DEAR DR. DONOHUE: Will you tell us about an inflamed pancreas? Why is a person hospitalized for it? Is it a diet problem? – E.B.

ANSWER:
The pancreas has two functions. First, it provides enzymes for the digestion of food. Its second function is the production of insulin for blood-sugar regulation. It lies below the stomach, and its first portion is to the right of the midline. The rest of the gland stretches all the way to the left side.

An inflamed pancreas is pancreatitis. It can be a most serious condition, with 2 percent to 10 percent dying from it, so a hospital is the place where most pancreatitis patients are treated. An attack starts quickly, often with such severe stomach pain that it doubles up a person. Frequently, the pain bores to the back. Body temperature rises. Vomiting is common.

The pancreas is rested by feeding a patient intravenously. Pain medicine is essential. If large portions of the pancreas die, the patient’s course becomes rocky, as the dead tissue can become infected.

If you count excessive alcohol intake as a diet problem, then diet is a big cause of pancreatitis. So are gallstones. The gallbladder and the pancreas share a common drainage duct, which a gallstone can block. In that case, pancreatic enzymes begin to digest and inflame the gland. High blood triglycerides (fats), viruses, some medicines and abdominal injury are other causes. Fully one-quarter of patients have it without a cause ever being found.

With hospital care, most patients recover in a matter of weeks.

The above is acute pancreatitis. Chronic pancreatitis consists of repeated attacks of inflammation and is a different story with a different approach to treatment.

DEAR DR. DONOHUE: Why is pancreatic cancer so prevalent today? It seems as if every day I hear of someone who has just been diagnosed with it. My brother died from it, and we just lost a good friend because of it. I can think of at least 10 other people who had it. Is it known what causes it? – M.S.

ANSWER:
Between 1920 and 1978, the number of people with pancreatic cancer tripled. Since then, yearly cases in the United States have held steady at about 37,000. I don’t have an explanation for the rise in this cancer. It usually strikes between the ages of 65 and 84, rarely at ages younger than 50.

It’s the fourth-leading cause of cancer deaths, but it is not the fourth most common cancer.

The cause has yet to be discovered. However, cigarette smoking, obesity, family incidence and chronic pancreatitis are factors that influence its development.

DEAR DR. DONOHUE: My grandson, 34, has a strange illness where he suddenly falls asleep. He’s not allowed to drive a car, and he can’t work. Do you know what this is? Is there any treatment? – V.M.

ANSWER:
It has the earmarks of narcolepsy, attacks of overwhelming sleepiness that come on in inappropriate and sometimes dangerous circumstances, like when driving a car. This isn’t an uncommon illness. It affects 1 in 4,000 people.

Treatments do exist. Modafinil is one, and it has helped many to overcome the life disruption brought by this illness. Your grandson will likely be driving again and be back to work.

DEAR DR. DONOHUE: I am a woman who has survived rectal cancer since 1999. Two years ago, I developed type 2 diabetes. My last blood test showed a BUN:creatinine ratio of 25. My doctor said I had a “dry kidney.” I asked what it meant, and he only shrugged his shoulders. Will you tell me what it means and what I can do about it? – B.V.

ANSWER:
BUN – blood urea nitrogen – is a test of kidney function. So is creatinine. Both of your values are normal. When you divide the BUN by the creatinine, your value comes out 1 point above normal. That’s an insignificant rise, especially when the two values are normal. You don’t need to fret about it. I have no idea what a “dry kidney” means.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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