“Chronic pancreatitis cases have a high cancer risk,” according to Delhi AIIMS Gastro HoD

While the liver has received most of the attention when discussing stomach problems, the pancreas is another essential organ that plays a major role in determining general health. Speaking with Ashish Srivastava, Dr. Anoop Saraya, the former head of the gastroenterology and human nutrition department at AIIMS Delhi, explains how pancreatitis, which was formerly known as the “disease of the South” because of its high incidence in South India, is now also very common in the North and how persistent cases can result in pancreatic cancer. Take-outs:

 

What is the etiology of pancreatitis?

There are many forms of pancreatitis, which is an inflammation of the pancreas. Patients with acute illnesses have upper abdominal discomfort that lasts longer than 8 to 10 hours, sometimes radiating to the back and accompanied by nausea and abdominal distension. The two most prevalent causes are gallstones and alcohol consumption. However, there is a significant amount of pancreatic tissue recovery after an acute pancreatitis episode, once the inflammation has subsided. However, in persistent instances, there is irreparable tissue damage that might result in endocrine and exocrine deficiencies. However, in 30–40% of instances, idiopathic pancreatitis is the reason that can be determined.

Does it also affect other areas of the body?

Chronic pancreatitis may lead to a number of issues. The primary signs of chronic pancreatitis are recurrent bouts of abdominal pain and endocrine deficiencies, such as diabetes and steatorrhea, which are characterized by the abnormal excretion of fat in the feces due to a lack of the enzymes needed for fat digestion. In addition to restricting the arteries around the pancreas and causing clot formation, the recurrent episodes may also result in segmental portal hypertension.

Dr. Anoop Saraya, the former head of AIIMS Delhi’s department of gastroenterology and human nutrition
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In South India, pancreatitis is quite prevalent, according to a 2004 study. In the last 20 years, what has changed?

In terms of epidemiology, pancreatitis was regarded as a “disease of the South” when we began our careers in gastroenterology, but there hasn’t been a shift in that regard. There has been evidence to suggest that eating certain foods in this region might harm pancreatic tissues. It was later shown that the theory linking cassava to chronic pancreatitis was untrue. However, after more investigation, we discovered that the North also had a high frequency of this illness. Thus, the underlying cause of the occurrences might be a genetic disorder, particular gene mutations, or recurrent damage to the pancreas brought on by certain toxins.

Can pancreatic cancer develop from chronic pancreatitis?

The chance of getting cancer is higher in those with chronic pancreatitis. Patients with chronic pancreatitis also have a higher incidence of pancreatic cancer. They are regarded as a high-risk population for pancreatic cancer. These people need to be diagnosed, closely monitored, and given treatment for any inadequacies. In the event of an exocrine deficit, supplementation with enzymes is necessary. Diabetic endocrine deficit is addressed. In cases when patients have weight loss as a result of uncontrolled diabetes or steatorrhea, physicians should consider pursuing an early diagnosis of pancreatic cancer. However, the prognosis is not favorable for this kind of malignancy. The illness is highly feared because to its low 5-year survival rate of less than 5% and its less than 6-month median survival in instances that cannot be operated upon. Resection is only feasible in around 10% of instances.

Given the very poor survival rate, what can individuals do to avoid this condition?

One has to give up smoking and drinking. These two risk variables are significant. A patient may have significant oxidative stress, which may lead to specific mutations in the pancreatic tissue and predispose the patient to pancreatic cancer, if they are a persistent smoker, drink even after experiencing pancreatitis, and consume foods rich in toxins and animal proteins.