2014: Issue 30

BetterHealth Magazine by Bumrungrad International Hospital RSS Feed Follow BetterHealth by RSS

Pancreatic Diseases

Pancreatic diseases
Another threat to your GI system

Pancreatitis, pancreatic cancer and pancreatic cysts may be rare diseases compared to other ailments in the gastrointestinal system, but these illnesses can be deadly while showing no noticeable symptoms.

For those who possess risk factors, being informed about pancreatic diseases and their specific conditions raises awareness and promotes a patient’s prompt action to engage specialists for treatment, increasing the odds of survival. The sooner these diseases get diagnosed, the better the chances for a cure.

This issue of Better Health has information about pancreatic diseases from Dr. Rujapong Sukhabote, a physician specializing in gastroenterology and hepatology.

The pancreas, an introduction

The pancreas is an organ in the gastrointestinal track. It is a sizable gland, shaped like an elliptical leaf around 10 cm long. The pancreas is not positioned in the abdominal cavity, but rather is located behind the stomach, close to the upper part of the small intestine.
The pancreas is composed of two kinds of cells. Endocrine gland cells produce various hormones including insulin and glucagon, which control blood sugar levels. Exocrine gland cells produce juice for digesting food, especially fat. This juice is delivered to the small intestine through the pancreas.

Pancreas location

pancreatitis diagnosis treatment thailand



Pancreatitis is the most common pancreatic disease. Dr. Rujapong explains that pancreatitis is a condition in which pancreatic juice cannot flow through the pancreatic duct, resulting in the self-digesting of pancreatic tissue and consequently inflammation. Serial incidents of these inflammations will turn into a chronic condition and cause calcification in the pancreas. The pancreas will then reduce in size, limiting its efficiency.

“Pancreatitis comprises two types: acute and chronic,” says Dr. Rujapong. “The disease starts with acute inflammation. If the ailment is not properly treated, or is treated, but the condition reoccurs because the cause is not dealt with, the inflammation becomes chronic.”

Acute pancreatitis patients suffer from non-stop, intense pain. “The searing pain feels as if the patient were being stabbed with a knife,” the doctor notes. “Nausea or vomiting are also symptoms. In rare cases patients only have minor abdominal discomfort or no pain at all.”

For chronic pancreatitis, the abdominal pain may be lessened, but it is accompanied by other complicated conditions such as chronic stomachache, uncontrollable sugar levels, diabetes, chronic diarrhea due to undigested fat, fat-filled feces, weight loss and jaundice.

Causes of pancreatitis

Heavy alcohol consumption and gallstones in the gallbladder are the most common causes of pancreatitis. Other causes are high triglyceride levels, side effects from some drugs, autoimmune diseases, parasites or viruses. “There is about a 5 to 10 percent chance that the cause can’t be determined. These patients will time and again suffer from the disease because we don’t know what to treat,” says Dr. Rujapong.

Diagnosis and treatment

A patient with acute pancreatitis will probably see a doctor because of symptoms that include stomachache, nausea, vomiting, or fever. The doctor will then perform tests to confirm that the ailment is pancreatitis. A blood test reveals which of the pancreas’s enzymes are heightened and ultrasound and CT scans show if the pancreas is inflamed.
For a patient diagnosed with pancreatitis the doctor prescribes analgesics and then forbids the patient from drinking any water or consuming food for a certain time to stop the pancreas’s functioning. (The patient will be provided with enough water for 24 to 48 hours to prevent dehydration.) In cases of severe pancreatitis where the pancreatic tissue is in decay, there is a high chance for infection. The doctor will prescribe antibiotics or perform surgery to directly cleanse the pancreas.

“Acute pancreatitis can be permanently cured if the cause is identified,” says Dr. Rujapong. “For example, if there are gallstones in the gallbladder, removing the gallstones will resolve the problem. That’s why — unless it is found too late or with complications — acute pancreatitis has a low fatality rate. For patients with chronic pancreatitis with an unknown cause, they need to follow their doctors’ instructions closely since the disease can lead to other debilitating conditions such as diabetes or pancreatic cancer.”

Pancreatic cancer

Though rarely found in Thailand, patients with pancreatic cancer are increasing in number. According to World Health Organization reports, pancreatic cancer ranks seventh worldwide and fourth in the USA as the cause of cancer deaths.

Causes and symptoms

Pancreatic cancer is classed as a severe condition because diagnosis is difficult and there are no definite symptoms in the early stage. The patient may complain to his or her doctor about stomachache, flatulence, loss of appetite or jaundice. However, in many cases, there are no visible symptoms. Many times the condition is discovered through a routine physical check-up. In this instance the doctor notices anomalies in blood tests and develops a further diagnosis by using a CT scan.

  “Acute pancreatitis has a low fatality rate because it can be permanently cured if the cause is identified with no complications.”

Dr. Rujapong Sukhabote
dr. rujapong sukhabote gastroenterology hepatology

The cause of this disease is yet to be identified, but those who smoke, eat meat with high fat content and have a genetic predisposition are at risk of developing pancreatic cancer. Additionally, those who suffer from chronic pancreatitis and pancreatic cysts are also at risk.


Surgery to remove the cancer is always the best treatment as long as the tumor is found quickly and has not yet spread to other parts of the body. “There are many cases that are found too late,” Dr. Rujapong warns. “Patients either have conditions too critical to undergo the operation or have really low survival rates. That’s why we always advise those who are at risk to get regular physical check-ups, once every six months to a year.”
This disease does not always come with obvious symptoms or a cure. If you are seemingly healthy, but at risk for any diseases, don’t take it for granted. When it comes to your health you can’t let your guard down.


Pancreatic cysts

Cysts are a condition that can occur on any organs or tissue, including the pancreas. A cyst is a sack containing water or some other bodily liquid. Sometimes it can contain soft flesh, which is a mix of liquid and tissue. Pancreatic cysts are a rare condition. Many times they are so small they cause no discernable symptoms. These tiny cysts can be found using ultrasound or CT scans. If the liquid inside does not show any abnormality in the test, the doctor will take no action other than to continue to observe if they get bigger. But if the doctor suspects that they have a risk of developing into cancer then he or she will immediately suggest surgery to remove them. Pancreatic cysts can happen to anyone no matter the patient’s age or gender. Finding this disease is just one advantage of having regular physical check-ups.


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