endoscopic procedures may be employed to obtain highly detailed views or tissue samples of the pancreas and bile ducts. These include:

  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Utilised for evaluating and, in some cases, treating bile duct obstructions that may cause or complicate pancreatitis.

  • Endoscopic Ultrasound (EUS): Provides highly detailed images of the pancreas and surrounding areas, and can be used to obtain tissue samples (biopsy) if needed.

Get an Accurate Diagnosis & Specialised Treatment For Pancreatitis

Consult with Dr. Thng for a detailed assessment and understand your pancreatitis treatment options in Singapore today.

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Treatment Options for Pancreatitis

Treatment strategies for pancreatitis aim to relieve symptoms, address the underlying cause, and prevent complications.

Pancreatitis Surgery

In severe cases or when complications arise, surgery might be necessary to remove damaged tissue or relieve duct obstructions.

 

In gallstone pancreatitis, laparoscopic cholecystectomy is needed to prevent a recurrence.

Treatment Options for Acute Pancreatitis

Management of acute pancreatitis primarily focuses on supportive care and addressing the underlying cause.

  • Hospitalisation for Supportive Care

    Patients with acute pancreatitis typically require hospitalisation to receive close monitoring and supportive medical care.

  • IV Fluids and Pain Management

    Intravenous (IV) fluids are administered to maintain hydration, and appropriate pain management strategies are employed to alleviate discomfort.

  • Nutritional Support

    Initially, patients may be kept “nil per os” (NPO), meaning no food or drink by mouth, to rest the pancreas, with a gradual reintroduction of a suitable diet as symptoms improve.

  • Identifying Underlying Causes and Targeted Interventions

    Identifying and addressing the underlying cause of acute pancreatitis is a crucial part of its management. For instance, Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed if the pancreatitis is caused by gallstones obstructing the bile or pancreatic ducts.

Chronic Pancreatitis

Management of chronic pancreatitis focuses on alleviating symptoms, managing complications, and preserving pancreatic function.

  • Pain Management Strategies

    Long-term pain management strategies are often implemented to help patients cope with persistent abdominal pain associated with chronic pancreatitis.

  • Pancreatic Enzyme Replacement Therapy

    Pancreatic enzyme replacement therapy (PERT) is provided to supplement the body's reduced ability to produce digestive enzymes, aiding in nutrient absorption.

  • Management of Diabetes if Present

    If chronic pancreatitis leads to impaired insulin production, resulting in diabetes mellitus, a pancreatitis doctor will recommend an appropriate treatment plan that includes the management of blood sugar levels.

  • Surgical Interventions for Complications

    In cases where complications arise, a pancreatitis specialist may perform surgery, such as the drainage of pseudocysts or specific resection procedures, as part of pancreatitis treatment in Singapore.

Lifestyle Adjustments

Adopting a low-fat diet, drinking plenty of fluids, smoking cessation and avoiding alcohol can help manage and prevent further episodes of pancreatitis.

 

Managing and Preventing Pancreatitis

Complications Associated with Pancreatitis

Chronic or severe pancreatitis can lead to complications that affect overall health:

Pancreatic Infection

Pancreatitis can lead to pancreas infection, requiring prompt antibiotic treatment or surgery to remove infected tissue.

Pancreatic Pseudocyst

Fluid and debris accumulating in cyst-like pockets in the pancreas can cause pain, infection, or even rupture.

Malnutrition

Chronic pancreatitis can impair the pancreas’s ability to produce digestive enzymes, leading to malabsorption and weight loss.

Diabetes

Damage to insulin-producing cells in the pancreas from chronic pancreatitis may result in diabetes.

Pancreatic Cancer

Long-term inflammation of the pancreas is associated with an increased risk of pancreatic cancer, especially in individuals with hereditary pancreatitis.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.
  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.

 

Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.

 

Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

Prevention and Management of Pancreatitis

  • Dietary Changes: Adopting a low-fat diet and eating smaller, more frequent meals can help manage pancreatitis symptoms and prevent future episodes.
  • Alcohol and Smoking: Avoiding alcohol and smoking is crucial in preventing pancreatitis, especially for individuals with a history of alcohol-related pancreatitis.
  • Regular Medical Checkups: Regular follow-ups with a doctor can help monitor the condition and prevent complications.
  • Staying Hydrated: Adequate hydration is essential, especially during episodes of acute pancreatitis, to support overall health and kidney function.
  • Managing Underlying Conditions: Effectively managing conditions like gallstones, high triglyceride levels, and autoimmune disorders can reduce the risk of pancreatitis.

Frequently Asked Questions About Pancreatitis Treatment in Singapore

What is the difference between acute and chronic pancreatitis?
Acute pancreatitis involves sudden, temporary inflammation of the pancreas, often resolving with treatment. Chronic pancreatitis, however, refers to long-standing inflammation that causes permanent damage to the pancreas over time, potentially impairing its function and leading to persistent symptoms.

Acute pancreatitis can often resolve completely with appropriate medical treatment. However, chronic pancreatitis is ongoing and cannot be fully “cured”. Instead, treatment for chronic pancreatitis focuses on managing and controlling symptoms, preventing flare-ups, and addressing complications.

Leaving pancreatitis untreated can lead to complications. These may include pancreatic cysts known as pseudocysts, pancreatic necrosis (tissue death), infections, and organ failure in acute cases. Chronic untreated pancreatitis can result in persistent pain, malnutrition, diabetes, and an increased risk of pancreatic cancer.

Related Pancreas Treatments

Besides pancreatitis, the pancreas can be affected by various other conditions that require specialised medical attention. Dr. Thng’s expertise extends to the diagnosis and management of these related pancreatic diseases.

Pancreatic Cancer

Pancreatic cancer is a serious malignancy that requires complex and specialised care, including multidisciplinary approaches to diagnosis and treatment by a pancreatic cancer specialist.

Pancreatic Cysts

Pancreatic cysts are fluid-filled sacs that can develop on the pancreas. While some are benign, others may require monitoring or intervention due to their malignant potential. A pancreatic cysts specialist will be able to assess and recommend an appropriate treatment plan.

Corporate & Personal Insurance Plans

Clinic Locations

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

Nexus Surgical @ Mt. Alvernia

Nexus Surgical @ Mt. Elizabeth Orchard

Nexus Surgical @ Mt. Elizabeth Novena

Nexus Surgical @ Parkway East

Nexus Surgical @ Gleneagles Medical Centre

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