Symptoms and Treatment of Pancreatitis

Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland close to the duodenum and behind the stomach.

Acute pancreatitis is a sudden inflammation of the pancreas that causes severe abdominal pain. It usually resolves itself in a short time with the proper medical treatment.

Most people do not have pain with chronic pancreatitis. For those people that do have pain, the pain is usually severe, however; as the condition worsens, pain often goes away. This is not a good sign as it means the pancreas has probably stopped working.

Pancreatitis occurs in men and women, although men are more likely to have chronic pancreatitis. Children are rarely affected.

What causes pancreatitis?

The most common causes of acute pancreatitis are alcoholism and gallstones. Gallstones block the pancreatic duct, trapping digestive enzymes in the pancreas. Other causes can be abdominal trauma, surgery, elevated triglycerides, infection, trauma and some prescription drugs.

Chronic pancreatitis is most commonly caused by alcoholism and alcohol abuse, but sometimes the cause cannot be determined.

What are the symptoms?

Acute pancreatitis usually begins with pain in the upper abdomen. Mild pain may be experienced after eating, or severe pain can come on suddenly and may radiate to the back and other areas.

Acute pancreatitis symptoms may include:

Severe abdominal pain
Abdominal swelling and tenderness
Nausea
Vomiting
Fever
Rapid Pulse

Chronic pancreatitis symptom can be identical to those of acute pancreatitis and tend to follow one of two patterns. In one pattern, the patient has persistent mid-abdominal pain that varies in intensity. This pattern is more likely caused by a cyst, an inflammatory mass or pancreatic cancer. In the second pattern, a person has intermittent bouts of pain, with symptoms similar to those of mild or moderate pancreatitis. The pain can last for hours or days.

Symptoms of chronic pancreatitis:

Upper abdominal pain
Back pain
Nausea
Vomiting
Weight Loss
Pale, Fatty Stools
Fever
Sweating

How is pancreatitis diagnosed?
A doctor diagnoses pancreatitis by doing a complete physical exam, asking questions about your symptoms and past health, and by blood tests. Blood tests will show if your enzymes are elevated- signs of possible pancreatitis. A CBC (complete blood count), stool analysis, and urine tests may also be ordered.

If blood and lab tests don't confirm a diagnosis of pancreatitis, your doctor may request an ultrasound or CT scan of your abdomen to examine your pancreas and check for gallstones or a duct problem.

An x-ray of the bile and pancreatic ducts is sometimes used to help diagnose chronic pancreatitis. For this procedure, the doctor gently threads an endoscope, a small, flexible tube with a light, down your throat and through your stomach to the opening of the bile and pancreatic ducts in your duodenum. Dye passed through a thin, flexible tube in the endoscope allows x-ray images of the ducts.

How is pancreatitis treated?

Acute pancreatitis usually requires hospitalization. Mild cases are usually given analgesics for pain, and fast in order to rest the pancreas. Normal eating can usually resume in two to three days.

Those with moderate pancreatitis receive intravenous drugs to control pain and nausea, with intravenous fluids given as well. People with severe acute pancreatitis are admitted to the intensive care unit, where vital signs and urine production can be continuously monitored.

Severe cases of acute pancreatitis can lead to a number of complications including:

Infection- A damaged pancreas can become infected with bacteria from the small intestine. Symptoms of infection include fever and an elevated white count. Intensive treatment includes drainage or surgery to remove the infected tissue.

Abscess- A collection of pus forms in or near your pancreas. Treatment involves draining the abscess by catheter or surgery.

Pseudocysts- Collections of pancreatic fluid and tissue debris form within your pancreas or an obstructed duct. No special care is needed for a small cyst, but large, bleeding, infected cysts need immediate medical attention.

Shock- If your blood pressure is too low, your organs fail and if left untreated, death can occur within minutes.

Severe cases of chronic pancreatitis can lead to a number of complications including:

Bleeding
Malnutrition and weight loss
Diabetes
Drug addiction from pain medication
Pancreatic cancer

The goals of treatment of chronic pancreatitis are pain relief, correct poor pancreatic function, and managing complications. Simple measures for pain control include:

Avoiding alcohol
Eat small, low fat meals
Non-narcotic analgesics
Pancreatic enzyme supplements
Prescription narcotic analgesics (if pancreatic enzymes fail to relieve pain)