Pancreatitis is a rare disease in which the pancreas becomes inflamed. Damage to the gland occurs when digestive enzymes are activated and begin attacking the pancreas. In severe cases, there may be bleeding into the gland, serious tissue damage, infection, and cysts. Enzymes and toxins may enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidney. Pancreatitis is classified as either acute or chronic.

Diet and pancreatitis
Eating more fruits and vegetables may reduce the risk for pancreatitis. Avoid or reduce alcohol intake and frequent and heavy ingestion of fats. Avoid or reduce smoking.

Antioxidants for chronic pancreatitis
Daily antioxidant supplementation appears to relieve pain and reduces oxidative stress in patients with chronic pancreatitis. Individuals with chronic pancreatitis may be deficient in antioxidants. Oxidative stress is an important mechanism of injury and inflammation of the pancreas in chronic pancreatitis. Dr. Pramod K. Garg and colleagues from the All India Institute of Medical Sciences in New Delhi gave chronic pancreatitis patients daily doses of 600 ug organic selenium, 54o mg ascorbic acid, 9000 IU beta-carotene, 270 IU alpha-tocopherol and 2 g methionine. All patients were treated in the standard manner with analgesics on demand and pancreatic enzyme replacement therapy. After 6 months, the reduction in the number of painful days per month was higher in the antioxidant group than the placebo group. One third of patients became pain free on treatment. Gastroenterology 2009.

Antioxidant supplementation relieves chronic pancreatitis pain
In a randomized controlled trial, daily antioxidant supplementation relieved pain and reduced oxidative stress in patients with chronic pancreatitis. Dr. Pramod K. Garg, from the All India Institute of Medical Sciences in New Delhi gave 127 chronic pancreatitis patients daily doses of 600 ug organic selenium, 500 mg of ascorbic acid, 9000 IU beta-carotene, 270 IU alpha-tocopherol and 2 grams of methionine. All patients were treated in the standard manner with analgesics on demand and pancreatic enzyme replacement therapy. After 6 months, the reduction in the number of painful days per month was higher in the antioxidant given patients than those receiving placebo. About a third of patients receiving the antioxidants became pain free. Gastroenterology 2009.

Probiotics not helpful in acute pancreatitis
Dr. Hein G. Gooszen, at the University Medical Center Utrecht, gave 296 patients with acute pancreatitis a probiotic preparation or placebo. The probiotic product consisted of six bacterial strains -- Lactobacillus acidophilus, L. casei, L. salivarius, L. lactis, Bifidobacterium bifidum and B. lactis - and was administered enterally twice daily (total 10 billion bacteria per day) for 28 days. There were more deaths in the probiotic group. The majority of deaths was due to multiorgan failure. Intestinal blood flow and oxygen supply at the mucosal level are reduced in acute pancreatitis. The probiotic bacteria given along with enteral nutrition may have further increased local oxygen demand. Lancet, 2008.

Acute Pancreatitis treatment
Hospital admission is necessary if you have acute pancreatitis. Patients receive intravenous (IV) fluids to replace lost fluids and pain medicines such as meperidine (Demerol) to control pain until the inflammation goes away. Most likely no food will be given for a few days will be give to allow the pancreas to rest.

Chronic Pancreatitis treatment
Chronic pancreatitis is characterized by histologic changes that persist even after the cause has been removed. Chronic pancreatitis is a progressive disease without curative treatment. Abdominal pain is the most predominant symptom of chronic pancreatitis that initially brings most of the patients to the physician's attention. Some studies have correlated the course of pain in chronic pancreatitis in comparison with the duration of the disease, progressing exocrine and endocrine pancreatic insufficiency, and morphological changes such as pancreatic calcification and duct abnormalities. Furthermore, the course of pain has been studied after alcohol abstinence or surgery in some groups. However, there are only few well-performed and valid studies, and some of them even have produced different results.

