Chronic pancreatitis secondary to chronic alcoholism

Chronic pancreatitis secondary to chronic alcoholism Student Name: Instructors Name: Instructor`s Name: Institution`s Name: Word count: 1251 1 Pancreas is a dual gland, where it is an endocrine gland and exocrine gland. As an endocrine gland it produces insulin, glucagon and somatostatin hormones. As an exocrine gland it secretes pancreatic juices which contain digestive enzymes to help in breakdown of carbohydrates, proteins and fats as noted by News-Medical.Net (2011) 2 At the cephalic phase there is gastric secretion in the pancreas in response to sight, taste, thought or smell of food. When these sensory and mental inputs are triggered, they send the information to the hypothalamus which in turn relays the information to the brain. The brain via the vagus nerve fibers stimulates the enteric nervous system and there is secretion of gastric juice. At the gastric phase, the swallowed food and semi digested protein activate the gastric activity. The ingested food stimulates the gastric activity through either stretching the stomach which raises the PH In the intestinal phase, the duodenum in response to the arriving chyme regulates the gastric activity through hormones and nervous reflex. 3 Chronic pancreatitis is defined the Nordqvist (2010) as the long term progressive inflammatory disease of the pancreas that leads to the permanent deterioration of the functioning and structure of the pancreas. 4 The physical symptoms in the physicians H&P consistent with Ms. Jordan`s diagnosis are that twelve months ago she began to experience bouts of epigastric pain, she experiences severe abdominal pain which is now radiating to the back and lasts for 4hours to three days, of late she complains of anorexia and nausea. Ms. Jordan has a history of taking alcohol since she was in secondary school. The patient has also lost weight and appetite. 5 The most common etiology for pancreatitis is gallstones as noted by Afonso (2008) where he observed that it accounts for 45% of the cases in Western Europe, Asia and USA. The physiological consequences of the disease include cases of protein- energy mal-nutrition and it can also result to insulin dependent diabetes 6 After consumption of alcohol, it passes from the stomach to the intestine and into the blood. It is then metabolized by alcohol dehydrogenase enzymes in the liver to acetaldehyde, which is eventually metabolized to carbon dioxide and water. Women absorb and metabolize alcohol differently from men. They have a higher BAC`s after consuming the same amount of alcohol as men and are thus more susceptible alcohol related diseases. The higher BAC is attributed to women having smaller body water than men, and it is also found that women have flower ADH enzyme in the stomach causing more alcohol to reach the blood as observed by NIAAA (2011). 7 Freeman (2009) observed that there are twelve major health consequences associated with chronic alcohol consumption. This includes anemia, cancer, cardiovascular diseases, cirrhosis, dementia, depression, seizures, gout, hypertension, nerve damage and pancreatitis. 8 Ms. Jordan`s percentage weight loss is (28/140)*100= 20% per annum 9 Ms. Jordan`s Body Mass Index is 17.0 10 Ms. Jordan is underweight give that she has a BMI of 17 which falls under the category of underweight persons as observed by WHO (2009) and may indicate that she is either having malnutrition or having an eating disorder. Estimate of the Ms. Jordan`s energy needs using Mifflin-Jeor Equation is 1286.6 calories. The formula is {10W+6.25H-5A-161)*stress factor. the stress factor is 1.0 since Ms. Jordan is not active {10*114+6.25*5`8-5*30-161}=which gives her energy needs to be 1286.6 Queensland Health Dietitian/ Nutritionists (2009) developed a standard table for calculation of energy and protein needs. The protein needs of a person suffering from pancreatitis are 1.2-1.5g/kg. Therefore Ms. Jordan`s protein needs will range from: first convert pounds to kg (114*0.45359237) =51.71kgs therefore the protein needs will range from 62.05g to 77.565g. US Dietary Guideline for Americans (2005) on alcohol intake indicate that the consumption of alcohol can have beneficial or adverse effects depending on the amount consumed, age of the person, and other attributes of the per...