Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

The inflammation of your pancreas over a short period of time indicates acute pancreatitis, which is a serious health condition. You may experience symptoms such as severe abdomen pain all of a sudden, diarrhoea and feeling of being sick. Acute pancreatitis occurs when there are some problems with certain enzymes in the pancreas. This condition is often associated with gallstones and alcohol consumption.


Treatment
Acute pancreatitis can be cured in a hospital, where you will get monitored for signs of serious issues. In some cases, supportive things like oxygen and fluids are required. Here are the various ways by which the condition can be treated:


1. Fluids: The body may get dehydrated during acute pancreatitis. Fluids are provided via a tube connected to one of the veins of the patient. This is known as intravenous or IV fluid. These fluids may help in the prevention of a problem called hypovolemic shock, which occurs when the amount of blood in your body gets lowered due to a drop in fluids. 
2. Nutrition: Diet is usually not restricted for people with acute pancreatitis, but some patients are recommended not to consume solid food for some time. Attempting to digest solid food may cause a strain on the pancreas. You may need to avoid solid food for some days. You should use a feeding tube to get essential nutrients. This process is called enteral feeding and it may involve the insertion of a tube into your stomach via the nose. 
3. Oxygen: For ensuring sufficient oxygen supply to your vital organs, you will be supplied with oxygen through the tubes on your nose. The tube may be removed when your condition improves. In some cases, ventilation equipment may be required for assistance to breathe.
4. Painkillers: Acute pancreatitis causes severe abdominal pain and strong painkillers such as morphine may be given to the patient. These may make the patient feel drowsy. 


Treatment of underlying cause
After controlling the symptoms, the underlying cause must be treated. They are as follows:
1. Gallstone: When pancreatitis occurs because of a gallstone, you may require a process known as endoscopic retrograde cholangiopancreatography or ERCP. The gallbladder may have to be removed, if necessary. 


2. Alcohol consumption: After getting treated for acute pancreatitis and you have recovered from this condition, you should try to avoid alcohol completely. Alcohol may spoil your recovery and the condition might reoccur or the symptoms may reappear. For freedom from alcohol, you may try counselling, joining self-help groups such as Alcoholics Anonymous (AA) or take a medicine which reduces your craving for alcohol. 


It is recommended that you visit a doctor immediately after experiencing any slight or severe symptoms of acute pancreatitis. This will help in early diagnosis and the chances of the symptoms getting worse are prevented.

Acute Pancreatitis - Can it be Cured?

An inflammation of the pancreas is known as pancreatitis. The pancreas is an organ that produces digestive enzymes. Pancreatitis might start any day and continue for long period and it requires immediate medical attention. It is of two types- acute pancreatitis and chronic pancreatitis. Although the treatment usually requires hospitalization, pancreatitis can be easily stabilized and the underlying cause can be treated thereafter.

Causes
Pancreatitis may be caused due to various reasons:
1. Gall bladder stone: The pancreatic duct lies next to the bile duct. The gallstones enter the small intestine after passing through the common bile duct. Often the stones that remain in the common bile duct have a negative effect on the pancreas, which causes a hindrance to the normal flow of the pancreatic fluids, causing pancreatitis. Also a back flow of the bile into the pancreas can cause pancreatitis. 
2. Alcohol: Long time alcohol use also causes pancreatitis. Alcohol can damage the pancreas tremendously causing it to get inflamed.
3. Other causes: Hereditary disorders in the pancreas, cystic fibrosis, high level of triglycerides, and a few medicines may also cause pancreatitis.

Symptoms: 
1. The first symptom of pancreatitis is abdominal pain: The pain may be sudden or gradually increasing, but is usually aggravated after eating. It is severe and constant, and may continue for a few days. If you are suffering from pancreatitis, you will feel very sick after a sudden attack and you might require medical assistance immediately.
2. Swollen abdomen: Pancreatitis may cause your abdominal area to swell up and become tender.
3. Nausea: If your abdomen suddenly starts paining due to the onset of pancreatitis, you tend to feel extremely nauseous. You might end up vomiting and may also have violent heaves.
4. Fever: The inflammation will cause you to run a temperature, along with a searing pain in your stomach, which will make you feel extremely uncomfortable.
5. Rapid pulse: Pancreatitis affects the rate, at which the heart beats, causing a rapid increase in the pulse rate.

Causes and Symptoms of Pancreatitis

Enlarged pancreas can result beacuse of factors such as: 

An abscess in your pancreas: This refers to a dangerous formation inside the pancreas. Neglecting its occurrence can also turn out to be fatal. An abscess is a cavity containing pus that further infects the rest of the organ. Presence of harmful bacteria in the pancreas leads to such a case.
A cyst in the lining of your pancreas: Epithelial cysts in the pancreas can also cause the organ to swell up. Such cysts are mostly benign but they are accompanied by disabling pain.
Pancreatitis is one disease with an array of threats: Highly active enzymes within the organ can make its tissues wear down thus, affecting the size of your pancreas. If you are an alcoholic, you are more prone to develop this condition. It could also be contracted due to an excess of calcium or fats in the blood.
Cancer of the pancreas is dreadful too: Due to the unanticipated growth of cancer cells in the pancreas, the organ grows bigger. A person suffers from excruciating pain under the influence of this condition.
Pseudocysts in the pancreas can have serious ill effects: When benign cysts become unmanageably harmful, they result into pseudocysts. The cysts contain remains of your tissues and other damaging fluids that can increase the size of the pancreas.
An enlarged pancreas surfaces in the form of these symptoms:

The kind of stool you pass indicates a lot about your health. Oily poop can be indicative of an enlarged pancreas. Persisting diarrhea can also be a symptom of pancreatic ailments.
You may even experience an accelerated pulse rate.
You may feel feverish continually. Bouts of fever can impede your free movement and general health.
Health issues with your pancreas can make you suffer from jaundice. It could be a one- time affair or it could reappear from time to time.
Constant queasiness could hint at some underlying problem in your pancreas.
You may even lose more than a few pounds over a short span of time. Such a thing should not be taken lightly as it not only makes you look sick but also degrades your immunity.

