The pancreas is a gland that produces digestive secretions and hormones and is located below the liver. Common pancreatic diseases include inflammation, diabetes and cancer.
Below you will find further information on the most common pancreatic diseases and pancreas specialists.
98 percent of the organ belongs to the exocrine part of the pancreas. This section produces digestive secretions that are passed into the duodenum. The pancreas produces around 1.5 to three liters of secretion per day, which is necessary for the digestion of food.
The smaller, endocrine part of the pancreas produces the hormones
These hormones regulate energy metabolism.
If the pancreas becomes diseased, affected patients often feel pain in the upper abdomen. This can extend like a belt into the back. Depending on the disease, the blood flow in the blood vessels may also be impaired.
In some pancreatic diseases, such as inflammation or a tumor, the mouth of the gallbladder duct narrows. If the bile cannot flow out as a result, bile congestion can occur. This manifests itself in the form of jaundice.
The most common diseases of the pancreas include
Gastroenterologists differentiate between acute and chronic pancreatitis. Inflammation of the pancreas is characterized by upper abdominal pain radiating to the back and shoulders.
In the case of acute pancreatitis, digestive enzymes are released. They attack neighboring tissue. This causes severe pain in the upper abdomen as well as nausea and vomiting.
Acute pancreatitis is an emergency that requires immediate medical treatment. It is caused by gallstones or excessive alcohol consumption.
In chronic pancreatitis, the symptoms are less pronounced. Typical signs of the chronic form are
In the long term, deficiency symptoms occur due to impaired absorption of fat-soluble vitamins.
The main cause of chronic pancreatitis is long-term excessive alcohol consumption, as well as certain medications.
Pancreatic carcinoma is a malignant tumor. This type of cancer particularly often affects men aged 65 and over with chronic pancreatitis.
Sometimes symptoms only appear at an advanced stage, which can hardly be distinguished from chronic pancreatitis. The earlier pancreatic cancer is detected, the better the prognosis.
If metastases have not yet formed and the tumor has not spread excessively, surgical removal is sufficient.
Diabetes mellitus affects the endocrine part of the pancreas. There are two types of diabetes.
In type 1 diabetes mellitus, the insulin-producing cells are destroyed by the body's own immune system. As a result, insulin is no longer produced and blood sugar levels rise.
The cause of type 1 diabetes has not yet been clarified. Scientists assume an interplay of genetic predisposition and various environmental factors.
In type 2 diabetes mellitus, the body's own blood sugar-lowering insulin becomes less and less effective. At the beginning, the pancreas can still counteract the insulin insensitivity of the cells by increasing insulin production.
Over time, however, the pancreas becomes permanently overloaded. It then produces less and less insulin.
Type 2 diabetes is caused by genetic predisposition as well as factors such as obesity and nicotine consumption.
Cystic fibrosis is a congenital metabolic disease. It mainly affects the white population in Europe and the USA.
In this disease, the cells of the pancreas
certain channels for chloride are defective. Instead of a thin secretion, these cells produce a viscous mucus. This leads to
There is currently no cure for cystic fibrosis.
The first step in the diagnosis of pancreatic diseases is to take a medical history. During this discussion with the patient, the doctor asks about their symptoms and medical history.
This is followed by various examinations. Since 2016, newborn screening has also included a test for cystic fibrosis, which can provide initial indications.
A sweat test is also carried out to diagnose cystic fibrosis. The salt content in sweat is increased in cystic fibrosis. The test is considered the gold standard for diagnosis.
The following tests also help to diagnose pancreatic disease.
In the diagnosis of pancreatitis, stool examination is an important means of detecting pathological changes. If elastase excretion is reduced, it can be assumed that hormone production is impaired.
The same applies to chymotrypsin, which, like elastase, is an important digestive enzyme. A clear indication of pancreatic disease is also fatty stools.
A urine test plays a role in the diagnosis of diabetes mellitus. Glucose is excreted in the urine when a certain amount of sugar is present in the blood.
The doctor can also detect ketoacidosis (metabolic derailment due to insulin deficiency) by means of urine.
If pancreatic disease is suspected, the doctor will also check the blood values.
A clear indication of inflammation or a tumor of the pancreas are elevated pancreatic enzymes and, above all, elevated lipase. Blood sugar levels are elevated in diabetes mellitus.
Chronic inflammation is problematic, as the blood values are often within the normal range.
The doctor uses an endoscope to examine the common pancreatic and bile ducts. The endoscope can be pushed through the oesophagus and stomach into the duodenum without cutting tissue.
By administering an X-ray contrast medium, possible obstructions such as tumors can be visualized.
The doctor can use other imaging procedures to detect calcification due to chronic inflammation and other problems. He mainly uses ultrasound, but computer tomography and magnetic resonance imaging also contribute to the diagnosis.
The treatment depends on the underlying disease:
|
Disease |
Treatment options |
|
Acute pancreatitis |
Conservative therapy with monitoring of the patient as well as treatment of pain and sufficient fluid intake through infusions. In severe cases, drainage, irrigation and removal of dead tissue may be necessary. Surgery is necessary in cases of multiple organ failure. |
|
Chronic pancreatitis |
Pain treatment, conservative and interventional therapy with stent insertion, surgery if pain remains severe |
|
Pancreatic carcinoma |
Without spread Removal of the tumor in combination with radiotherapy |
|
Diabetes mellitus |
Regulation of blood sugar with medication or insulin therapy (type 1 and type 2) or by changing diet and weight reduction (only possible for type 2) |
Just like the therapy, the course of the disease also depends on the specific disease.
In a severe form of acute pancreatitis, the prognosis depends on the degree of tissue destruction and possible complications. If a large part of the organ tissue has died, the chance of survival is around 20 to 60 percent. However, multi-organ failure due to sepsis often leads to death.
The mild form of acute pancreatitis heals completely in 90 percent of cases, provided the cause is eliminated. The mortality rate here is less than one percent.
Chronic pancreatitis progresses gradually. If the cause is eliminated, the progression can be slowed down. Only rarely is a complete cure possible. In most cases, however, patients can still lead a normal life. For this purpose, the patient receives the missing enzymes in the form of medication.
Chronic inflammation always increases the risk of pancreatic cancer. If the pancreatitis is caused by alcohol, life expectancy is lower due to the general lifestyle.
The RKI gives a 5-year survival rate of 6.4 percent for men and 7.6 percent for women. How high the chance of recovery actually is depends on when the tumor is discovered.
Complete removal by surgery is only possible in around 15 to 20 percent of patients. The 5-year survival rate is then 22 to 37 percent. In these cases, however, patients also undergo post-operative chemotherapy.
In the advanced stage, the prognosis is significantly worse, with a survival rate of 0.2 to 0.4 percent.
The course of the disease and the prognosis vary depending on the type of diabetes. In both cases, however, patients can positively influence the course of the disease by adhering to the treatment recommendations.
This helps to prevent complications and the risk of secondary diseases. For this reason, regular check-ups are also essential.
The extent to which diabetes can be cured depends on the form of the disease. Type 1 diabetes is currently not curable. In the early stages of type 2 diabetes, a consistent change in lifestyle can contribute to a significant improvement.
The life expectancy of diabetes patients depends on whether their blood sugar can be well controlled in the long term. The willingness to adapt their lifestyle has a major influence here.
However, the presence of concomitant diseases (e.g. high blood pressure, elevated blood lipid levels) also plays a role. If these illnesses are treated by a specialist, this has a positive effect on life expectancy.
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