Get the facts on acute and chronic pancreatitis
Learn the signs and symptoms of pancreatitis with this review. If you have the condition, it’s important that you be diagnosed and treated without delay.
What Is the Pancreas?
Your pancreas is a large gland behind your stomach and close to your duodenum. The pancreas secretes powerful digestive enzymes that enter the small intestine through a duct. These enzymes help you digest fats, proteins, and carbohydrates. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones play an important part in metabolizing sugar.Pancreatitis is a disease in which the pancreas becomes inflamed. Damage to the gland occurs when digestive enzymes are activated and begin attacking the pancreas. In severe cases, there may be bleeding into the gland, serious tissue damage, infection, and cysts. Enzymes and toxins may enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidneys.There are two forms of pancreatitis. The acute form occurs suddenly and may be a severe, life-threatening illness with many complications. Usually, the patient recovers completely. If the injury to the pancreas continues, such as when a patient persists in drinking alcohol, a chronic form of the disease may develop, bringing severe pain and reduced functioning of the pancreas that affects digestion and causes weight loss.
What Is Acute Pancreatitis?
An estimated 50,000 to 80,000 cases of acute pancreatitis occur in the United States each year. This disease occurs when the pancreas suddenly becomes inflamed and then gets better. Some patients have more than one attack but recover fully after each one.Most cases of acute pancreatitis are caused either by alcohol abuse or by gallstones. Other causes may be the use of prescribed drugs, trauma or surgery to the abdomen or abnormalities of the pancreas or intestine. In rare cases, the disease may result from infections, such as mumps. In about 15 percent of cases, the cause is unknown.
What Are the Symptoms of Acute Pancreatitis?
Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days. The pain is often severe. It may be constant pain, just in the abdomen, or it may reach to the back and other areas.The pain may be sudden and intense, or it may begin as a mild pain that is aggravated by eating and slowly grows worse. The abdomen may be swollen and very tender. Other symptoms may include nausea, vomiting, fever and an increased pulse rate. The person often feels and looks very sick.About 20 percent of cases are severe. The patient may become dehydrated and have low blood pressure. Sometimes the patient’s heart, lungs or kidneys fail. In the most severe cases, bleeding can occur in the pancreas, leading to shock and sometimes death.
How Is Acute Pancreatitis Diagnosed?
During acute attacks, high levels of amylase (a digestive enzyme formed in the pancreas) are found in the blood. Changs may also occur in blood levels of calcium, magnesium, sodium, potassium, and bicarbonate.Patients may have high amounts of sugar and lipids (fats) in their blood too. These changes help the doctor diagnose pancreatitis. After the pancreas recovers, blood levels of these substances usually return to normal.
What Is the Treatment for Acute Pancreatitis?
The treatment a patient receives depends on how bad the attack is. Unless complications occur, acute pancreatitis usually gets better on its own, so treatment is supportive in most cases. Usually, the patient goes into the hospital.The doctor prescribes fluids by vein to restore blood volume. The kidneys and lungs may be treated to prevent failure of those organs. Other problems, such as cysts in the pancreas, may need treatment too.Sometimes a patient cannot control vomiting and needs to have a tube through the nose to the stomach to remove fluid and air. In mild cases, the patient may not have food for three or four days but is given fluids and pain relievers by vein.An acute attack usually lasts only a few days, unless the ducts are blocked by gallstones. In severe cases, the patient may be fed through the veins for three to six weeks while the pancreas slowly heals.
What If the Patient Has Gallstones?
Ultrasound is used to detect gallstones and sometimes can provide the doctor with an idea of how severe the pancreatitis is. When gallstones are found, surgery is usually needed to remove them. When they are removed depends on how severe the pancreatitis is. If it is mild, the gallstones often can be removed within a week or so. In more severe cases, the patient may wait a month or more, until he improves, before the stones are removed.
What Is Chronic Pancreatitis?
Chronic pancreatitis has many causes but 70 to 80 percent of cases are due to chronic alcohol abuse. It may develop after only one acute attack, especially if the ducts of the pancreas become damaged. Damage to the pancreas from drinking alcohol may cause no symptoms for many years, and then the patient suddenly has an attack of pancreatitis.