Saturday , 20 April 2019

Why do people get Pancreatitis

Nandkumar Kamat

Human pancreas is a long, flat gland, a prodigious and biochemically amazing cellular factory of complex biomolecules located behind the stomach in the upper abdomen. It produces digestive enzymes and hormones regulating sugar metabolism. Enzymes include several complex proteases, lipases, nucleases, amylase and hormones include – gastrin, cholecystokinin, secretin, insulin, glucagon and somatostatin. With more than 100 important biomolecules synthesised by cellular factories of pancreas involved in digestion obviously one can’t ignore pancreatic health. This means knowing how to maintain it with appropriate diet and lifestyle.

USA is the leading country on our present knowledge on the structure, function and pathology of this organ because in USA every year three lakh patients report pancreatitis. In USA, pancreatic cancer is the fourth most common cause of death due to cancer. However less than 100 pancreatitis cases are reported per year in Goa, thanks to use of coconuts. Ever since the Chief Minister of Goa Manohar Parrikar was diagnosed with pancreatitis the whole nation became aware of this important digestive organ in the human body. As Indians are moving away from their traditional diets, slow foods, consume less fermented foods, use less spices and condiments, the pancreas is getting loaded with factors which it can’t deal with.

Indian food has inbuilt probiotic and antibiotic, antiviral, immunomodulatory and immunostimulant ingredients. Centuries of innovation has gone into time tested and validated ethnic Indian recipes which also act as preventive medicines. Beneficial and protective factors in coconut oil, garlic, onion, turmeric and ginger are universally known to be good for maintenance of normal pancreatic functions. But with no control over food adulteration, quality of cooking oil, edible fats, xenobiotics (pesticide, insecticide) residues in all food products, even healthy Indians can get pancreatitis.

But the medical experts at world famous Mayo clinic – acute pancreatitis can be caused by alcoholism, gallstones, abdominal surgery, certain types of medications, cigarette smoking, cystic fibrosis, family history of pancreatitis, high calcium levels in the blood (hypercalcemia), which may be caused by an overactive parathyroid gland (hyperparathyroidism), high triglyceride levels in the blood (hypertriglyceridemia), infection, injury to the abdomen and pancreatic cancer. Signs and symptoms of pancreatitis may include depending on what the patient experiences.

Some of these are so vague that differential diagnosis and detail medical tests are necessary. Initially when it develops, acute pancreatitis signs and symptoms may include pain in upper abdominal region, abdominal pain that radiates to your back, abdominal pain that feels worse after eating, fever, rapid pulse, nausea, Vomiting, tenderness when touching the abdomen. The signs of Chronic pancreatitis include upper abdominal pain, losing weight without trying, oily, smelly stools (steatorrhea). Complications of pancreatitis include a pseudocyst caused by fluid and debris collected in cystlike pockets. A large pseudocyst that ruptures can cause complications such as internal bleeding and infection.

Acute pancreatitis makes pancreas vulnerable to bacteria and infection requiring intensive treatment, such as surgery to remove the infected tissue. Acute pancreatitis may cause kidney failure, which can be treated with dialysis if the kidney failure is severe and persistent. Acute pancreatitis can cause chemical changes that affect lung function, causing the level of oxygen in blood to fall to dangerously low levels. Damage to insulin-producing cells in pancreas from chronic pancreatitis can lead to diabetes. Both acute and chronic pancreatitis can cause pancreas to produce fewer of the digestive enzymes leading to malnutrition, diarrhoea and weight loss despite eating well and in adequate quantity. Long-standing pancreatic inflammation caused by chronic pancreatitis may lead to pancreatic cancer.

So how to avoid pancreatitis? It all depends on lifestyle and diet. Alcohol and tobacco are dangerous for pancreas. So also red meat, deep fried foods, anything containing trans fatty acids. Legume proteins, fruits, vegetables, nuts are highly recommended. Broccoli, cabbage, cauliflower, apples, mangoes, pineapple, papaya are excellent for preventing pancreatitis. Goans were protected from pancreatitis all these years because of use of coconut oil in cooking. But nobody knew the biochemical basis. Now it is found to be Medium-chain triglycerides (MCTs). Since 1970s vigorous campaigns by branded refined vegetable cooking oil companies weaned Goans away from beneficial coconut oil based cooking methods.

Now coconut oil has been found very effective in preventing and curing pancreatitis. It helps in reducing the symptoms of pancreatitis such as controlling weight loss that occurs due to malabsorption. The medium chain triglyceride in coconut oil bypasses the normal fat absorption process and gets rapidly absorbed helping in counteracting weight loss effect. So replacement of vegetable oils with coconut oil for cooking can do the magic of preventing pancreatitis. Medical field is giving increasing emphasis on Medium-chain triglycerides (MCTs). These comprise a glycerol molecule attached to 3 fatty acid chains ranging between 6 to 12 carbons in length. Other lipid molecules need a complex process of digestion. But MCTs are more easily absorbed into the bloodstream from the gastrointestinal tract. These features of MCTs confer unique benefits in the management of gastrointestinal disorders.

So it’s becoming increasingly clear that if we change our cooking methods, use refined vegetable oils instead of coconut oil, change our normal traditional diet, reduce use of onion, garlic, ginger, cinnamon, cardamom and patronize deep fried, high fat foods then it is invitation to pancreatitis.

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