I was inspired to write this post, sadly, because I have a neighbor that I will call, Annie,who is suffering with pancreatitis. What is pancreatitis? It is inflammation of the pancreas, according to MedicineNet.com. This typically happens when the digestive enzymes found inside the pancreas become active, causing inflammation and even damage to the organ.

Annie has had a lot of pain in her left side that would radiate to her left shoulder. She also is constantly nauseated and these painful attacks would come on without warning. Surprisingly, it took a long time and several attacks, plus doctor visits and trips to the emergency room, for Annie to be diagnosed. Annie’s husband and I Googled her symptoms and came up with our amateur diagnoses prior to the doctors confirming it was indeed pancreatitis. Believe me when I say, we did not want to be right.

 

Pancreatitis can either be acute or chronic, as stated by MedicineNet.com. Acute, or sudden, pancreatitis is sometimes caused by the presence of gallstones, which are small, pebble-like masses of hardened bile that form in the gallbladder and can cause irritation when they pass through the common bile duct. Heavy alcohol use is another common cause of acute pancreatitis.

Most cases of chronic, or long-term, pancreatitis are caused by long-term alcohol abuse, cystic fibrosis or hereditary disorders, according to WebMD. In about 25 percent of cases, the causes of chronic pancreatitis are unknown.

Annie was first rushed to the ER the day after Thanksgiving 2015, and she continues to suffer with the debilitating symptoms. Today’s date is 12/15/2016. Medical intervention has done little to relieve the recurring attacks. She has lost around 30 pounds and is scared to eat fearing that it may bring on an attack. A few weeks ago, she had an outpatient procedure when a stent was inserted into a duct in her pancreas that helps fluid drain into her stomach and hopefully eliminating the attacks.  Yesterday, she was experiencing more pain so the stent was not a successful procedure.

What is the pancreas?

The pancreas is a small organ located behind the stomach in the abdomen (the size of a dollar) and functions as a digestive organ and an endocrine organ. In the digestive system, the pancreas helps break down food. In the endocrine system, the pancreas releases key hormones, such as insulin and glucagon.

What is Chronic Pancreatitis?

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve—it gets worse over time and leads to permanent damage. Chronic pancreatitis eventually impairs a patient’s ability to digest food and make pancreatic hormones. Industrialized countries have estimated an annual incidence rate of 5-12/100,000 people who will develop chronic pancreatitis. The prevalence of chronic pancreatitis is 50/100,000 people. Chronic pancreatitis often develops in patients between the ages of 30 and 40, and is more common in men than women.

What blood test are preformed at the ER?

To confirm whether a person has pancreatitis Blood tests can evaluate the function of the gallbladder, liver, and pancreas. Levels of the pancreatic enzymes amylase and lipase can be measured. Blood tests can also check for signs of related conditions, including infection, anemia (low blood count), and dehydration. A tumor marker called CA 19-9 may be checked if pancreatic cancer is suspected.

Here is a scenario:

A person arrives at the ER complaining of intense pain in their left quadrant along with nausea. The P.A. or the nurse who first evaluates the patient will use this mnemonic tool: OPQRST

O = Onset – The word “onset” should trigger questions regarding what the patient was doing just prior to and during the onset of the specific symptom(s) or chief complaint. • What were you doing when the symptoms started? • Was the onset sudden or gradual? It may be helpful to know if the patient was at rest when the symptoms began or if they were involved in some form of activity. This is especially true with patients presenting with suspected cardiac signs & symptoms.

P = Provoke – The word “provoke” should trigger questions regarding what makes the symptoms better or worse. • Does anything you do make the symptoms better or relieve them in any way? • Does anything you do make the symptoms worse in any way? This is sometimes helpful in ruling in or out a possible musculoskeletal cause. A patient with a broken rib or pulled muscle will most likely have pain that is easily provoked by palpation and/or movement. This is often in contrast to the patient having chest pain of a cardiac origin whose pain is not made any better or worse with movement or palpation.

Q = Quality – The word “quality” should trigger questions regarding the character of the symptoms and how they feel to the patient. • Can you describe the symptom (pain/discomfort) that you are having right now? • What does if feel like? • Is it sharp or dull? • Is it steady or does it come and go? • Has it changed since it began?

