Pancreatology

The pancreas is an organ situated behind the stomach inside the abdomen. It is composed of two main components, namely the exocrine pancreas and the endocrine pancreas.The exocrine pancreas is responsible for secretion of digestive enzymes that are primarily responsible for digestion of fat, protein and carbohydrate consumed in our diet. The endocrine pancreas produces hormones such as insulin and glucagon, which are responsible for the control of blood glucose.The pancreas could be afflicted by a few specific diseases, namely, acute pancreatitis, chronic pancreatitis, pancreatic cancer, pancreatic neuroendocrine tumours, cystic tumours of the pancreas and autoimmune pancreatitis. Out of these, the first two conditions, i.e. acute and chronic pancreatitis are common in India; and the incidence of pancreatic cancer also appears to be rising.Acute pancreatitis results most commonly from excessive alcohol intake and small stones in the gallbladder. Smoking could also cause acute pancreatitis, along with other causes such as high triglyceride and calcium in the blood, certain drugs and genetic abnormalities. In acute pancreatitis, there is sudden onset of swelling in the pancreas and could be associated with life-threatening situations such as organ failure and infections.Chronic pancreatitis in India is most commonly idiopathic, meaning definite cause cannot be identified on routine testing. Many of these patients have different genetic abnormalities that could contribute to the development of chronic pancreatitis. Other important causes include alcohol and smoking. Chronic pancreatitis is characterised by a decrease in the size of the pancreas, increase in size of the pancreatic duct, the formation of pancreatic duct stones or narrowing (called stricture), calcium deposits in the pancreatic tissue, and development of diabetes. A small proportion of patients with chronic pancreatitis could progress to develop pancreatic cancer, especially those who have disease onset at an early age. The predominant clinical symptom of chronic pancreatitis is a recurrent abdominal pain.

The Lakshmi Sai Gastro has all the up-to-date biochemical radiological and pathological facilities to diagnose pancreatic diseases and the complications.CT scan, MRI/MRCP and endoscopic ultrasonography (EUS) could detect pancreatitis, pancreatic cysts and tumours. In addition to the routine tests, we also offer a CP nutrition package that assesses the nutritional status and markers of oxidative stress, which is important especially in patients with chronic pancreatitis.We also offer genetic testing for pancreatitis and include 13 common individual genes in the test panel, which is the highest number done in India at present. The results are discussed in details with the patients and their relatives, and they are appropriately counselled before and after the test.