Pancreatitis

Digestive enzymes travel from the pancreas to the small intestine through the pancreatic duct. Normally, they are not activated until they reach the small intestine, but if the pancreatic duct is blocked, the enzymes become trapped and accumulate in the pancreas. Eventually, these enzymes become activated while still in the pancreas and begin irritating the pancreas tissue, causing inflammation, bleeding, infection, and damage to the pancreas.

The most common cause of acute pancreatitis is gallstones, which can block the pancreatic duct. Years of heavy alcohol use can also cause acute pancreatitis and is the leading cause of chronic pancreatitis.

Several other factors can cause pancreatitis, including:

• Abdominal surgery or trauma
• Smoking
• Certain medications
• Family history of pancreatitis
• Infection
• High levels of calcium or triglycerides in the blood
• Cystic fibrosis
• Hereditary disorders of the pancreas

Both acute and chronic pancreatitis can be serious and life threatening. The most common symptom is severe upper abdominal pain that may radiate to your back or feel worse after eating or drinking alcohol. Other symptoms may include:

• Nausea and vomiting
• Fever and chills
• Rapid heartbeat
• Swollen and tender abdomen

As chronic pancreatitis progresses, abdominal pain usually goes away, which indicates that the pancreas has stopped working. Other serious complications include:

• Pancreatic pseudocyst
• Infection
• Kidney failure
• Type 2 diabetes
• Breathing problems (hypoxia and lung failure)
• Inability to digest food
• Weight loss
• Pancreatic cancer

To diagnose pancreatitis, your doctor will review your medical history and conduct a physical exam. Be sure to tell your doctor about your symptoms and risk factors for pancreatitis, especially alcohol use. They will order a blood test to check for elevated levels of pancreatic enzymes or a stool test if they suspect chronic pancreatitis.

Imaging tests are usually ordered, as well, including:

• X-rays
• Abdominal ultrasound
• CT scan
• Endoscopic ultrasound (EUS)
• ERCP

Treatment for pancreatitis is aimed at treating the underlying cause of the condition, relieving symptoms, and restoring pancreatic function.

Acute pancreatitis requires a hospital stay. You will not be allowed to eat or drink for a couple of days, so your pancreas can rest and heal. You will receive IV fluids, antibiotics, and pain medication. If vomiting occurs, a nurse may insert a tube through your nose and into your stomach to remove stomach fluids and air.

If your acute pancreatitis is caused by gallstones or another medical condition, such as a pancreatic pseudocyst or narrowed bile duct, the doctor may be able to remove the stones or correct the condition by performing a procedure during an ERCP or minimally invasive surgery.

Chronic pancreatitis may or may not require a hospital stay. Treatment goals for chronic pancreatitis include pain relief, hydration, reducing pancreatic irritation, and improving the ability to eat and digest food. Prescription medication is used to treat pain or aid in digestion.

Your doctor will also recommend lifestyle and dietary changes, such as:

• Stop drinking alcohol
• Stop smoking
• Eat a low-fat diet