R = Region/Radiate – The words “region and radiate” should trigger questions regarding the exact location of the symptoms. • Can you point with one finger where it hurts the most? • Does the pain radiate or move anywhere else? Although it is not always easy for a patient to identify the exact point of pain, especially with pediatric patients, it is important to ask. Asking if they can point with one finger to where it hurts the most is a good start. From there you will want to know if the pain “moves” or “radiates” anywhere from the point of origin.

S = Severity – The word “severity” should trigger questions relating to the severity of the symptoms. • On a scale of 1 to 10, how would you rate your level of discomfort right now? set.

T = Time – The word “time” should trigger questions relating to the when the symptoms began. • When did the symptoms first begin? • Have you ever experienced these symptoms before? If so, when?

Next blood tests, abdominal X-rays,EKG, blood pressure, oxygen saturation tests will be administered along with a stethoscope placed on the patient’s abdomen to listen for intestinal sounds. If a patient is experiencing a pancreatic attack then the intestines will be quiet.

Pain medicine will be administered and usual the patient will be admitted and placed on IV to keep them hydrated and a strict no food protocol will be prescribed for a few days until the pain subsides.

The Pancreatitis Diet

Pancreatitis patients require varying amounts of fat, depending on factors such as weight and height; however, for most patients, the recommended limit is 20 grams of fat per day, states the National Pancreas Foundation. Each meal should not exceed 10 grams of fat content. A carrot and sweet potato soup with cranberry relish and a blend of black beans, carrots, lime juice and red peppers are healthy appetizers. Citrus chicken with cumin and oregano makes a great main dish.

For patients who suffer a flare, doctors typically suggest avoiding solid foods for one or two days, notes the National Pancreas Foundation. Severe pain requires patients to start a diet of clear liquids. Because this type of diet lacks nutrition, patients should gradually add other food items based on the instruction of their doctors.

It is crucial for pancreatitis patients to avoid drinking alcohol, as alcohol consumption can cause pancreas to flare due to dehydration, explains the National Pancreas Foundation. To keep the body properly hydrated, physicians often recommend carrying a bottle of water at all times.

Do’s and Do Not’s for Acute Pancreatitis Diets

Do’s

• Eat snacks throughout the day rather than large meals
• Eat foods low in fat (a max of 30 grams of fat a day)
• Eat foods high in “lean” protein like beans, chicken, fish, lean cut beef, etc…
• Eat foods that are high in antioxidants like berries, oranges, and broccoli
• Eat foods that have good amounts of vitamins C, B₉, and B₁₂
• When you do eat fat, pick foods high in Omega-3 fatty acids like Salmon, flaxseed, walnuts, etc…
• Try and drink anywhere from 6-8 glasses of water daily

 

Do Not’s

• Stay away from spicy foods of any type
• Try and rid yourself of caffeine, cigarettes, and alcohol
• Limit foods that stimulate the gut such as peppermint and black pepper
• Diminish your sugar intake as much as possible (sugar causes inflammation)
• Limit your use of foods like butter, bacon, margarine, etc..
• Use fat-free (or low fat) dressings with the idea that less is better
• Get rid of processed grains like white bread, and say hello to 100% whole grain
• Don’t touch fried foods

If you want to avoid acute pancreatitis and of course, chronic pancreatitis, there are a few things you will need to keep in mind.

Fats and processed foods are some of your biggest enemies. The typical modern diet makes these foods difficult to avoid. You want to keep your pancreas from being overloaded. So eating small portions and avoiding foods that stress your pancreas is important. Some experts recommend eating six small meals a day with a supplement of pancreatic enzymes each time.

Processed and fatty foods are literally everywhere. Try to stick with fresh foods as much as possible. Avoid frozen meals and canned meals. Avoid boxed foods like cold cereal and crackers.

Basically, if it can sit on your shelf and not go bad for months and months, you may want to think twice about eating it.

Avoid drinking alcohol and smoking as well. These two activities can make your pain worse and increase your risks.

Ideas for Breakfast, Lunch, and Dinner

Acute pancreatitis diets can be difficult to find.  Although there are many limitations to what you should and shouldn’t eat, you can still enjoy food and put together great meals.  One thing to keep in mind when doing so is to try and stick to a fairly routine schedule, also providing assistance in providing some relief to the workload of your pancreas. Below are some ideas for putting meals together to form a complete and good Acute Pancreatitis Diet plan for you. As you try these combinations see what works for you and stick to those foods that do.

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