Pancreatitis

What Is Pancreatitis?

Pancreatitis is a disease in which your pancreas becomes inflamed.

The pancreas is a large gland behind your stomach and next to your small intestine. Your pancreas does two main things:

• It releases powerful digestive enzymes into your small intestine to help you digest food.
• It releases insulin and glucagon into your bloodstream. These hormones help your body control how it uses food for energy.

Your pancreas can be damaged when digestive enzymes begin working before your pancreas releases them.

What Are the Types of Pancreatitis?

The two forms of pancreatitis are acute and chronic.

• Acute pancreatitis is sudden inflammation that lasts a short time. It can range from mild discomfort to a severe, life-threatening illness. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can cause bleeding, serious tissue damage, infection, and cysts. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.
• Chronic pancreatitis is long-lasting inflammation. It most often happens after an episode of acute pancreatitis. Another top cause is drinking lots of alcohol for a long period of time. Damage to your pancreas from heavy alcohol use may not cause symptoms for many years, but then you may suddenly have severe pancreatitis symptoms.

What Are the Symptoms of Pancreatitis?

Symptoms of acute pancreatitis

• Fever
• Higher heart rate
• Nausea and vomiting
• Swollen and tender belly
• Pain in the upper part of your belly that goes into your back. Eating may make it worse, especially foods high in fat.

Symptoms of chronic pancreatitis

The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. But you may also have:

• Constant pain in your upper belly that radiates to your back. This pain may be disabling.
• Diarrhea and weight loss because your pancreas isn’t releasing enough enzymes to break down food
• Upset stomach and vomiting

What Are the Pancreatitis Causes and Risk Factors?

Acute pancreatitis causes include:

• Autoimmune diseases
• Drinking lots of alcohol
• Infections
• Gallstones
• Medications
• Metabolic disorders
• Surgery
• Trauma

In up to 15% of people with acute pancreatitis, the cause is unknown.

Chronic pancreatitis causes include:

• Cystic fibrosis
• Family history of pancreas disorders
• Gallstones
• High triglycerides
• Longtime alcohol use
• Medications

In about 20% to 30% of cases, the cause of chronic pancreatitis is unknown. People with chronic pancreatitis are usually men between ages 30 and 40.

Can Pancreatitis Cause Complications?

Pancreatitis can have severe complications, including:

• Diabetes if there’s damage to the cells that produce insulin
• Infection of your pancreas
• Kidney failure
• Malnutrition if your body can’t get enough nutrients from the food you eat because of a lack of digestive enzymes
• Pancreatic cancer
• Pancreatic necrosis, when tissues die because your pancreas isn’t getting enough blood
• Problems with your breathing when chemical changes in your body affect your lungs
• Pseudocysts, when fluid collects in pockets on your pancreas. They can burst and become infected.

How Is Pancreatitis Diagnosed?

To check for acute pancreatitis, the doctor will probably press on your belly area to see if it is tender and check for low blood pressure, low fever, and rapid pulse.

To diagnose chronic pancreatitis, X-rays or imaging tests such as a CT scan or MRI may show whether the pancreas is calcified. Your doctor will take blood samples and check your stool for excess fat, a sign that the pancreas is no longer making enough enzymes to process fat. You may be given a pancreatic function test to see how well the pancreas releases digestive enzymes. You may also be checked for diabetes.

To diagnose acute pancreatitis, your doctor tests your blood to measure two digestive enzymes: amylase and lipase. High levels of these two enzymes mean you probably have acute pancreatitis. They’ll also test your blood for white blood cells, blood sugar, calcium, and liver function.

Other tests can include:

• Pancreatic function test to find out whether your pancreas is making the right amounts of digestive enzymes
• Ultrasound, CT scan, and MRI, which make images of your pancreas to show the extent of inflammation, causes such as bile duct problems and gallstones, for complications like cysts.
• ERCP, in which your doctor uses a long tube with a camera on the end to look at your pancreatic and bile ducts
• Biopsy, in which your doctor uses a needle to remove a small piece of tissue from your pancreas to be studied

In some cases, your doctor may test your blood and poop to confirm the diagnosis. They may also do a glucose tolerance test to measure damage to the cells in your pancreas that make insulin.

How Is Pancreatitis Treated?

Treatment for acute pancreatitis

If you have an attack of acute pancreatitis, you may receive strong drugs for pain. You may have to have your stomach drained with a tube placed through your nose. If the attack is prolonged, you may be fed and hydrated intravenously (through a vein).

You’ll probably need to stay in the hospital, where your treatment may include:

• Antibiotics if your pancreas is infected
• Intravenous (IV) fluids, given through a needle
• Low-fat diet or fasting. You might need to stop eating so your pancreas can recover. In this case, you’ll get nutrition through a feeding tube.
• Pain medicine

If your case is more severe, your treatment might include:

• Endoscopic retrograde cholangiopancreatography (ERCP), a procedure that involves the insertion of a tube down your throat into the stomach and upper intestines to take out gallstones if they’re blocking your bile or pancreatic ducts. A small cut is made to remove stones in the bile duct, or a plastic tube called a stent is inserted into the ducts to relieve the obstruction.
• Gallbladder surgery if gallstones caused your pancreatitis
• Pancreas surgery to clean out fluid or dead or diseased tissue

Treatment for chronic pancreatitis

If you have chronic pancreatitis, the doctor will focus on treating pain -- guarding against possible addiction to prescription painkillers -- and watching for complications that affect digestion. You may be placed on a pancreatic enzyme replacement therapy to restore the digestive tract's ability to digest nutrients; this will also likely reduce the frequency of new attacks.

You might need:

• Insulin to treat diabetes
• Pain medicine
• Pancreatic enzymes to help your body get enough nutrients from your food
• Surgery or procedures to relieve pain, help with drainage, or treat blockages

Injection of anesthetics into the nerves near the spine may give pain relief. If the pain does not respond to medication or nerve blocks, the damaged pancreatic tissue may be surgically removed, but only as a last resort.

How Do You Prevent Pancreatitis?

Because many cases of pancreatitis are caused by alcohol abuse, prevention often focuses on limiting how much you drink or not drinking at all. If your drinking is a concern, talk to your doctor or health care professional about an alcohol treatment center. A support group such as Alcoholics Anonymous could also help.

Stop smoking, follow your doctor's and dietitian's advice about your diet, and take your medications so you’ll have fewer and milder attacks of pancreatitis.

Read more on: digestive disorders