Ask the doctors: Low likelihood of getting parasite in pacreas

Dear Doctors: How do I cleanse my pancreas of parasites?

Dear Reader: Your question assumes that you have a parasitic infection in your pancreas. Without additional details, such as symptoms you are having, any tests you’ve done or a specific diagnosis you received, we can’t offer much guidance. What we can do, which we hope will be helpful, is talk about the pancreas. What does it do? How can this type of infection happen? And if it did, how would it be treated?

The pancreas is fascinating. It functions as an organ and a gland. It’s part of the digestive system. The pancreas sits in the upper abdomen, behind the stomach and near the liver, small intestine and spleen. The pancreas secretes several enzymes that aid in digestion. It also produces insulin, a hormone that plays two key roles. Insulin helps cells absorb glucose from the blood. In doing so, it keeps blood glucose within healthy levels.

As with any organ in the body, the pancreas can be affected by disease. This includes parasitic infection. However, this type of infection is quite rare, even in regions of the world where intestinal parasites are common. This is due in large part to the location of the pancreas within the body. To reach the organ, a parasite would have to enter through the pancreatic duct from the small intestine, or through the blood. The fact that the pancreas produces enzymes also makes it inhospitable to organisms trying to invade.

Entry through the small intestine is difficult. It requires fighting the downward flow of peristaltic movement created by the intestinal walls and the directional flow through the pancreatic duct. A rich network of blood and lymph vessels serves the pancreas. So, infection by a blood-borne parasite is technically possible. However, immune defenses and the lack of direct vascular connections make this very rare. The challenge of entering through one of these pathways is evident in how rare parasitic infections are in the pancreas.

A parasite in the pancreas would often produce symptoms like pancreatitis. This includes pain in the upper abdomen that may radiate to the lower back. Also, nausea or vomiting and fever. For many people, these symptoms get worse after eating. A person suspected of having pancreatitis would be diagnosed through blood tests, and sometimes imaging tests. If a parasitic infection is suspected, a stool sample may identify shed cells, eggs and larvae. A blood test can also flag the immune and inflammatory responses that suggest a parasitic infection. For parasites that create cysts, imaging tests might also be needed.

Treatment includes managing the symptoms of pancreatitis as well as medications to kill the infectious organism. The specific drugs used depend on the parasite involved. If you have symptoms that are consistent with a parasitic infection in your pancreas, it is important to seek medical care right away.

Send your questions to askthedoctors@mednet.ucla.edu.