Diseases & Conditions

 

Pancreatitis

Diseases & Conditions

 

What is Pancreatitis?

Pancreatitis is an uncommon disease characterized by inflammation of the pancreas. The pancreas is a large gland behind the stomach close to the small intestine that produces chemicals called enzymes, which are needed to digest food. It also produces the hormones insulin and glucagon. Pancreatitis can be acute or chronic. Both constitute serious conditions and can lead to complications.1

  • Acute pancreatitis is an inflammation of the pancreas that occurs suddenly and usually resolves in few days with treatment.
  • Chronic pancreatitis is an inflammation of the pancreas that does not resolve with time and worsen leading to a permanent damage.

 

What causes pancreatitis?

A number of causes have been identified for acute and chronic pancreatitis. 2

The most common cause of acute pancreatitis is the presence of gallstones (small, pebble-like substances made of hardened bile) causing inflammation of the pancreas when passing through the common bile duct.

The most common causes of chronic pancreatitis include:

  • Chronic and heavy alcohol use
  • Hereditary disorders
  • Cystic fibrosis
  • High level of calcium in the blood
  • High level of fats

 

What are the symptoms of pancreatitis?

Acute pancreatitis usually includes the following symptoms: 3

  • Gradual or sudden upper abdominal pain
  • A swollen and tender abdomen
  • Nausea and vomiting
  • Fever
  • A rapid pulse
  • Dehydration
  • Low blood pressure

Chronic pancreatitis usually includes the following symptoms:

  • Upper abdominal and back pain
  • Pain when eating or drinking
  • Nausea and vomiting
  • Weight loss due to the lack of pancreatic enzymes to digest food
  • Diarrhea
  • Oily stools due the poor digestion leading to malnutrition and excretion of fat in the stool

 

How is pancreatitis diagnosed?

In order to diagnose acute and chronic pancreatitis, the doctor could order one or more of the following tests: 4

  • Blood test to see the level of digestive enzymes produced by the pancreas
  • Abdominal ultrasound which can show the presence and the location of the inflammation
  • Computerized tomography (CT) scan to find gallstones and the extent of damage to the pancreas
  • Endoscopic ultrasound that sends sound waves to create visual images of the pancreas and the bile ducts
  • Magnetic resonance cholangiopancreatography that uses magnetic resonance imaging to create images of the body and locate the inflammation

 

How is pancreatitis treated?

Treatment for acute pancreatitis include:1

  • Intravenous fluids given through a vein (during a stay in a hospital)
  • Medications to relieve the pain
  • Antibiotics
  • Stopping food or fluid by mouth to limit the activity of the pancreas
  • If vomiting and severe pain do not improve, a tube may be inserted through the nose or mouth to remove the contents of the stomach

  Treatment for chronic pancreatitis include:1

  • Hospitalization for intravenous hydration
  • Feeding through the nose may be necessary for several weeks if the patient continue to lose weight
  • Medication for pain management
  • Medications to complete pancreatic enzymes if the pancreas does not secrete enough on its own
  • Surgery:5
    • A procedures to remove bile duct obstructions is recommended if the pancreatitis is caused by a narrowed or blocked bile duct
    • Gallbladder surgery if the pancreatitis is caused by gallstones
    • Pancreas surgery to drain fluids from the pancreas

 

People with acute and chronic pancreatitis are strongly advised not to smoke, drink alcohol, or eat meals rich in fat.

 

 References:

  1. Pancreatitis: MedlinePlus (U.S National Library of Medicine) https://www.nlm.nih.gov/medlineplus/pancreatitis.html
  2. Pancreatitis Causes, Symptoms, Treatments, Tests (WebMD) http://www.webmd.com/digestive-disorders/digestive-diseases-pancreatitis?page=2 (Accessed December 21, 2015)
  3. Acute Pancreatitis (: Practice Essentials, Background, Pathophysiology) http://emedicine.medscape.com/article/181364-overview (Accessed December 21, 2015)
  4. Cappell, Mitchell S. "Acute pancreatitis: etiology, clinical presentation, diagnosis, and therapy." Medical Clinics of North America 92.4 (2008): 889-923.
  5. Pancreatitis (Treatments and drugs) http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/treatment/con-20028421 (Accessed December 21, 2015)