D - Xylose Absorption Test Tips

Pancreas are a small, but a pretty important part of a person s digestive system. So when it needs to be removed, the reason has got to be quite serious, to say the least, doesn t it? The procedure is known formally as pancreatectomy and it is most often required for people who are suffering from cancer of the pancreas. Ideally, these people would only need the cancerous tumours removed, but things are not always this simple. As a matter of fact, only a little more than a tenth of the people who have pancreatic cancer can have the tumour alone removed. As a result, most need to go for a pancreatectomy, which involves removing the entire pancreas. Whether the pancreas can be kept is usually related to how soon the cancer was detected, with people who have done so in time being a majority of the 10% of people with pancreatic cancer who have not needed pancreatectomies.

If a person does not have cancer, the reason he or she may need a pancreatectomy due to an accident which has injured the area significantly badly. In this case, a procedure which is known as a partial pancreatectomy is carried out on the patient. The good news is that the success rate of this sort of operation is generally quite high and the long-term effects on the body are nil. This is the case in spite of a lot of the normal tissue of the pancreas being removed, pretty amazing, isn t it?

While it may be called a pancreatectomy, it does not always mean that the pancreas is the only thing that is removed. In fact, in a lot of pancreatectomies, the surgeons also remove other parts of the digestive system which are usually the common bile duct, the spleen and the gallbladder.

There is, of course, the case of chronic pancreatitis, which occurs when the organ just swells up repeatedly. The repeated swelling leads to permanent damage to it, which affects the rest of the body, too. In most cases, the cause of this happens to be a sustained addiction to alcohol. When this is the case, it is really hard to perform a pancreatectomy and the utility of the pancreas is greatly reduced. Not a good situation to be in, under any circumstances, at all!

A pancreatectomy is a process which nobody would voluntarily wish to undergo, but there are advantages to knowing what it is, in any case!

Chronic pancreatitis refers to an inflammation of the pancreas the organ that creates enzymes and hormones to manage blood sugar levels and aids in digestion. The condition either does not heal completely and keeps coming back, or persists for months or years at a stretch.

Chronic pancreatitis is a serious, debilitating condition, which can potentially lead to permanent damage and scarring of the organ. The following are the consequences-

Formation of cysts and calcium stones in the pancreas
Blockage of the gastrointestinal tract
Malnutrition
Diabetes

The condition is most likely to develop between the ages of 30 and 40 and is commonly observed in men than in women.

Causes of Chronic Pancreatitis:

A number of factors are responsible for long-term pancreatitis. The most common ones include-

Alcohol abuse Reportedly, 70% of all cases regarding the condition is related to alcohol consumption
Autoimmune diseases When your body attacks the healthy tissues and cells mistakenly
Genetics
A constrict pancreatic duct The tube that carries enzymes to the small intestine from the pancreas
A blockage of the pancreatic duct by stones
Cystic fibrosis A hereditary disorder that causes mucus to build up in the lungs
Hypercalcemia When the level of calcium in the bloodstream increases abnormally
Hypertriglyceridemia When the level of triglycerides in the blood rises up

Warning Signs of Chronic Pancreatitis:

Symptoms of chronic pancreatitis do not show up at the early stages. They become more evident when inflammation aggravates. However, you should look out for the following signs-

Severe abdominal pain Usually in the upper portion
Loose stool that appears pale and does not flush away easily
Vomiting and nausea
Unintentional weight loss
Fatigue
Excessive thirst
Shortness of breath
Diarrhoea
Jaundice
Pancreatic fluids inside the stomach
Intestinal blockage
Internal bleeding

The above symptoms vary based on the severity of the condition. Painful episodes may last for days. For some people, drinking and eating seem difficult because that makes the pain worse. With the progression of persistent pancreatitis, the pain becomes constant. Seeking treatment at the earliest is necessary for the condition to heal.

Diagnosis and Treatment:

A blood test alone is not sufficient to detect the changes in your pancreas in the initial stages. An imaging test is the most reliable method to confirm the diagnosis. Your doctor may recommend the following tools-

CT Scan
X-ray
Ultrasound
MRI Scan

The objective of the treatment is to reduce pain and improve the functioning of your digestive system. The damage to the pancreas cannot be cured, but your doctor will prescribe necessary measures to manage the symptoms of the condition.

The primary treatment methods include endoscopic therapy, medications, and surgery.

