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What is Pancreatitis?

  • Pancreatitis is inflammation (swelling) of the pancreas that is most often caused by gallstones or alcohol abuse.

    • There are other causes that your gastroenterologist will look for, as well.
  • Pancreatitis often starts as a sudden attack of upper belly pain.

  • Treatment for pancreatitis usually focuses on easing pain and meeting the fluid and nutritional needs of the patient.

  • There are two types of pancreatitis, acute and chronic.

    • Both have similar symptoms that can be recurrent and either mild or severe.
Acute pancreatitis Chronic pancreatitis
Can occur suddenly and goes away within a few days. Takes many years to develop and does not go away.
Most often from gallstones or alcohol abuse, but there are other causes. Sometimes, no cause for it can be found. The pancreas is permanently injured or scarred.
Most cases are mild. Chronic pancreatitis is associated with frequent flare-ups or persistent symptoms of pain, often connected to diabetes or issues digesting fat.
Mostly involves a short hospital stay to heal the pancreas. Many patients with chronic pancreatitis will have calcifications of the pancreas that show on an X-ray or computerized tomography (CT) scan.
Most people with chronic pancreatitis have a good outlook if they follow their treatment plan.

Symptoms

Chronic and acute pancreatitis have similar symptoms, but a few vary.

Patients may have a few or all of these symptoms:

  • A slow or sudden severe pain in the middle part of the upper belly going through to your back. This pain may get worse when you eat and builds to a pain that does not go away.

  • Nausea and throwing up.

  • Fever.

  • Jaundice (hen your skin and/or the whites of your eyes turn yellow).

  • Skin nodules.

  • Diarrhea (loose stool).

  • Swollen or tender belly.

  • Weight loss (with chronic pancreatitis).

  • Greasy or oily stools (with chronic pancreatitis).

  • Diabetes.

If you have unexplained weight loss that lasts more than a few weeks, call your doctor.

Getting Tested

In talking with your doctor about your symptoms, he or she may order certain tests to find out if you have pancreatitis and to see if it is acute or chronic.

You can expect your doctor to:

Take your medical history and do an exam of your belly

  • Be sure to give your doctor a list of all medications you take, including prescription and over-the-counter medicines, vitamins and supplements.

  • Be sure to tell your doctor how much alcohol you drink and cigarettes you smoke (if any).

Take blood

  • Your blood can show the doctor your pancreatic enzyme levels.

  • High levels may be a sign you have pancreatitis.

X-ray or other imaging test

  • This will show how hurt or scarred your pancreas may be.

  • Most likely, you will be awake for the test, but it will not hurt.

  • Examples of imaging tests are:

    • Ultrasound of the pancreas, liver and gallbladder.

    • Computerized tomography (CT) scan.

    • Endoscopic ultrasound (EUS).

    • Magnetic resonance cholangiopancreatography (MRCP).

      • MRCP is a medical imaging test that looks at your bile and pancreas ducts.

Treatment

Treating either acute or chronic pancreatitis calls for similar plans. Most cases of acute pancreatitis can go away within a week, while chronic pancreatitis can often be managed if the treatment plan is followed properly.

  • You will need to stay at the hospital for a few days (with acute pancreatitis).

  • You will be given antibiotics if there is evidence of a bacterial infection.

  • If needed, you can ask for medicine to help ease any pain.

  • You will not be able to eat or drink, so that your pancreas can rest. You will be given IV fluids through a vein.

  • If the cause of your acute pancreatitis is gallstones, you might be told to have your gallbladder removed to put off further attacks.

  • You might have an endoscopic retrograde cholangiopancreatography (ERCP).

    • This is used to treat your pancreas if something is blocking it or a bile duct is enlarged.

    • To learn more about ERCP, click here.

  • Your doctor will give you a special diet to follow as part of your plan to cut the amount of fats you eat, since your body has trouble digesting fat.

  • You may need to take pancreatic enzyme supplements with each meal. These supplements will help your body absorb food and help you get back some of the lost weight.

  • The low-fat diet and the enzyme supplements may also help control pain by lowering stimulation of the pancreas.

  • If you drink alcohol, you need to stop drinking.

  • If you smoke cigarettes, you need to stop smoking.

Complications

Things to Be Aware Of

Pancreatitis can cause other issues, so caring for it the right way is very important to stop other problems from occurring. Talk to your doctor about ways to stop future attacks or future health issues.

Acute pancreatitis

  • Gallstones.

    • Gallstones can be the reason for acute pancreatitis.

    • You may need surgery to remove the stones or the gallbladder.

    • To learn more about gallstones, click here.

  • Infection.

    • Endoscopic retrograde cholangiopancreatography (ERCP) or surgery may be needed to drain infected areas (abscesses).
  • Pseudocysts (buildup of fluid and tissue).

    • These often resolve on their own.

    • These can be drained with ERCP and or a computerized tomography (CT) scan

    • If not treated, pseudocysts could cause issues in the heart, lungs, kidneys or other organs.

  • Kidney failure.

  • In rare cases, pancreatitis can cause breathing problems.

Chronic pancreatitis

  • Severe stomach and/or back pain (if you drink large amounts of alcohol).

  • Gallstones.

    • You may need surgery to remove the stones or the gallbladder.
  • Pseudocysts (buildup of fluid and tissue).

    • These often resolve on their own.

    • These can be drained with ERCP or CT scan.

    • If not treated, pseudocysts could cause issues in the heart, lungs, kidneys or other organs.

  • Calcification of the pancreas (the tissue becomes hard).

    • Surgery may be needed to remove part of the pancreas.

    • Pancreatic stones may block the main pancreatic duct and require ERCP for removal.

  • In some cases, chronic pancreatitis can cause diabetes.

  • Pancreatic cancer develops more frequently in patients with chronic pancreatitis.