Pancreatitis

Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it derives from food for energy.

Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food. But if these enzymes become active inside the pancreas, they start "digesting" it.

Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Cysts, which are fluid-filled sacs of tissue, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.

Gallstones and Pancreatitis
Gallstones can cause pancreatitis and they usually require surgical removal. Ultrasound or a CAT scan can detect gallstones and can sometimes give an idea of the severity of the pancreatitis. When gallstone surgery can be scheduled depends on how severe the pancreatitis is. If the pancreatitis is mild, gallstone surgery may proceed within about a week. More severe cases may mean gallstone surgery is delayed for a month or more.

After the gallstones are removed and inflammation goes away, the pancreas usually returns to normal.

Pancreatitis in Children
Chronic pancreatitis is rare in children. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis, a progressive, disabling, and incurable lung disease, may also have pancreatitis. But more often the cause is not known.

Points to Remember

  • Pancreatitis begins when the digestive enzymes become active inside the pancreas and start "digesting" it.
  • Pancreatitis has two forms: acute and chronic.
  • Pancreatitis is often caused by gallstones or by alcohol abuse.
  • Symptoms of acute pancreatitis include pain in the abdomen, nausea, vomiting, fever, and a rapid pulse.
  • Treatment for acute pancreatitis can include intravenous fluids, oxygen, antibiotics, or surgery.
  • Acute pancreatitis becomes chronic when pancreatic tissue is destroyed and scarring develops.
  • Treatment for chronic pancreatitis includes easing the pain; eating a high-carbohydrate, low-fat diet; and taking enzyme supplements. Surgery is sometimes needed as well.

For More Information

Information about pancreatitis is also available from:

American Gastroenterological Association
7910 Woodmont Avenue, Suite 700
Bethesda, MD 20814
Phone: (301) 654-2055
Fax: (301) 654-5920
www.gastro.org

NIH Publication No. 04–1596
The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.

 

Pancreatitis FAQs

General:

  1. What is pancreatitis?
    Pancreatitis happens when the pancreas becomes inflamed. It’s a disease that occurs when the digestive enzymes produced in the pancreas are activated before they are released into the small intestine and begin attacking the pancreas. 
     
  2. What are the different types of pancreatitis?
    There are two forms of pancreatitis: acute and chronic. Acute pancreatitis is sudden, but lasts for only a short time. In severe cases, however, acute pancreatitis can result in organ damage or even death. Chronic pancreatitis is long-lasting scarring inflammation of the pancreas. It usually occurs after several episodes of acute pancreatitis. 

Symptoms and causes:

  1. What are the symptoms of pancreatitis?
    Acute pancreatitis symptoms include:
  • Upper abdominal pain that radiates into the back
  • Nausea and vomiting
  • Fever
  • Increased heart rate

Symptoms of chronic pancreatitis are similar to above, with addition of:

  • Diarrhea
  • Weight loss
  • Diabetes 
  • Chronic abdominal pain

    2. Where is pancreatitis pain located?
    Pain is usually located in the upper abdomen, with pain radiating to the back.

3. What are the most common causes of pancreatitis?
Acute and chronic pancreatitis are most often caused by gallstones or heavy alcohol use. Acute pancreatitis can also be caused by metabolic disorders, medications, immune disorders, pancreatic cancer, trauma, and surgery. Chronic pancreatitis can also be caused by hereditary disorders of the pancreas, cystic fibrosis, high triglycerides, and anatomical abnormalities of the pancreas.

Diagnosis and treatment:

  1. How is pancreatitis diagnosed?
    Acute pancreatitis can typically be diagnosed with a simple blood test. A CT scan or MRI may also be performed. In chronic pancreatitis, urine and stool evaluation may be required, as well as other, more invasive techniques.
     
  2. What are the treatment options for pancreatitis?
    IV fluids and pain medications are the first line of treatment for acute pancreatitis. In severe cases, a patient may need to be admitted to an intensive care unit. Severe pancreatitis can result in death of pancreatic tissue, so in these cases invasive procedures may be necessary to remove damaged tissue. Chronic pancreatitis may require oral pancreatic enzymes. 
     
  3. How long does it take to recover from acute pancreatitis?
    Depending on the severity of your case, pancreatitis can be resolved in as little as a few days. In severe cases, it can take three to six weeks to fully recover. 
     
  4. How does diet effect pancreatitis?
    Cutting back on the foods that cause gallstones can help reduce your risk of pancreatitis. Likewise, curbing your drinking can help keep the disease at bay. In general, a low-fat diet filled with fruits, vegetables, and whole grains is your best bet for avoiding pancreatitis.

Pancreatic Cancer – Diagnosis and treatment

  1. What are the symptoms of pancreatic cancer? 
    Unfortunately, symptoms of pancreatic cancer do not typically appear until the disease is advanced, but early detection is key. Some symptoms include:
    • Sudden onset diabetes
    • Weight loss 
    • Jaundice (yellow skin)
    • Fatty (floating) stools
    • Abdominal pain
    • Acute pancreatic after age 60
  2. How is pancreatic cancer diagnosed?
    A CT scan or MRI is often performed to find the mass and then a biopsy is done with an endoscopic ultrasound (EUS) or endoscopic retrograde cholangiopancreatography (ERCP).
     
  3. Is pancreatitis related to pancreatic cancer?
    Chronic pancreatitis can increase your risk of developing pancreatic cancer, but most people with chronic or acute pancreatitis do not develop pancreatic cancer. Unexplained acute pancreatitis in older adults may be a sign of pancreatic cancer.
     
  4. Are pancreatic cysts precancerous?
    Most pancreatic cysts are benign, but some are precancerous and should be discussed with a physician.
     
  5. Is there a screening test for pancreatic cancer? 
    No pancreatic screenings are recommended for people of average risk. However, in cases where there is a family history, genetic testing and screening is sometimes recommended.
     
  6. What are treatment options for pancreatic cancer?
    There are five treatment options for pancreatic cancer:
  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Chemoradiation therapy
  • Targeted therapy


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