Medication - Pain killers, insulin steroids, and artificial digestive enzymes may be taken as per the doctor s recommendation
Endoscopy - The procedure involves inserting a flexible, long tube (known as an endoscope) through the mouth. It allows the doctor to look at the pancreatic stones formed inside. He/she then removes the stones, places stents to improve the flow, and seals the leakage.
Surgery - The last resort is surgery. The doctor will recommend it only if medications and endoscopy therapy have failed to rectify the painful symptoms. Removing a portion of the diseased pancreas can offer relief. Surgery may also be performed to drain cysts and to unblock or widen the pancreatic duct.

The outlook depends on the underlying causes and the seriousness of the disease. However, immediate treatment and diagnosis can improve the outlook. Consult a doctor as soon as you encounter the above symptoms of pancreatitis.

Also called gluten-sensitive enteropathy and celiac sprue, celiac disease is an autoimmune digestive disorder, wherein the consumption of gluten-based foods leads to damage of the tissues that line the small intestine. This hinders the ability of your body to absorb the essential nutrients from the foods you eat.

Causes

Under normal conditions, the immune system of the body offers protection against external intruders. When individuals diagnosed with celiac disease consume gluten-based foods, gluten resistant antibodies are formed by the immune system. This causes them to attack the linings around the intestines, thus causing irritation in the digestive tract and harming the villi (hair-like structures on the covering of the small intestine which absorb nutrients from the food). This impairs the nutrient absorbing capacity of the individual, thus increasing chances of malnourishment.

Symptoms

Celiac disease has symptoms that vary from patient to patient. Some of the common symptoms include:

A severe skin rash called dermatitis herpetiformis.
Digestive problems such as:
Pain
Gas
Abdominal Bloating
Diarrhoea
Weight loss
Pale stools
Musculoskeletal problems such as bone and joint pain as well as muscle cramps
Seizures
Aphthous ulcers which are basically sores occurring in the mouth
Tingling sensation in the legs which are caused by low calcium and nerve damage
Growth issues in children since they cannot absorb the required amount of nutrients
Irregular menstrual cycles
Other complications associated with celiac disease

Miscarriage or Infertility
Osteoporosis. This is a disease which weakens the bones and causes fractures. It is caused because of a deficiency of Vitamin D and calcium.
Intestinal Cancer
Other birth defects: Such as irregular spinal shape because of the deficiency of certain nutrients, especially folic acid.

Exocrine Pancreatic Insufficiency (EPI), also called pancreatic deficiency, is a disorder where the pancreas is unable to produce a sufficient amount of enzymes that are required to digest food. The pancreatic enzymes help to break down and absorb nutrients from the food in the small intestine. So, this disease causes nutritional deficiencies.

Causes of Exocrine Pancreatic Insufficiency

This condition is generally caused as a complication of other diseases because EPI develops only as a result of severe damage to the pancreas. The following reasons can cause EPI:

1. Inflammation of the pancreas
After surgery in the pancreas, stomach or the intestines, there may be inflammation in the pancreas as a post-surgical complication. A high content of triglyceride fat in the blood can also cause pancreatic inflammation and hinder the secretion of the enzymes.

2. Chronic Pancreatitis
In this disease, the pancreatic ducts are swollen and blocked and so the digestive enzymes cannot be passed into the small intestine. This condition is often caused by heavy consumption of alcohol.

3. Cystic Fibrosis
The digestive fluids and enzymes become thick and sticky and block the passageways of the pancreas and other organs like the lungs and the kidneys. This can obstruct secretion and passage of enzymes afterwards.

4. Shwachman-Bodian-Diamond syndrome
This is an autosomal recessive genetic condition where enzyme-producing pancreatic cells are not formed properly. This rare disorder causes a number of associated disorders like bone marrow diseases, skeletal defects and exocrine pancreatic insufficiency.

Symptoms of Exocrine Pancreatic Insufficiency

The symptoms appear in the middle stages of the disease when the process of absorption of nutrients has already been affected. The common warning signs are:

1. Digestive problems like gas, diarrhea and indigestion because the food remains mostly undigested.
2. Severe and frequent stomach pain in the lower abdominal region
3. Greasy stools due to the excretion of undigested fat
4. Rapid loss of weight and body mass due to mal-absorption of nutrients
5. Constantly feeling bloated and full even if you have not eaten anything
6. A general sense of fatigue and exhaustion
7. Excessive bleeding from small wounds because protein deficiencies hamper blood clotting
8. Pain in the muscles and bones
9. Increased susceptibility to infections of the body systems
10. Anemia
11. Joint pains
12. Abnormal swelling of the limbs or edema

An inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

CAUSES:

Pancreatitis may be caused due to various reasons:

1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also a back flow of the bile into the pancreas can cause pancreatitis.
2. Alcohol: Long time alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.
3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.

