twitter google

Understanding the Impact of Obesity on Pancreatitis

rmpancreatitis

Being obese might ultimately make it harder to avoid or control other health conditions. For instance, longstanding scientific evidence supports the idea that many people who suffer from pancreatitis could have been predisposed to more acute forms of the disease by their body weight.

This isn’t to say that obesity outright causes pancreatitis. Nonetheless, there are numerous potential connections that seem to implicate being excessively overweight in contributing to an increased incidence of related problems.
Overweight vs. Obesity

The Centers for Disease Control define commonly-accepted limits for what constitutes healthy weight.[1] These rely on an individual’s body mass index, or BMI, which is their weight measured in kilograms divided by the square of their height measured in meters. Those with BMIs between 25.0 and 29.9 are considered overweight, while individuals in excess of 30.0 are deemed obese.

These limits may not always adequately qualify who is obese, however. For instance, the United Nations’ World Health Organization defines both conditions as any excessive or abnormal buildup of body fat that might negatively impact health.[2] Although this definition also accounts for the use of BMI measurements, it draws attention to the fact that excessive body fat could impact different individuals in unique ways. It’s possible that some people might be within acceptable BMI limits overall yet remain at higher risk for pancreatitis due to the location of their excess fat deposits.

The Realities of Pancreatitis:

Simply put, pancreatitis is a condition characterized by inflammation in the pancreas. The Mayo Clinic says this gland, which is situated behind the stomach, creates enzymes that help people digest food and hormones that regulate how they metabolize sugars.[3] Acute vs. Chronic

In some cases, pancreatitis is a mild ailment that resolves itself without needing medical intervention. In other instances, however, it can lead to complications that are potentially deadly.

When this disease manifests swiftly and lasts for a few days, it’s usually known as acute pancreatitis. If, on the other hand, it unfolds over the course of years or some other extended time frame, it’s referred to as chronic pancreatitis.

Acute suffers may become nauseous or vomit. Some feel physical tenderness or radiating abdominal pain that might grow worse following meals.

Chronic patients can experience unintended, unexpected weight loss. In severe cases, they’ll undergo wasting, also known as cachexia.[4] Their stools may also become greasy, difficult to flush and foul smelling as the result of a condition known as steatorrhea, or excess fat in one’s excreta.[5] Possible Outcomes

Pancreatitis commonly occurs when the enzymes intended to break down food in the stomach get activated too early. If such events occur in the pancreas, the enzymes actually harm the organ itself, which leads to the inflamed condition known as pancreatitis.

This process can result in the development of growing scar tissue that compromises pancreatic function. In some instances, the damage caused by suffering multiple acute cases over time eventually leads to chronic forms of the disease. Sufferers might also develop diabetes once their pancreas stops producing appropriate quantities of insulin.

Other possible complications include renal, or kidney failure, difficulty breathing, infections, malnutrition and diarrhea. These conditions can often be treated, but depending on their severity, they might require surgery, dialysis, continuous monitoring, emergency medical intervention or a combination of such remedies.

Pancreatitis Severity Factors:

If obesity doesn’t strictly cause pancreatitis, why should obese sufferers be concerned? The data has been accumulating for years, but based on analyses published as recently as 2012, those who were merely overweight had significantly higher rates of severe acute pancreatitis, complications and related fatalities.[6] Another study from 2008 suggested that being obese is linked to suffering from notable, if limited, inflammation that might make individuals more likely to develop serious complications.[7] Does Excess Weight Make Pancreatitis Worse?

Pancreatitis is associated with a number of risk factors. For instance, smoking, alcohol consumption and fat-rich diets can all raise someone’s likelihood of serious trouble. Certain medications and forms of gallstone therapy could also contribute. So could sustaining an abdominal injury or suffering from pancreatic cancer. Obesity’s symptoms may have impacts on these kinds of risks. They also affect whether treatment goes as planned.

Obesity and Negative Care Outcomes:

A research project whose results were presented in California in 2016 discovered that seriously overweight patients who suffered from pancreatitis-style inflammation were also exposed to other factors that contributed to their overall poor health.[8] Although the 34,495 morbidly obese patients in a cohort of 257,405 total individuals didn’t die at notably greater frequencies during their hospital stays, they were the only patients whose chances for ICU admission and shock were higher. All obese patients, however, stood higher chances of multiple-organ failure, and they tended to stay in the hospital longer. Obese patients also paid significantly more for hospital care.
Chemical Damage Links

Other studies seem to support the idea that pancreatic injury complications occur more often and more harshly in obese patients.[9] Researchers believe this may somehow be directly related to small proteins, or cytokines. The release of cytokines commonly corresponds with the amount of visceral adipose tissue, or fatty tissue around internal organs, contained in an individual’s body. Obese patients also have more of these cytokines in their bloodstreams in general, which could promote inflammation.

