PROLONGED STRESS FROM TRANSITION FOR HIGHER STUDY AMONG YOUNG ADULTS AND RISK OF PANCREATITIS PURUSHOTTAM PRAMANIK

Many young adults suffer in chronic stress for transition to college or university from home or school. Chronic stress significantly affects various physiological systems of our body. The aims of this review article to analyze the impact of chronic stress on pancreatic health among young adults engaged in higher study in abord. This review paper critically analyzes the existing literature to explore the complex relationship between chronic stress and risk of pancreatitis. The hypothalamic-pituitary-adrenal (HPA) axis is a neuroendocrine pathway involved body’s response to stress by enhancing secretion of glucocorticoids (GC) from adrenal cortex. In acute stress GC level is maintained by negative feedback mechanism. In chronic stress GC level is increased in plasma due to development of GC insensitivity. Prolonged exposure to high GC level from chronic stress may induce upregulation of proinflammatory gene transcription and down regulation of anti-inflammatory gene transcription and the subsequent release of more proinflammatory cytokines to enhance pancreatitis. Activation of HPA axis and inflammation are linked to oxidative stress. Oxidative stress produces necrosis of various cells including acinar cells. The oxidative stress and its constant companion inflammation play critical roles in the pathogenesis of pancreatitis. Chronic stress augments the development of obesity from changed lifestyle. Obesity may result in the increase plasma triglyceride and increase risk of cholelithiasis, both are well-known contributors of pancreatitis. Obesity as persistent low-grade inflammation induces hypoalbuminemia and severity of hypertriglyceridemia-induced acute pancreatitis. Thus, this review article suggested that chronic stress augments the risk of pancreatis by inducing glucocorticoids resistance and lifestyle modification. Social support is the most important tool to overcome prolonged stress induced by transition to abord and to minimize risk of pancreatitis.