Symptoms:

1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant, and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.
2. Swollen abdomen: Pancreatitis my cause your abdominal area to swell up and become tender.
3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.
4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.
5. Rapid pulse: Pancreatitis affects the rate at which the heart beats, causing a rapid increase in the pulse rate.

Exocrine Pancreatic Insufficiency (EPI), also called pancreatic deficiency, is a disorder where the pancreas is unable to produce a sufficient amount of enzymes that are required to digest food. The pancreatic enzymes help to break down and absorb nutrients from the food in the small intestine. So, this disease causes nutritional deficiencies.

Causes of Exocrine Pancreatic Insufficiency

This condition is generally caused as a complication of other diseases because EPI develops only as a result of severe damage to the pancreas. The following reasons can cause EPI:

1. Inflammation of the pancreas
After surgery in the pancreas, stomach or the intestines, there may be inflammation in the pancreas as a post-surgical complication. The high content of triglyceride fat in the blood can also cause pancreatic inflammation and hinder the secretion of the enzymes.

2. Chronic Pancreatitis
In this disease, the pancreatic ducts are swollen and blocked and so the digestive enzymes cannot be passed into the small intestine. This condition is often caused by heavy consumption of alcohol.

3. Cystic Fibrosis
The digestive fluids and enzymes become thick and sticky and block the passageways of the pancreas and other organs like the lungs and the kidneys. This can obstruct secretion and passage of enzymes afterwards.

4. Shwachman-Bodian-Diamond syndrome
This is an autosomal recessive genetic condition where enzyme-producing pancreatic cells are not formed properly. This rare disorder causes a number of associated disorders like bone marrow diseases, skeletal defects and exocrine pancreatic insufficiency.

Symptoms of Exocrine Pancreatic Insufficiency

The symptoms appear in the middle stages of the disease when the process of absorption of nutrients has already been affected. The common warning signs are:

1. Digestive problems like gas, diarrhea and indigestion because the food remains mostly undigested.
2. Severe and frequent stomach pain in the lower abdominal region
3. Greasy stools due to the excretion of undigested fat
4. Rapid loss of weight and body mass due to mal-absorption of nutrients
5. Constantly feeling bloated and full even if you have not eaten anything
6. A general sense of fatigue and exhaustion
7. Excessive bleeding from small wounds because protein deficiencies hamper blood clotting
8. Pain in the muscles and bones
9. Increased susceptibility to infections of the body systems
10. Anaemia
11. Joint pains
12. Abnormal swelling of the limbs or edema

The diagnosis, as well as management of pancreatic cystic lesions, is a general problem. Nearly 1% of the patients in the chief medical centers have been observed to have pancreatic cystic lesions on cross-sectional imaging. It has also been observed that a quarter of all pancreas scanned in an autopsy series contain pancreatic cysts. Earlier, these cystic lesions were regarded as benign but with increasing evidence made available from the cystic lesions, they are regarded as origin of pancreatic malignancies.

Information on Asymptomatic Neoplastic Pancreatic Cysts

The most vital medical tools that are used in the diagnosis and management of pancreatic cystic lesions include the endoscopic ultrasound and cross-sectional imaging. These are used to distinguish non-mucinous cysts from mucinous cysts. The identification of pancreatic cysts creates a lot of anxiety for the clinicians as well as the patients related to the probable presence of a fatal tumor. The findings of a macro cystic lesion that enclose viscous fluid loaded in CEA are helpful in the analysis of a mucinous lesion.

The most common pancreatic cysts are the non-neoplastic inflammatory pseudo cysts, and they can be detected easily by imaging. The identification of pancreatic irregularity with probable association with malignant cells is a vital source of referral for the specialist. The set of guidelines that have been proposed for the management and diagnosis of patients with asymptomatic neoplastic pancreatic cysts are based specifically on the analysis of the quality of the data. It is also designed to address the most important and frequent clinical scenarios. The diagnostic suggestions are provided based on the clinical problem as well as the risk of malignancy.


Imperative Guidelines to Follow

To achieve accurate diagnosis of asymptomatic neoplastic pancreatic cysts is indeed a great challenge. It is all the more important to find the reproducible methods that can be used to stratify the threat of cancer for the patients. The main guidelines include a two-year screening interval of cysts that can be of any size as well as stopping observation after 5 years, in case there is no change. The new guidelines, for the most part, recommend surgery if more than one concerning feature is confirmed on the MRI by use of endoscopic ultrasound. The new guidelines even suggest discontinuation of inspection after the surgery if no dysplasia or invasive cancer is identified. The guidelines have mainly been developed by use of Grading of Recommendations Assessment, Development and Evaluation.

Inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for a long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

CAUSES:
Pancreatitis may be caused due to various reasons:

1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also, a backflow of the bile into the pancreas can cause pancreatitis.

2. Alcohol: Longtime alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.

3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.


Symptoms:

1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant, and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.

2. Swollen abdomen: Pancreatitis may cause your abdominal area to swell up and become tender.

3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.

4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.

5. Rapid pulse: Pancreatitis affects the rate at which the heart beats, causing a rapid increase in the pulse rate.

Chronic pancreatitis refers to an inflammation of the pancreas the organ that creates enzymes and hormones to manage blood sugar levels and aids in digestion. The condition either does not heal completely and keeps coming back, or persists for months or years at a stretch.

Chronic pancreatitis is a serious, debilitating condition, which can potentially lead to permanent damage and scarring of the organ. The following are the consequences-

Formation of cysts and calcium stones in the pancreas
Blockage of the gastrointestinal tract
Malnutrition
Diabetes

The condition is most likely to develop between the ages of 30 and 40 and is commonly observed in men than in women.

Causes of Chronic Pancreatitis:

A number of factors are responsible for long-term pancreatitis. The most common ones include-

Alcohol abuse Reportedly, 70% of all cases regarding the condition is related to alcohol consumption
Autoimmune diseases When your body attacks the healthy tissues and cells mistakenly
Genetics
A constrict pancreatic duct The tube that carries enzymes to the small intestine from the pancreas
A blockage of the pancreatic duct by stones
Cystic fibrosis A hereditary disorder that causes mucus to build up in the lungs
Hypercalcemia When the level of calcium in the bloodstream increases abnormally
Hypertriglyceridemia When the level of triglycerides in the blood rises up

Warning Signs of Chronic Pancreatitis:

Symptoms of chronic pancreatitis do not show up at the early stages. They become more evident when inflammation aggravates. However, you should look out for the following signs-

Severe abdominal pain Usually in the upper portion
Loose stool that appears pale and does not flush away easily
Vomiting and nausea
Unintentional weight loss
Fatigue
Excessive thirst
Shortness of breath
Diarrhoea
Jaundice
Pancreatic fluids inside the stomach
Intestinal blockage
Internal bleeding

The above symptoms vary based on the severity of the condition. Painful episodes may last for days. For some people, drinking and eating seem difficult because that makes the pain worse. With the progression of persistent pancreatitis, the pain becomes constant. Seeking treatment at the earliest is necessary for the condition to heal.

Diagnosis and Treatment:

A blood test alone is not sufficient to detect the changes in your pancreas in the initial stages. An imaging test is the most reliable method to confirm the diagnosis. Your doctor may recommend the following tools-

CT Scan
X-ray
Ultrasound
MRI Scan

The objective of the treatment is to reduce pain and improve the functioning of your digestive system. The damage to the pancreas cannot be cured, but your doctor will prescribe necessary measures to manage the symptoms of the condition.

The primary treatment methods include endoscopic therapy, medications, and surgery.

Medication - Pain killers, insulin steroids, and artificial digestive enzymes may be taken as per the doctor s recommendation
Endoscopy - The procedure involves inserting a flexible, long tube (known as an endoscope) through the mouth. It allows the doctor to look at the pancreatic stones formed inside. He/she then removes the stones, places stents to improve the flow, and seals the leakage.
Surgery - The last resort is surgery. The doctor will recommend it only if medications and endoscopy therapy have failed to rectify the painful symptoms. Removing a portion of the diseased pancreas can offer relief. Surgery may also be performed to drain cysts and to unblock or widen the pancreatic duct.

The outlook depends on the underlying causes and the seriousness of the disease. However, immediate treatment and diagnosis can improve the outlook. Consult a doctor as soon as you encounter the above symptoms of pancreatitis.

An inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for a long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

CAUSES:

Pancreatitis may be caused due to various reasons:

1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also, a backflow of the bile into the pancreas can cause pancreatitis.
2. Alcohol: Longtime alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.
3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.

Symptoms:

1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.
2. Swollen abdomen: Pancreatitis may cause your abdominal area to swell up and become tender.
3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.
4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.
5. Rapid pulse: Pancreatitis affects the rate at which the heart beats, causing a rapid increase in the pulse rate.