Introduction
The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that help digestion and hormones that help regulate the way human body processes sugar (glucose). Pancreatitis is inflammation in the pancreas. Pancreatitis can occur as acute — meaning it appears suddenly and lasts for days, or as chronic, which is pancreatitis that occurs over many years. Mild cases of pancreatitis may go away without treatment, but severe cases can cause life-threatening complications.
Signes et symptômes
Signs and symptoms of pancreatitis may vary, depending on which type:
Acute pancreatitis
- Upper abdominal pain
- Abdominal pain that radiating to back
- Abdominal pain that feels worse after eating
- Fièvre
- Rapid pulse
- Nausées
- Vomissements
- Tenderness of abdomen
Chronic pancreatitis
- Upper abdominal pain
- Losing weight without trying
- Oily, smelly stools (steatorrhea)
Causes
Pancreatitis occurs when digestive enzymes become activated while still in the pancreas, irritating the cells of pancreas and causing inflammation. With repeated bouts of acute pancreatitis, damage to the pancreas can occur and lead to chronic pancreatitis. Scar tissue may form in the pancreas, causing loss of function. A poorly functioning pancreas can cause digestion problems and diabetes.
Sometimes, a cause for pancreatitis is never found.
Conditions that can lead to pancreatitis include:
- Abdominal surgery
- Alcoholism
- Certains médicaments
- Cystic fibrosis
- Gallstones
- High calcium levels in the blood (hypercalcemia), which may be caused by an overactive parathyroid gland (hyperparathyroidism)
- High triglyceride levels in the blood (hypertriglyceridemia)
- Infection
- Injury to the abdomen
- Obésité
- Pancreatic cancer
- Endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to treat gallstones, also can lead to pancreatitis.
Risk factors
Excessive alcohol consumption
Cigarette smoking
Obésité
Family history of pancreatitis
Physiopathologie
Acute pancreatitis is an inflammatory disease, which varies in severity from mild to severe. Factors determining the severity of pancreatitis are not known. It is generally believed that the earliest events in the evolution of acute pancreatitis lead to premature intra-acinar cell activation of digestive zymogens and that those enzymes, once activated cause acinar cell injury. Recent studies have suggested that the ultimate severity of resulting pancreatitis may be determined by events which occur subsequent to acinar cell injury. These include inflammatory cell recruitment and activation as well as the generation and release of cytokines and other chemical mediators of inflammation. Recently, we have undertaken studies to elucidate the role of various inflammatory agents in determining the severity of pancreatitis. Results from these ongoing studies indicate that substance P acting via neurokinin-1 (NK1) receptors, chemokines interacting with CCR1 receptors and platelet activating factor play an important pro-inflammatory role in regulating the severity of pancreatitis and associated lung injury. On the other hand, complement factor 5a (C5a) acts as an anti-inflammatory agent during the development of pancreatitis.
Diagnostic
Blood tests to look for elevated levels of pancreatic enzymes
Faecal examination
Computerized tomography (CT) scan
Abdominal ultrasound
Endoscopy
Magnetic resonance imaging (MRI)
Traitements
Fasting, followed by drinking clear liquids and eating bland foods. With time, slowly back to normal diet
Pain medications
Intravenous (IV) fluids
Depending on the cause of pancreatitis, treatment may include:
Endoscopic retrograde cholangiopancreatography (ERCP)
Gallbladder surgery (cholecystectomy).
Pancreas surgery
Treatment for alcohol dependence.
Additional treatments for chronic pancreatitis
Pain management.
Enzymes to improve digestion.
Changes in diet.
Pronostic
Acute pancreatitis show better prognosis than chronic. In the chronic form, episodes of pancreatitis tend to become more severe over time and the overall 10-year and 20-year survival rates are estimated to be about 70% and 45%, respectively.
Complications
Pseudocyst
Infection
Kidney failure
Problèmes respiratoires
Diabète
Malnutrition
Pancreatic cancer
Maladies et Ayurveda
There is no exact correlated name for the disease pancreatitis in Ayurveda. The organ pancreas is known as Agnyasaya in Ayurveda, meaning the seat of digestive fire, as pancreas secretes many enzymes. Shotha denotes the inflammatory condition.
Nidana
Causative factors for the vitiation of all three doshas, Kapha, Pitta and Vaata
Purvaaroopa
Non mentionné
Samprapti
Due to the causative factors, three doshas get vitiated. Due to some block or derangement in the corresponding channel or site, when they get lodged in Agnyasaya and produce sotha the diseases manifests.
Lakshana
Sharp abdominal pain
Indigestion
Heartburn
Bloating
Vomiting & nausea
Diarrhée
Divisions
Non mentionné
Pronostic
Kricchrasadhya in new cases in healthy young individuals. Asadhya in others.
Chikithsa
The treatment of Pancreatitis depends upon many factors like the age, constitution, physical & mental health of the patient and how severe is the inflammation. As all the three doshas are involved, it is important to know which dosha imbalance is the predominant and leading, to control it in the beginning. In most of the cases, pacifying pitta along with removing aama (undigested toxic metabolic wastes in the body) is the first line of treatment.
Samana
Aamapaachana
Agnideepana without causing aggravated Pitta state
Sothaharachikithsa
Sodhana
Virechana is the main sodahana therapy in agnyasaya sotha. It can be done as a sadyovirechana or after a course of Sneha-sweda as per the condition.
Vamana in needed cases
Asthapana vasti and anuvasana vasti are done only if Vaata is involved.
Médicaments couramment utilisés
Vaasaguduchyadi kashayam
Daadimaadi ghrutam
Daadimaashtaka choornam
Sukumaram kashayam
Jeevaraksha Gulika
Malla Sindhoor
Marques disponibles
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
After taking treatment, life style changes can help prevent further problems, like
- Stop drinking alcohol
- Stop smoking.
- Choose a low-fat diet.
- Drink more fluids.
Régime alimentaire
- À éviter
Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Boissons gazeuses - rendent l'estomac plus acide et perturbent la digestion
Aliments réfrigérés et congelés - provoquent une digestion faible et paresseuse en affaiblissant Agni (le feu digestif).
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies
- A ajouter
Des repas légers et des aliments faciles à digérer
Green gram, soups, honey
Aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.
Comportement :
Protect yourself from extreme climate changes.
Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.
Maintenir une alimentation et un sommeil réguliers.
Évitez de retenir ou de forcer les envies comme l'urine, les selles, la toux, les éternuements, etc.
Avoid sedentary lifestyle. Be active.
postures de Yoga
Regular stretching and mild cardio exercises are advised in cases which are not complicated. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
L'exercice régulier contribue à améliorer la biodisponibilité des médicaments et des aliments ingérés et favorise la santé.
Le yoga permet de maintenir l'harmonie à l'intérieur du corps et avec le système environnant.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Exercices simples pour la santé des poumons et du cœur
Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.
Articles de recherche
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Rédacteur :
Rajesh Nair, cofondateur et consultant en chef d'Ayurvedaforall.Com, est diplômé du prestigieux Vaidyaratnam Ayurveda College (affilié à l'université de Calicut), au Kerala, en Inde. Il est également titulaire d'un diplôme de troisième cycle en thérapie par le yoga de l'université d'Annamalai.
Le docteur Nair propose des consultations dans deux cliniques très fréquentées à Haripad, Alleppey, Kerala, l'État du sud, célèbre dans le monde entier pour ses traitements ayurvédiques authentiques et ses médecins. Tout en offrant des consultations sur tous les aspects des traitements ayurvédiques, le Dr Nair s'intéresse tout particulièrement au Panchkarma, au yoga et aux massages.
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