Pancreatitis is an inflammation of the pancreas gland. Located behind the stomach on the left side of the abdomen, the pancreas produces hormones and digestive enzymes to help process glucose. When those enzymes start their work in the pancreas rather than the stomach, the cells become irritated and inflamed, leading to pancreatitis. Here’s a look at the types and causes of pancreatitis.
Types of Pancreatitis
Pancreatitis is divided into two main types: chronic and acute. The clearest differentiating factor is that chronic pancreatitis develops slowly, while acute pancreatitis starts quickly with little warning. Endoscopic retrograde cholangiopancreatography (ERCP), an imaging test used to examine bile ducts, can actually cause acute pancreatitis and is responsible for about 4% of cases.
Chronic pancreatitis is further divided into large and small duct pancreatitis. Hereditary pancreatitis is more likely to appear as a form of chronic pancreatitis, tends to occur in younger patients, and is frequently in tandem with some forms of pancreatic cancer.
Alcoholism is a common cause of both chronic and acute pancreatitis. Long term abuse of alcohol accounts for about 35% of acute pancreatitis cases and about 60% of chronic pancreatitis cases. While other bad habits like smoking can contribute to pancreatitis, alcohol in particular can be a major issue, particularly for those with a personal or family history of pancreatitis.
The ethanol found in alcohol interferes with the pancreas on a cellular level. It is important to note that while pancreatitis is more common in those who have been drinking heavily for at least 5 years, even those with a tendency to only binge drink may develop acute pancreatitis. Exactly what predisposes some heavy drinkers to pancreatitis and not others is not understood yet.
Infection, such as the hepatitis or varicella-zoster viruses, is a rare but potential cause of pancreatitis, especially in children. Developmental abnormalities, pancreatic cancers, some toxins (i.e. the poison of certain snakes and scorpions), malnutrition, and blockages are all also rare but possible causes of pancreatitis.
Acute pancreatitis in particular can be caused by abdominal trauma and a wide variety of medications. Biliary disease, or gallbladder disease, and thus the presence of gallstones, appears to the the most common cause of acute pancreatitis.
Certain types of disorders are also major causal factors of pancreatitis. One example is metabolic disorders, particularly parathyroidism, which causes high levels of calcium in the blood (hypercalcemia). High levels of triglycerides (hypertriglyceridemia), a type of fat found in the blood, may also cause pancreatitis.
In fact, chronic pancreatitis is usually caused by some form of metabolic dysfunction. Autoimmune diseases appear to have some sort of link with pancreatitis, although it is not completely understood. Congenital diseases, such as cystic fibrosis, can also cause pancreatitis. Ultimately not every case of pancreatitis has an identifiable cause — as much as ? of pancreatitis causes are considered idiopathic, or unknown.