Pancreatitis
Pancreatitis is inflammation of the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that help digestion and hormones that help regulate the way your body processes sugar (glucose).
Pancreatitis can occur as acute pancreatitis — meaning it appears suddenly and lasts for days. Some people develop chronic pancreatitis, which is pancreatitis that occurs over many years.
Mild cases of pancreatitis improve with treatment, but severe cases can cause life-threatening complications.
Symptoms
Signs and symptoms of pancreatitis may vary, depending on which type you experience.
Acute pancreatitis signs and symptoms include:
- Upper abdominal pain
- Abdominal pain that radiates to your back
- Tenderness when touching the abdomen
- Fever
- Rapid pulse
- Nausea
- Vomiting
Chronic pancreatitis signs and symptoms include:
- Upper abdominal pain
- Abdominal pain that feels worse after eating
- Losing weight without trying
- Oily, smelly stools (steatorrhea)
When to see a doctor
Make an appointment with your doctor if you have acute onset or persistent abdominal pain.
Seek immediate medical help if your abdominal pain is so severe that you can't sit still or find a position that makes you more comfortable.
Causes
Pancreatitis occurs when digestive enzymes become activated while still in the pancreas, irritating the cells and causing inflammation. With repeated bouts, chronic pancreatitis may develop, leading to scar tissue and loss of function.
Conditions that can lead to acute pancreatitis include:
- Gallstones
- Alcoholism
- Certain medications
- High triglyceride levels in the blood (hypertriglyceridemia)
- High calcium levels in the blood (hypercalcemia)
- Pancreatic cancer
- Abdominal surgery
- Cystic fibrosis
- Infection
- Injury to the abdomen
- Obesity
- Trauma
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Idiopathic pancreatitis (no cause found)
Risk factors
- Excessive alcohol consumption. Heavy alcohol users are at increased risk.
- Cigarette smoking. Smokers are three times more likely to develop chronic pancreatitis. Quitting reduces the risk by half.
- Obesity. Being obese increases your likelihood of developing pancreatitis.
- Diabetes. Having diabetes raises your risk.
- Family history. Genetics plays a role, especially in chronic pancreatitis.
Complications
- Kidney failure. Acute pancreatitis may cause kidney failure, sometimes requiring dialysis.
- Breathing problems. Chemical changes can reduce oxygen levels in your blood.
- Infection. Pancreatic infections are serious and may require surgery.
- Pseudocyst. Fluid and debris may form cystlike pockets that can rupture.
- Malnutrition. Reduced enzyme production can cause malnutrition, diarrhea and weight loss.
- Diabetes. Chronic inflammation damages insulin-producing cells.
- Pancreatic cancer. Chronic pancreatitis increases cancer risk.
Diagnosis
Tests and procedures used to diagnose pancreatitis include:
- Blood tests (enzymes, WBC, kidney and liver function)
- Abdominal ultrasound
- CT scan
- MRI
- Endoscopic ultrasound
- Stool tests for fat absorption (chronic cases)
Treatment
Initial treatments in the hospital may include:
- Early eating. Eating as tolerated helps pancreas healing.
- Pain medications. To manage severe pain.
- IV fluids. To prevent dehydration.
Once stabilized, treatment targets the underlying cause:
- ERCP. To remove bile duct obstructions.
- Gallbladder surgery. If gallstones caused pancreatitis.
- Pancreas procedures. To drain fluid or remove diseased tissue.
- Treatment for alcohol dependence.
- Medication changes. If drugs caused pancreatitis.
Additional treatments for chronic pancreatitis:
- Pain management (medications, nerve blocks, endoscopic ultrasound)
- Pancreatic enzyme supplements with meals
- Dietary changes (low-fat, nutrient-rich foods)
Lifestyle and home remedies
- Stop drinking alcohol
- Stop smoking
- Choose a low-fat diet
- Drink more fluids
Alternative medicine
Alternative therapies can't treat pancreatitis but may help manage pain:
- Meditation
- Relaxation exercises
- Yoga
- Acupuncture
Preparing for your appointment
Start with your family doctor, then possibly a gastroenterologist. Be prepared to discuss symptoms and history.
What you can do
- Follow any pre-appointment restrictions
- Write down symptoms
- Note key personal information
- Make a list of medications and supplements
- Bring a family member or friend
- Write down questions to ask your doctor
Questions to ask your doctor
- What is likely causing my symptoms?
- What tests do I need?
- Is my condition temporary or chronic?
- What are my treatment options?
- How do I manage pancreatitis with my other health conditions?
- Any restrictions I need to follow?
- Should I see a specialist?
- Any generic medicine alternatives?
- What follow-up is required?
What to expect from your doctor
Your doctor may ask questions such as:
- When did symptoms begin?
- Are they continuous or occasional?
- How severe are they?
- What improves or worsens symptoms?
- Have you had these symptoms before?
- Any history of pancreatitis?
- Do you drink alcohol?
- Did you start new medications?
- Any family history of pancreas disease?