Incidence of Pancreatitis on the rise

Cases misdiagnosed may suffer irreversible losses;
569 cases reported in PIMS in one year, 28 die of complications

Islamabad

The incidence of both the acute and chronic pancreatitis is on the rise in twin cities of Islamabad and Rawalpindi and it is found that in obese females above 40 years of age, gallstones are frequently reported in one in every five patients of severe abdominal pain reaching hospitals.

A total of 569 cases of acute pancreatitis have been reported at Pakistan Institute of Medical Sciences (PIMS) in last one year. As many as 83 patients with severe pancreatitis were admitted to Intensive Care Unit of PIMS of which 28 patients lost their lives due to complications of the disease.

ICU Medical Specialist at PIMS Dr. Muhammad Haroon expressed this while talking to ‘The News’ on Friday. He said that alcoholism is one of the major causes of chronic pancreatitis and incidence of pancreatitis is found to be on the rise among alcoholics.

Defining pancreatitis, he termed it a lethal and deadly inflammation of pancreas that can rapidly cause the deterioration of body organs in hours. Pancreas is one of the most important organs. It is involved in maintenance of blood glucose by insulin and glucagon production and digestion of food by polypeptides, he said.

He added the most common causes of pancreatitis are stones in gall bladder and alcohol use. The stones from gall bladder obstruct the ducts of pancreas that causes digestion of pancreas by its own enzymes and chemicals. Alcohol causes initiation of acute inflammatory reaction in pancreas causing damage to pancreatic acinar cells. Bacterial invasion can further add fuel to the fire by pushing the patient into frank sepsis and multi-organ failure, said Dr. Haroon.

He added the mortality in severe cases of pancreatitis in Pakistan ranges from 40 to 80 per cent and it makes the incidence of the disease more alarming. The most important step is early diagnosis that can save a patient’s life, he said.

He said majority of patients often misdiagnosed suffer irreparable losses. The patient of pancreatitis initially experience pain in abdomen that is like a band around upper abdomen. Pain is of moderate to severe intensity that does not respond to conventional medications. These patients are commonly misdiagnosed as having gastric reflux disease or peptic ulcer disease. Any person with severe abdominal pain who does not respond to medications should always be evaluated for acute pancreatitis, said Dr. Haroon while responding to a query.

He added that along with pain, the patients also have recurrent vomiting, low blood pressure, palpitations, restlessness, agitation, shortness of breath and loose motions.

He said Pancreatitis has devastating complications and most of the patients with severe pancreatitis may have kidney failure, respiratory failure, heart failure, sepsis, local abscess and if untreated in time can eventually lead to death. All patients with pancreatitis should be admitted in hospital and those with severe disease should be kept in intensive care units, he said.

He added that by creating awareness among public and general practitioners about various aspects of the disease, cases of misdiagnosis can be avoided. The common symptoms are vomiting, nausea, diarrhoea, loss of appetite, pain with coughing, vigorous movements and deep breathing. Other symptoms include tenderness when the abdomen is touched, fever, jaundice as the skin and whites of the eyes take on a yellowish tinge and strong painkillers often fail to relieve the pain. Blood pressure may drop or rise, but will fall when the patient stands, sometimes causing faintness, said Dr. Haroon.