Pancreatitis

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Introduction

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas. The pancreas is a gland located behind the stomach that plays a key part in the digestive process. The gland secretes digestive juices into the small intestine, and these juices break down food. The pancreas also releases insulin and glucagon, two hormones that help the body regulate glucose levels.

The pancreas can become inflamed if the digestive juices, called enzymes, attack the gland itself, causing damage to the tissues of the pancreas. Pancreatitis can be an acute or a chronic condition. Common causes of pancreatitis include gallstones that form in the nearby gallbladder and travel to the pancreas via the common bile duct; long-term, heavy alcohol use; and certain conditions such as cystic fibrosis.

Acute pancreatitis is marked by the onset of severe pain in the upper abdomen that may spread to the back. With proper treatment, acute pancreatitis can be managed and resolved, although the condition and its complications may be life threatening in some cases. About 200,000 people in the United States are hospitalized each year due to acute pancreatitis(Source: NIDDK).

Chronic pancreatitis is a long-term condition that can result in permanent damage. In this condition the pancreas is slowly destroyed until it can no longer produce the important digestive enzymes. Treatment may include a prescription for synthetic pancreatic enzymes.

Acute pancreatitis may start as a minor pain in the abdomen spreading to the back. The pain may intensify and worsen. Seek immediate medical care (call 911) for serious symptoms, such as a swollen and tender abdomen, fever, nausea, rapid pulse, and vomiting.

Seek prompt medical care if you are being treated for chronic pancreatitis, but you have mild symptoms that persist, recur, or cause you concern.

Symptoms

What are the symptoms of pancreatitis?

Acute and chronic pancreatitis often present with the same symptoms. Symptoms of chronic pancreatitis are ongoing or recurring and may require permanent dietary and lifestyle changes. Symptoms of pancreatitis affect the pancreas and other organs in the digestive system.

Common symptoms of pancreatitis

You may experience pancreatitis symptoms daily or just once in a while. At times, any of these pancreatitis symptoms can be severe:

  • Abdominal pain or cramping
  • Abdominal swelling, distension or bloating
  • Fever
  • Low blood pressure
  • Nausea with or without vomiting
  • Rapid heart rate (tachycardia)
  • Severe abdominal, pelvic, or lower back pain
  • Yellowing of the skin and whites of the eyes (jaundice)

Serious symptoms that might indicate a life-threatening condition

In some cases, acute pancreatitis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life threatening symptoms including:

  • Abdominal swelling, distension or bloating
  • High fever (higher than 101 degrees Fahrenheit)
  • Hypotensive shock (extreme low blood pressure)
  • Rapid heart rate (tachycardia)
  • Severe abdominal, pelvic, or lower back pain
  • Vomiting blood or black material (resembling coffee grounds)
  • Yellowing of the skin and whites of the eyes (jaundice)
Causes

What causes pancreatitis?

Pancreatitis is an inflammation of the pancreas. The pancreas can become inflamed if the digestive juices it produces, called enzymes, attack the gland itself. Pancreatitis can be an acute or a chronic condition.

Common causes of pancreatitis

Causes of pancreatitis include:

  • Abdominal injury or trauma

  • Adverse effects of drugs such as steroids

  • Alcohol abuse

  • Complications of medical procedures such as imaging studies of the bile ducts

  • Cystic fibrosis (hereditary disease characterized by buildup of abnormally thick, sticky mucus in the lungs and other organs)

  • Drug allergy such as allergy to penicillin or codeine

  • Gallstones

  • Hypercalcemia (high level of calcium in the bloodstream)

  • Hyperlipidemia (high level of fats in the bloodstream)

  • Pancreatic cancer

What are the risk factors for pancreatitis?

A number of factors increase the risk of developing pancreatitis. Not all people with risk factors will get pancreatitis. Risk factors for pancreatitis include:

  • Alcohol abuse

  • Cigarette smoking

  • Gallstones

  • Hereditary disorders such as cystic fibrosis

  • Infections (mumps, coxsackie, cryptosporidiosis)

Reducing your risk of pancreatitis

You may be able to lower your risk of pancreatitis by:

  • Avoiding excessive consumption of alcohol

  • Avoiding excessive consumption of fatty or greasy foods

  • Keeping your diabetes under control

  • Seeking early diagnosis and treatment for hereditary disorders

  • Seeking prompt medical care for any symptoms that suggest pancreatitis

Treatments

How is pancreatitis treated?

If you have acute pancreatitis, you will be treated in the hospital. Treatment includes antibiotics, administration of intravenous fluids, and medication to relieve pain. Food and drink may be prohibited during this hospital stay to allow your digestive system to rest. If you are vomiting, your health care provider may place a tube through your nose and into your stomach to remove air and fluid. Your health care provider will advise you not to drink alcohol, consume fatty or greasy foods, or smoke while your pancreas heals.

Severe acute pancreatitis or chronic pancreatitis may require more intensive treatment. Your health care provider also may prescribe a synthetic pancreatic enzyme along with a low-fat diet.

Procedures to treat pancreatitis

In some cases, surgical or invasive procedures may be required for pancreatitis. These include:

  • Bile duct drainage or removal of an obstruction with an endoscopic retrograde cholangiopancreatography (ECRP), in which a long, flexible tube with a camera is guided through the digestive system to the area of blockage

  • Surgical removal of the gallbladder (cholecystectomy) if gallstones are the cause of the pancreatitis

  • Surgical removal of the pancreas (pancreatectomy), either complete or partial

What you can do to improve your pancreatitis

You can also prevent or limit acute or chronic pancreatitis by:

  • Avoiding excessive consumption of alcohol or alcohol abuse

  • Avoiding excessive consumption of fatty or greasy foods

  • Keeping your diabetes under control

  • Keeping your elevated cholesterol under control

  • Receiving treatment for symptomatic gallstones

What are the potential complications of pancreatitis?

Complications of untreated or poorly controlled pancreatitis can be serious and even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan that you and your health care professional design specifically for you. Complications of pancreatitis include:

  • Adverse effects of treatment for pancreatitis

  • Development of diabetes (chronic disease that affects your body’s ability to use sugar for energy)

  • Malnutrition

  • Pancreatic cancer

  • Pseudocyst (development of fluid collections in the pancreas that may cause bleeding or infection)

  • Severe discomfort or pain

  • Spread of cancer

  • Spread of infection

  • Surgical removal of the pancreas
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Pancreatitis. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/.
  2. Understanding pancreatitis. American Gastroenterological Association. http://www.gastro.org/patient-center/digestive-conditions/pancreatitis.
  3. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
  5. Yadav D, O'Connell M, Papachristou GI. Natural history following the first attack of acute pancreatitis. Am J Gastroenterol 2012; 107:1096.
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