Understanding The Potential Ties:

Like any complex medical condition, pancreatitis cases and their outcomes may be the result of numerous factors that are hard to pin down. For instance, using different measures of obesity, such as waist diameters and the ratios between people’s waists and hips, can result in seemingly disparate correlations. As such, scientists are still searching for the most accurate ways to predict how severe the disease will be.

It should be noted, however, that the medical community has compiled many decades’ worth of evidence supporting the conclusion that obesity can cause pancreatitis to become more severe or advanced. Excess fatty tissue around abdominal organs may release hormones and FFAs, or free-fatty acids. These substances can contribute to related conditions, such as central insulin resistance or liver problems. Unfortunately, obese patients have to deal with these issues for prolonged periods that may not give their bodies sufficient chances to recover.

Managing Obesity-Related Pancreatitis Risk:

Pancreatitis patients with mild cases may be treated via a form of therapy known as pancreatic rest. In this procedure, the patient is restricted from eating food for a few days before being given a special high-carbohydrate, low-fat oral diet. Although this practice is used in low-BMI and obese patients alike, serious suffers may have to be fed through a naso-jejunal tube inserted through their noses into their intestines. They could also be administered oxygen therapy, antibiotic courses or aggressive fluid replacement.

Obese patients who go on feeding regimens are often purposefully underfed according to what doctors perceive as their ideal healthy BMIs. While this can potentially aid in weight loss, improve insulin resistance and confer other benefits, it may not be the most desirable or comfortable course of treatment for all patients.

While pancreatitis researchers are constantly searching for new treatment methodologies and medications, being overweight or obese may complicate the efficacy of any such remedies. Some observers say that dealing with obesity in advance before it contributes to pancreatic conditions is the best course of action. Proactive weight management may also be the most cost-effective option for the patient in question and their family.

Sources:
[1] Defining Adult Overweight and Obesity. (2012, April 27). Retrieved May 27, 2016, from http://www.cdc.gov/obesity/adult/defining.html
[2] Obesity and overweight. (2015, January). Retrieved May 27, 2016, from http://www.who.int/mediacentre/factsheets/fs311/en/
[3] Pancreatitis. (2013, September 7). Retrieved May 27, 2016, from http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/definition/CON-20028421
[4] Bachmann, J., Büchler, M. W., Friess, H., & Martignoni, M. E. (2013). Cachexia in Patients with Chronic Pancreatitis and Pancreatic Cancer: Impact on Survival and Outcome. Nutrition and Cancer, 65(6), 827-833. doi:10.1080/01635581.2013.804580. Retrieved May 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/23909726
[5] Domínguez–Muñoz, J. E. (2011). Chronic Pancreatitis and Persistent Steatorrhea: What Is the Correct Dose of Enzymes? Clinical Gastroenterology and Hepatology, 9(7), 541-546. doi:10.1016/j.cgh.2011.02.027. Retrieved May 27, 2016, from http://www.medscape.com/viewarticle/745453
[6] Stimac, D., & Franji, N. (2012). Obesity and Acute Pancreatitis. Acute Pancreatitis. doi:10.5772/26839 Retrieved May 27, 2016, from http://cdn.intechweb.org/pdfs/26184.pdf
[7] Hilal, M. A., & Armstrong, T. (2008). The Impact of Obesity on the Course and Outcome of Acute Pancreatitis. Obesity Surgery OBES SURG, 18(3), 326-328. doi:10.1007/s11695-007-9298-5 Retrieved May 27, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/18202895
[8] Fitzpatrick, C. (2016, May 21). The Impacts of Obesity, Morbid Obesity on Acute Pancreatitis. Retrieved May 27, 2016, from http://www.hcplive.com/conference-coverage/ddw-2016/the-impact-of-obesity-morbid-obesity-on-acute-pancreatitis
[9] Evans, A.C., Papachristou, G.I., & Whitcomb, D.C. (2010). Obesity and the risk of severe acute pancreatitis. Minerva Gastroenterol Dietol., 56(2):169-79. Retrieved May 27, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/20485254

Search

Recent