Pancreatitis - a common disease in alcoholics

Hanoi: A 50-year-old man, after 30 years of drinking an average of 150 ml of alcohol per day, had dull abdominal pain around the navel and poor appetite. Doctors at Bach Mai Hospital diagnosed him with chronic pancreatitis.

The patient also had pancreatic stones, and the doctor recommended surgery to treat pancreatitis and remove the stones. After surgery, the patient had to undergo nutritional intervention, exercise, and especially quit drinking alcohol, according to the doctor's advice.

On May 9, Dr. Nguyen Thanh Khiem, Department of Digestive Surgery - Hepatobiliary Pancreatic Surgery, Bach Mai Hospital, said that alcoholism is the leading cause of chronic pancreatitis, accounting for 90% of cases. Alcohol precipitates and increases the viscosity of pancreatic secretions, leading to the development of protein plugs in the small ducts of the pancreas. From there, stones form, causing inflammation and fibrosis, destroying exocrine pancreatic cells, stellate cells and pancreatic duct epithelial cells.

Alcohol prematurely activates other digestive enzymes in pancreatic cells, causing pancreatitis. Other causes include gene mutations, pancreatic duct stenosis, hypertriglyceridemia, hypercalcemia, and autoimmune pancreatitis. Some cases where no cause can be found are called idiopathic pancreatitis.

Chronic pancreatitis is an inflammatory disease characterized by progressive and irreversible destruction of pancreatic parenchyma. Over time, it gradually leads to pancreatic parenchyma fibrosis, causing impaired endocrine and exocrine pancreatic function. The incidence varies from country to country, with 7/100,000 in Europe and 14/100,000 in Asia.

According to doctors, people at risk are those who drink large amounts of alcohol over a long period of time. The symptoms of the disease are often nonspecific. Prolonged abdominal pain is the most uncomfortable symptom. Severe pain causes loss of appetite, malnutrition and weight loss. The pain is often located in the epigastric region, so it is often mistaken for gastritis.

Other signs include poor absorption of nutrients, loose stools, and weight loss, often seen in the advanced stages of the disease. Diabetes, which accounts for 20-28% of cases, is a manifestation of pancreatic endocrine insufficiency.

Dr. Do Van Minh, Department of Digestive Surgery - Hepatobiliary Pancreatology, said that chronic pancreatitis is a risk factor for developing pancreatic cancer. The rate of pancreatic cancer in patients with chronic pancreatitis is 1.8-3% after 10 years and 4% after 20 years. Research shows that the risk of pancreatic cancer is 16 times higher in patients with chronic pancreatitis.

Recurrent pancreatitis leads to chronic inflammation, loss of cell function, gland destruction and increased cell proliferation. In particular, increased number of pancreatic ductal epithelial cells is an important factor in the formation of pancreatic cancer. People with pancreatic cancer have a very poor prognosis, with a one-year survival rate of 68%, two-year survival rate of nearly 47% and five-year survival rate of nearly 19%.

"Chronic pancreatitis often progresses silently and is detected at a late stage. Therefore, it is necessary to have regular health check-ups every year, especially when there are risks such as diabetes, malabsorption, or long-term alcohol consumption," Dr. Minh warned.

Le Nga

Source link