A pilot study of the antioxidant effect of curcumin in tropical pancreatitis.
Indian J Med Res. 2005. Department of Pharmacology, Kasturba Medical College, Manipal, India.
Oxidative stress occurs in association with painful exacerbations of chronic pancreatitis and antioxidant supplementation appears to benefit this condition. Curcumin, the active constituent of turmeric, is known to exhibit antioxidant activity. This pilot study was therefore undertaken to evaluate the effect of oral curcumin with piperine on the pain, and the markers of oxidative stress in patients with tropical pancreatitis. Twenty consecutive patients with tropical pancreatitis were randomised to receive 500 mg of curcumin with 5 mg of piperine, or placebo for 6 wk, and the effects on the pattern of pain, and on red blood cell levels of malonyldialdehyde (MDA) and glutathione (GSH) were assessed. There was a significant reduction in the erythrocyte MDA levels following curcumin therapy compared with placebo; with a significant increase in GSH levels. There was no corresponding improvement in pain. Oral curcumin with piperine reversed lipid peroxidation in patients with tropical pancreatitis. Further studies with large sample are needed to define its effect on the pain and other manifestations of tropical pancreatitis.

Cause
Up to 90% of pancreatitis cases are due to alcohol abuse and gallstones. Certain medications can cause pancreatitis. These include Byetta used for diabetes, Xenical for weight loss, and statin drugs such as Lipitor. Smoking and diabetes are also risk factors.

Diabetes
People with type 2 diabetes have a much higher risk of acute pancreatitis and disease of the gallbladder and bile ducts compared with people without diabetes. Dr. Gary L. Bloomgren, at Amylin Pharmaceuticals in San Diego, California, report in the May 2009 issue of the journal Diabetes Care. Their study was supported by Amylin Pharmaceuticals and Eli Lilly, producers of the diabetes drug exenatide (Byetta), which has been associated with spontaneous reports of acute pancreatitis.
Dr. Gary L. Bloomgren used a nationwide managed care claims database that included nearly one million adults enrolled for at least 12 continuous months between 1999 and 2005.

Pancreatitis symptom
In both acute and chronic pancreatitis, the main symptom is upper abdominal pain. Typically the pain is central, continuous, and radiates to the back. Pancreatitis pain is often worse when lying down, and partly relieved by sitting forward. The pain usually builds up to a peak over half to one hour, and then remains steady for hours or days. There is usually associated nausea and vomiting, and the upper abdomen is often tender.

Acute pancreatitis
Acute pancreatitis refers to an acute inflammation that resolves both clinically and histologically. Acute pancreatitis is a common digestive disease of which the severity may vary from mild, edematous to severe, necrotizing disease. Acute pancreatitis leads to death and inflammation in the pancreas. Three types of necrosis may be distinguished: (1) interstitial tissue necrosis, which subsequently may also involve acinar and ductal cells, (2) ductal necrosis, and (3) acinar necrosis. The first type of necrosis is autodigestive in nature and is typical of the most common forms of acute pancreatitis, which are associated with alcohol, bile duct disease, metabolic conditions, and other rare factors. Clinically, these types of pancreatitis may be either mild or severe. The mild form is also known as edematous pancreatitis, because there is edematous swelling of the pancreas combined with tiny foci of interstitial (fat) necrosis. Severe or necrotizing pancreatitis shows large areas of often hemorrhagic necrosis of the pancreatic and particularly the peripancreatic tissue. The ductal type of necrosis is rare and may be seen in pancreatitis associated with prolonged circulatory failure. The acinar type of necrosis is caused by infectious agents. Complications of acute pancreatitis, such as pseudocyst, bleeding, and infection, determine the course of the disease.

Lab Test for acute pancreatitis
Among all the biochemical variables available, c-reactive protein is still the standard for a fast, reliable, and cost-effective assessment of severity in acute pancreatitis.

