What's in this article?
Pancreatitis is inflammation in the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that assist 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. Or pancreatitis can occur as chronic pancreatitis, which describes pancreatitis that occurs over many years.
Mild cases of pancreatitis may go away without treatment, but severe cases can cause life-threatening complications.
- About 80,000 cases of pancreatitis occur in the US every year.
- Pancreatitis causes abdominal pain.
- Pancreatitis can be an acute (short-term) or chronic (long-term) condition.
- The hallmark symptom of acute pancreatitis is abdominal pain. Other signs and symptoms of acute pancreatitis are:
- nausea and vomiting
- abdominal pain that may radiate to the back
- pain that worsens after eating
- chills and fever
- tenderness of the abdomen to touch
- lethargy and weakness
- Diagnosis of pancreatitis is generally with blood and imaging tests.
- Most cases of acute pancreatitis require hospitalization; however, treatment of chronic pancreatitis may be managed in an outpatient setting.
There are two forms of pancreatitis: acute and chronic.
Acute pancreatitis. Acute pancreatitis is a sudden inflammation that lasts for a short time. It may 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 result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.
Chronic pancreatitis. Chronic pancreatitis is long-lasting inflammation of the pancreas. It most often happens after an episode of acute pancreatitis. Heavy alcohol drinking is another big cause. Damage to the pancreas from heavy alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms.
What are the Causes of Pancreatitis?
Alcohol abuse and gallstones are the two main causes of pancreatitis, accounting for 80% to 90% of all individuals diagnosed with pancreatitis.
Pancreatitis from alcohol use usually occurs in individuals who have been long-term alcohol drinkers for at least five to seven years. Most cases of chronic pancreatitis are due to alcohol abuse. Pancreatitis is often already chronic by the first time the person seeks medical attention (usually for severe pain).
Gallstones form from a buildup of material within the gallbladder, another organ in the abdomen (please see previous illustration). A gallstone can block the pancreatic duct, trapping digestive juices inside the pancreas. Pancreatitis due to gallstones tends to occur most often in women older than 50 years of age.
The remaining 10% to 20% of cases of pancreatitis have various causes, including the following:
- exposure to certain chemicals,
- injury (trauma), as might happen in a car accident or bad fall leading to abdominal trauma,
- hereditary disease,
- surgery and certain medical procedures,
- infections such as mumps (not common),
- abnormalities of the pancreas or intestine, or
- high fat levels in the blood.
In about 15% of cases of acute pancreatitis and 40% of cases of chronic pancreatitis, the cause is never known.
Symptoms of Pancreatitis?
Most people who have acute or chronic pancreatitis experience upper abdominal pain as their primary symptom. Some of those who have chronic pancreatitis may show inflammation on imaging scans, but otherwise may show no symptoms.
Other symptoms of pancreatitis may include:
- pain that extends from your left side around to your back
- nausea or vomiting
- abdominal tenderness
- unintentional weight loss
- bloating with a distended (swollen) stomach
People who have chronic pancreatitis may also experience steatorrhea, or fatty stools that give off a foul odor. Steatorrhea can be a sign of malabsorption. This means you’re not getting all of your essential nutrients because your pancreas doesn’t secrete enough digestive enzymes to break down your food.
Pain associated with pancreatitis may last from a few minutes to several hours at a time. In severe cases, discomfort from chronic pancreatitis could become constant. Your pain is likely to increase after you eat or when you’re lying down. Try sitting up or leaning forward to make yourself more comfortable.
Complications of Pancreatitis
Pancreatitis can cause serious complications, including:
- Pseudocyst. Acute pancreatitis can cause fluid and debris to collect in cyst-like pockets in your pancreas. A large pseudocyst that ruptures can cause complications such as internal bleeding and infection.
- Infection. Acute pancreatitis can make your pancreas vulnerable to bacteria and infection. Pancreatic infections are serious and require intensive treatment, such as surgery to remove the infected tissue.
- Breathing problems. Acute pancreatitis can cause chemical changes in your body that affect your lung function, causing the level of oxygen in your blood to fall to dangerously low levels.
- Diabetes. Damage to insulin-producing cells in your pancreas from chronic pancreatitis can lead to diabetes, a disease that affects the way your body uses blood sugar.
- Kidney failure. Acute pancreatitis may cause kidney failure, which can be treated with dialysis if the kidney failure is severe and persistent.
- Malnutrition. Both acute and chronic pancreatitis can cause your pancreas to produce fewer of the enzymes that are needed to break down and process nutrients from the food you eat. This can lead to malnutrition, diarrhea and weight loss, even though you may be eating the same foods or the same amount of food.
- Pancreatic cancer. Long-standing inflammation in your pancreas caused by chronic pancreatitis is a risk factor for developing pancreatic cancer.
What is the treatment for Pancreatitis?
In most cases of acute pancreatitis, admission to the hospital is needed, whereas some cases of chronic pancreatitis can be managed in an outpatient setting.
Depending on the underlying cause of pancreatitis, management may vary to address the specific cause. In general, however, the following treatment regimen will always be initiated for the treatment of pancreatitis.
First-line treatment will involve:
- Fasting to help the pancreas to rest and recover.
- IV fluids to prevent dehydration while fasting
- Pancreatitis can be very painful, thus intravenous pain medication is often necessary.
If pancreatitis is due to an obstructing gallstone, surgical intervention may be required to remove the gallstone and/or remove the gallbladder. Intervention may also be required to treat a pseudocyst or to remove part of the affected pancreas.
If alcohol consumption is the cause of pancreatitis, abstinence from alcohol and an alcohol rehabilitation program will be recommended.
If a medication or chemical exposure is found to be the cause of pancreatitis, then removal of the medication or offending exposure is recommended.
If high triglycerides are the cause of pancreatitis, then your health-care professional may prescribe medication to decrease the patient’s triglyceride levels.