What Is Pancreatitis?

The pancreas is a large gland behind the stomach and next to the small intestine. The
pancreas does two main things:
It releases powerful digestive enzymes into the small intestine to aid the digestion of food.
It releases the hormones insulin and glucagon into the bloodstream. These hormones help the
body control how it uses food for energy.
Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens
when the digestive enzymes are activated before they are released into the small intestine and
begin attacking the pancreas.
There are two forms of pancreatitis: acute and chronic.

A. 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 cystformation. Severe pancreatitis can also harm other vital
organs such as the heart, lungs, and kidneys.

B. Chronic pancreatitis. Chronic pancreatitis is long-lasting inflammationof 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 Symptoms of Pancreatitis?

A. Symptoms of acute pancreatitis:

 Upper abdominal pain that radiates into the back; it may be aggravated by eating,
especially foods high in fat.
 Swollen and tender abdomen
 Nausea and vomiting
 Fever
 Increased heart rate

B. Symptoms of chronic pancreatitis:

The symptoms of chronic pancreatitis are similar to those of acute pancreatitis.

Patients frequently feel constant pain in the upper abdomen that radiates to the back.
In some patients, the pain may be disabling. Other symptoms are diarrhea and weight
loss caused by poor absorption (malabsorption) of food. This malabsorption happens
because the gland is not releasing enough enzymes to break down food.
Also, diabetes may develop if the insulin-producing cells of the pancreas are
damaged.
What Causes Pancreatitis?

In most cases, acute pancreatitis is caused by gallstones or heavy alcohol use. Other causes
include medications, autoimmune disease, infections, trauma, metabolic disorders, and
surgery. In up to 15% of people with acute pancreatitis, the cause is unknown.
In about 70% of people, chronic pancreatitis is caused by long-time alcohol use. Other causes
include gallstones, hereditary disorders of the pancreas, cystic fibrosis, high triglycerides, and
certain medicines. In about 20% to 30% of cases, the cause of chronic pancreatitis is
unknown.

What Are the Risk Factors for Pancreatitis?

Pancreatitis can happen to anyone, but it is more common in people with certain risk factors.

Risk factors of acute pancreatitis include:

 Gallstones
 Heavy alcohol drinking
 Acute pancreatitis may be the first sign of gallstones. Gallstones can block the
pancreatic duct, which can cause acute pancreatitis.

Risk factors for chronic pancreatitis include:

 Heavy alcohol drinking for a long time

 Certain hereditary conditions, such as cystic fibrosis
 Gallstones
 Conditions such as high triglycerides and lupus
 People with chronic pancreatitis are usually men between ages 30 and 40, but chronic
pancreatitis also may occur in women.

How Is Pancreatitis Diagnosed?

To diagnose acute pancreatitis, doctors measure levels in the blood of two digestive
enzymes, amylase and lipase. High levels of these two enzymes strongly suggest acute
pancreatitis.
Doctors may also use other tests, such as:
 Pancreatic function test to find out if the pancreas is making the right amounts of
digestive enzymes
 Glucose tolerance test to measure damage to the cells in the pancreas that
make insulin
 Ultrasound, CT scan, and MRI, which make images of the pancreas so that problems
may be seen
 ERCP to look at the pancreatic and bile ducts using X-rays
 Biopsy, in which a needle is inserted into the pancreas to remove a small tissue
sample for study
 In more advanced stages of the disease, doctors may use blood, urine, and stool
tests to confirm the diagnosis.
How Is Pancreatitis Treated?

Treatment for acute pancreatitis

People with acute pancreatitis are typically treated with IV fluids and pain medications in
the hospital. In some patients, the pancreatitis can be severe and they may need to be
admitted to an intensive care unit (ICU). In the ICU, the patient is closely watched because
pancreatitis can damage the heart, lungs, or kidneys. Some cases of severe pancreatitis can
result in death of pancreatic tissue. In these cases, surgery may be necessary to remove the
dead or damaged tissue if an infection develops.
An acute attack of pancreatitis usually lasts a few days. An acute attack of pancreatitis
caused by gallstones may require removal of the gallbladder or surgery of the bile duct. After
the gallstones are removed and the inflammation goes away, the pancreas usually returns to
normal.

Treatment for chronic pancreatitis

Chronic pancreatitis can be difficult to treat. Doctors will try to relieve the patient's
pain and improve the nutrition problems. Patients are generally given pancreatic enzymes and
may need insulin. A low-fat diet may also help.
Surgery may be done in some cases to help relieve abdominal pain, restore drainage
of pancreatic enzymes or hormones, treat chronic pancreatitis caused by blockage of the
pancreatic duct, or reduce the frequency of attacks.
Patients must stop smoking and drinking alcoholic beverages, follow their doctor's
and dietitian's dietary advice, and take the proper medications in order to have fewer and
milder attacks of pancreatitis.

Can Pancreatitis Be Prevented?

Because most cases of pancreatitis are caused by alcohol abuse, prevention is directed at
responsible drinking or no drinking at all. If heavy drinking is a concern, talk to your doctor
or health care professional about a referral to an alcohol treatment center. Also, you may
benefit from a support group such as Alcoholics Anonymous.