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Pancreatitis

Pancreatitis

Definition

The pancreas is a long, flat, pear-shaped organ that sits behind the stomach. It makes enzymes that help to break down food for use by the body. The enzymes pass from the pancreas through a duct to the small intestine.

Acute pancreatitis is an inflammation of the pancreas that occurs suddenly, then passes after treatment.

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Pancreatitis
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Causes

Pancreatitis may be caused by a number of conditions such as:

  • Blockage of the ducts from:
    • Gallstones
    • Cancer growth
    • Diseases of the small intestine
  • Alcohol
  • Surgery or trauma to the pancreas
  • Certain medications, such as those that treat cancer
  • Poor blood flow to the pancreas
  • Complications of endoscopic retrograde cholangiopancreatography—procedure to treat or diagnose problems of the pancreas

The enzymes are normally not active in the pancreas. Inflammation can turn on the enzymes in the pancreas which can damage the inside of the pancreas.

Risk Factors

Factors that may increase the risk of having acute pancreatitis include:

  • Alcohol abuse
  • Family history of pancreatitis
  • Personal history of previous acute pancreatitis
  • Congenital conditions, such as pancreas divisum
  • HIV or other viral infections, such as mumps or hepatitis B
  • Bacterial and parasitic infections
  • Hypertriglyceridemia—high blood triglyceride levels
  • Certain medications, such as those that treat high blood pressure
  • Pancreatic cancer
  • Hyperlipidemia—high blood fat levels
  • Hypercalcemia—high blood calcium levels
  • Cystic fibrosis
  • Scorpion bite
  • Exposure to certain toxins because of work duties or environment

Symptoms

Symptoms may start once or occur many separate times. A flare ups of symptoms is known as an attack.

Symptoms may include:

  • Severe pain in the center of the upper abdomen:
    • Pain may spread into the upper back
    • Pain is often made worse by eating, walking, or lying down on your back
  • Nausea and vomiting
  • Low grade fever
  • Yellowing of the skin and eyes
  • Rarely, shock—a medical emergency in which the organs and tissues don’t receive adequate blood or fluids

Untreated acute pancreatitis may progress into chronic pancreatitis. This is a more serious condition that can lead to permanent damage of the pancreas.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may ask about your alcohol habits and what medications you take. Blood tests will help to make the diagnosis. Certain enzymes are much higher in the blood with acute pancreatitis.

The doctor may also need to take images of the pancreas. The images can show changes to the pancreas, gallstones, or duct blockages. Images may be taken with:

  • Abdominal ultrasound
  • Abdominal CT scan
  • Abdominal MRI scan
  • Magnetic resonance cholangiopancreatography (MRCP)

The doctor will use information from all of the tests to make a diagnosis.

Treatment

Treatment will depend on the severity of the attack and what is causing it. For example, if medication is the cause, your doctor may simply change the medication or the dose.

In most cases, acute pancreatitis will pass in a few days with proper care. Most will have no lasting damage. Treatment includes:

Prevention

To help reduce your chance of getting acute pancreatitis, take these steps:

  • Limit intake of alcohol to a maximum of 2 drinks per day for men and 1 drink per day for women.
  • If you have hyperlipidemia, restrict your intake of fat and follow your doctor’s treatment plan to lower your lipids.
  • Increase your vegetable consumption.
  • Increase your activity level to help lose excess weight. Aim for 30 minutes per day on most days of the week.
  • Make sure your vaccinations are up to date. This includes mumps, rubella hepatitis B, and varicella.
  • If you smoke, talk to your doctor about ways to quit. Smoking can irritate the pancreas.
  • Avoid fatty meals. High amounts of fat intake put extra stress on the pancreas.
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