Enlarged Pancreas - 5 Factors Behind It 

The pancreas is a gland located in the abdominal region that performs two main functions for the body: produces digestive juices and the hormone insulin which regulates the blood sugar levels. The part which produces the digestive juices is exocrine and the insulin-producing part is the endocrine portion. Pancreatic cancer, which is an uncontrolled growth of the pancreas cells, often starts in the exocrine portion and is known as the pancreatic adenocarcinoma. The one which develops in the endocrine portion is known as neuroendocrine cancer or islet cell tumors.

Risk factors
Though not clearly established, the following factors are believed to up the risk of pancreatic cancer.

Smoking
Family history
Prolonged uncontrolled diabetes
Pancreatic conditions like inherited pancreatitis
Chronic inflammation of the pancreas
Symptoms
A pancreatic condition is of insidious onset, and the exact period of onset cannot be determined. The symptoms also are nonspecific abdominal symptoms, which do not pinpoint the pancreas per se.

Jaundice, which includes yellowing of the skin and whites of the white. This is because the growth of the pancreas puts pressure on the liver and bile ducts, and so hampers bile flow.
Weight loss, which was unintended. This is due to a bloated feeling plus inability to digest the foods.
Severe pain, which can be difficult and may even require regular injections to control.
Fluctuating sugar levels, which is unexplained.
Onset of diabetes, which is associated with weight loss and jaundice.
Increased tendency for blood clots.
Loss of appetite.
Bowel obstruction due to blockage of the growing pancreas.
Diagnosis
The above symptoms could lead to a further investigation that includes a few important tests, like the following.

Blood tests
Insulin levels
CT scan
Ultrasound
MRI
Laparoscopy, both to look for the extent of the disease and to do a biopsy, which can be used for confirming the type of cancer
Percutaneous transhepatic cholangiography: A dye is injected into the pancreas to study the spread of the dye, which will also help identify the diseased portion.
Treatment
Pancreatic cancer is very aggressive, usually not detected early, and has a very poor prognosis. So, if there is a family history or one has a prolonged pancreatic condition, it is advisable to go for annual screening to help with early detection and intervention. Once identified, treatment would include a combination of the three modalities   surgery, radiation, and chemotherapy. Surgery often may be followed by chemotherapy and/or radiation.

Prognosis
The prognosis for pancreatic cancer is very poor. Only about 25% of patients diagnosed with pancreatic cancer live past the first year. Early detection of risk factor remains the best way to improve prognosis. In case you have a concern or query you can always consult an expert & get answers to your questions!

Pancreatic Cancer - 8 Common Signs You Must Be Aware Of!

Problems are pancreas are common and are treated by gastroenterologists. There are two common pancreas problems -

1. Acute Pancreatitis: Sudden Inflammation of the pancreas is known as acute pancreatitis. It is usually due to Alcohol, gall stones, trauma, metabolic causes such as hypertriglyceridemia, and congenital causes such as Pancreas divisum. The patient presents with severe upper abdominal pain and vomiting. Patients require admission for IV fluids and analgesics. Nearly all patients recover from the pain and start eating within 3 to 4 days. Few patients with severe pancreatitis may develop kidney failure, respiratory failure or GI bleeding. Such patients require longer hospitalisation stay and critical care management. Recovery is usually uneventful but few patients develop peripancreatic fluid collection known as Pseudocyst or walled-off pancreatic necrosis(WOPN). In such cases, the patient requires additional treatment of fluid collection and requires internal drainage by Cystogastrostomy which is done by Endosonography (EUS) by a gastroenterologist. Some patients require ERCP (Endoscopic retrograde cholangiopancreatography) for evaluation of pancreatic ductal leak. EUS and ERCP are advanced endoscopic procedures done by a few gastroenterologists who are specially trained in such procedures.

2. Chronic pancreatitis: Long term irreversible damage to the pancreas is called chronic pancreatitis. It is usually due to Alcohol intake. It presents with upper abdominal pain, Diabetes mellitus and fat in stools (steatorrhea). The small duct in the pancreas called main pancreatic duct can have hard calcifications also known as stones, which obstruct the flow of pancreatic juice and cause severe abdominal pain. Treatment of chronic pancreatitis includes stopping alcohol intake to prevent further damage to the pancreas, medicines for pain, Pancreatic enzyme replacement therapy (PERT) and Endoscopy for those who do not respond to medical treatment. Endoscopy includes ERCP and plastic stenting to establish a flow of obstructed pancreatic duct and Endosonography (EUS) guided Celiac plexus block for decreasing pain. Patients who develop fluid collection such as Pseudocyst require internal drainage by Cystogastrostomy which is done by Endosonography (EUS)

In Brief About Types Of Pancreatic Disorders!

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