Cause of Chronic Pancreatitis Pain
The pathophysiology of pain in chronic pancreatitis is incompletely understood. Several hypotheses have been advanced, including pancreatic and extrapancreatic causes. The existence of different hypotheses to explain the genesis of pain in chronic pancreatitis also reflects the different therapeutic approaches to pain in these patients. Increased intraductal pressure as a result of single or multiple strictures and/or calculi is believed to be a common cause of pain in chronic pancreatitis patients with a dilated main pancreatic duct. Other suggested causes include pancreatic fibrosis, interstitial hypertension and pancreatic ischemia. Additionally, extrapancreatic causes like duodenal and common bile duct stenosis with scarring due to pancreatic inflammation are suggested as factors causing pain in chronic pancreatitis. The 'neurogenic inflammation' hypothesis is a fascinating theory which is supported by different studies. Immunohistological reports have shown that the amount of neurotransmitters, such as substance P and its receptor, calcitonin gene-related peptide and other neurotransmitters, are increased in afferent pancreatic nerves and a correlation between pain and immune cell infiltration of the nerves has been reported in chronic pancreatitis.

Pancreatitis Research studies
Polyphenols in the treatment of inflammatory bowel disease and acute pancreatitis: the missing ingredient in enteral and parenteral nutrition formulas?
Gut. 2006 Aug 24; Tel Aviv Sourasky Medical Center, Israel.
This article focuses on four polyphenols with established anti-inflammatory properties: resveratrol, epigallocatechin gallate, curcumin and quercetin. In rodents, ingestion or systemic administration of these agents inhibits Nuclear Factor Kappa B-dependent gene expression and induces Phase II anti-oxidant and detoxifying proteins. Conditions prevented and/or ameliorated by these polyphenols include inflammatory colitis and acute pancreatitis. Polyphenols also attenuate ischemia-reperfusion injury and endotoxemic sepsis, which play a role in the development of multiple organ dysfunction in severe acute pancreatitis. We suggest that the addition of polyphenols to artificial nutritional formulas would improve the outcome of patients with inflammatory bowel disease and acute pancreatitis in need of enteral or parenteral nutrition.

Pancreatitis natural treatment questions
Q. Can lipoic acid or serrapeptase help with chronic pancreatitis?
   A. I don't know about serrapeptase but it is possible alpha lipoic acid, as an antioxidant, may be helpful. Pancreatitis is a serious illness that needs to be addressed by accepted medical means since it can lead to serious consequences if mistreated.

Q. I was just diagnosed with acute pancreatitis. Do you know any supplements to support pancrease or do you know that any exist. I would like to take alternative medicine.
   A. Acute pancreatitis is a serious condition that requires medical attention.

Q. This it to inform you of a statin drug danger. My wife, 67, never smoked, no alcohol, very active physically (non stop gardening and ceramicist who hunks and throws clay up to 10kg at a a time) was started on 20mg Pravastatin ten weeks ago for high cholesterol. Two weeks ago she felt sensitivity at upper right abdomen unabated for 7 days. Then weakness / loss of appetite/ reduced drinking during a day. Early that day a doctor muttered about gall bladder after consulting current diagnosis software: she proposed ultrasound; queue, 4 weeks. Later in day, weaker and weaker, no temp. yet, back to a different general doctor. He was concerned: to ER. Passed out sitting! amylase already 3300! Statin stopped immediately; no food, no statin, pain stopped in 15 hours. Four days in ward; starvation, iv water/salts - ie wide metabolic 'rest'. After four days amylase down to 100. Liver function fine apart from elevated LDH. Ultrasound was negative as also CT, no sign of biliary deposits problem. Other exclusions: hepatitis etc etc. As in many cases of pancreatitis, the doctors have no suggestions. After 3 days back home wife seems herself, eating carefully; we hope that this is first/last time. Satins can have very wide 'mild' effects over a range of systems. So damage can be slight but slow, unnoticed till the cart tips suddenly. This is a particularly dangerous kind of situation. My wife is lucky - we hope; another week to diagnosis and the pancreatitis could have led to permanent pancreatic damage (at least cartilage and muscle effects are noticeable). Not only is the public very unaware of the danger to the pancreas, but it seems most GPs too! This is unacceptable. Is the FDA unaware too? Thanks for keeping an eye out for an unsatisfactorily protected public.