Pancreatitis

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon

MBBS

MMed

MRCS (IRE)

FRCSED

FAMS

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Causes Types Symptoms Diagnosis Treatment Options Management and Prevention Complications FAQ

What is Pancreatitis?

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.

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.
Other Causes: Other factors, including abdominal surgery, cigarette smoking, cystic fibrosis, and high levels of calcium or triglycerides in the blood, can also contribute to the onset of pancreatitis.

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.

Symptoms of Pancreatitis

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

Upper Abdominal Pain
Nausea and Vomiting
Fever and Increased Heart Rate
Weight Loss and Malnutrition
Jaundice

Diagnosis of Pancreatitis

Diagnosis of pancreatitis typically begins with a thorough medical history and physical examination. Blood tests are also used, as elevated levels of pancreatic enzymes can indicate pancreas inflammation.

Imaging tests, including abdominal ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI), might be used to assess the pancreas’s condition. In more complex cases, endoscopic ultrasound (EUS) or magnetic resonance cholangiopancreatography (MRCP) might be used to get a detailed view of the pancreas and bile ducts.

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Treatment Options for Pancreatitis

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

Initial Management

Hydration and Fasting: To rest the pancreas, patients may need to avoid food and fluids orally, receiving hydration intravenously instead.
Pain Management: Pain relief is crucial and may involve the use of medications ranging from non-opioid analgesics to more potent options.

Treating the Underlying Cause

Removing Gallstones: Procedures like endoscopic retrograde cholangiopancreatography (ERCP) can remove gallstones obstructing the bile or pancreatic ducts.

Medications

Enzyme Supplements: To aid digestion, especially in chronic pancreatitis where enzyme production is compromised.
Insulin: Some patients may require insulin due to pancreatic damage affecting insulin production.

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.

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

Effective management and prevention of pancreatitis involve:

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.

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).

Patient Reviews

I cannot possibly express how grateful I am for the compassionate care received by Dr Thng during my hospitalization. I was 20 hours away from flying back to the USA after a long work trip, and homesick already when diagnosed with acute appendicitis and a UTI. To say that I was nervous to undergo surgery so far away from home, friends and family is an understatement. He was expedient, attentive and thorough. He even took the time to text and call my husband back home multiple times to update him on my status. His infectious laugh, sense of humor and kindness helped to sooth my own frazzled nerves. I am so appreciative to have had Dr Thng as my surgeon.

Ms Tina Hunter

I was diagnosed for ampullory cancer in 2021. I am very thankful to Dr. Thng Yongxian who kept me calm when revealing the report to me. I really felt like God sent his angel to speak to me.He helped me overcome the operation. Dr. Thng said 3 things that I needed to do before the operation....Stay positive, exercise n eat well, have faith in God. He even gave me his handphone number incase I need to consult him when home. Indeed the 8 hrs operation was a success n I am able to write this testimonial, living a normal life. Finally, its still God who works all things good for those who love Him... Romans 8:28.

Mdm Tang K H

I recently underwent gallbladder stone removal surgery performed by Dr. Thng, and I am impressed with the quality of care I received during this process. Dr. Thng demonstrated exceptional professionalism and expertise throughout my entire experience. From the initial consultation to the post-operative care, Dr. Thng explained the procedure in great details, answered all my questions, and alleviated my concerns and ensuring that I fully understood each step of the process. His compassionate and caring demeanor put me at ease, making me feel confident in his abilities. The outcome of the procedure was beyond my expectations. Dr. Thng successfully removed all my 3 gallstones, and I experienced a smooth recovery process. I am grateful for his expertise and the care I received under his supervision. Overall, my experience with Dr. Thng was exceptional. I highly recommend him for his professionalism, compassion, and outstanding surgical skills. Thank you, Dr. Thng for your excellent care.

Mr Low LT

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Frequently Asked Questions (FAQ)

What dietary changes can help manage pancreatitis?

A low-fat diet, small frequent meals, and avoiding alcohol can significantly alleviate symptoms and prevent flare-ups.

Can pancreatitis lead to diabetes?

Yes, chronic pancreatitis can damage insulin-producing cells in the pancreas, increasing the risk of developing diabetes.

Is pancreatitis contagious?

No, pancreatitis is not contagious. It is an inflammation of the pancreas that results from various internal factors.

Can I live a normal life with pancreatitis?

Many individuals with pancreatitis manage their condition through dietary changes, medication, and lifestyle adjustments, leading relatively normal lives.