Pancreatitis is inflammation of the pancreas. The pancreas lies behind the stomach and it has a double function: (1) creating insulin and glucagon for sugar metabolism; (2) producing enzymes or chemicals that enter into the small intestine for the digestion of food.
In pancreatitis, the digestive enzymes contained within the gland escape into the unprotected surrounding tissues, which they proceed to digest and destroy. This results in considerable swelling or inflammation. This can be very serious and sometimes fatal. Repeated attacks eventually will further damage the pancreas and may result in the chronic or permanent form of the disease.
Causes
- Alcohol is by far the leading cause of chronic damage. It irritates the cells and blocks tiny tubes in the organ.
- Gallstones can block the bile duct. This traps juices and causes swelling. This is the top cause of acute attacks.
- Other factors that are thought to contribute to the disease include nutritional deficiencies.
- Prolonged use of certain drugs, such as diuretics and oral contraceptives.
- Cigarette smoking raises your chance of hurting the pancreas, especially when mixed with alcohol.
- Hereditary pancreatitis can occur.
What are the symptoms of pancreatitis?
Attacks of acute pancreatitis are usually signaled by severe abdominal pain and swelling. Other symptoms include vomiting, constipation, fever and jaundice. In very severe cases, the pancreas may bleed, resulting in shock. The level of pancreatic enzymes in the blood quickly rises above normal a few hours after the onset of acute pancreatitis.
In the chronic form of the disease, abdominal pain may be constant. A history of previous attacks of acute pancreatitis is the best lead to the diagnosis of chronic pancreatitis. The chronic patient is often diabetic with impaired digestion, resulting in steatorrhea, that is, increased excretion of fat in the stools.
Despite a normal appetite, weight loss is common, due to malabsorption of food resulting from destruction of the pancreas and the lack of pancreatic enzymes. If the pancreas has been excessively damaged, it may be unable to produce sufficient insulin and diabetes may develop.
Management
For the relief of pain, analgesic drugs and narcotics are usually prescribed. In milder cases, this may be the only treatment required. In severe cases, specifically in those involving shock, blood transfusion and fluid replacement may be necessary. In those relatively few cases that do not respond to treatment, become infected or where hemorrhage occurs, surgery may be indicated. With prompt and proper treatment, patients with mild to moderate acute pancreatitis usually recover in several days. To prevent future attacks, abstinence is strongly advised. If the condition is caused by some other factor, such as gallstones or a metabolic disturbance, this is corrected surgically or medically.
Pancreatitis is a severe illness with several forms.
Acute pancreatitis typically causes severe abdominal pain, often associated with nausea and vomiting. Because pancreatitis can be severe and life-threatening, antibiotics and hospital care may be required. In severe cases of acute pancreatitis, shock may occur, requiring intensive care and supportive therapy.
Gallstone pancreatitis is caused by irritation of the pancreas by gallstones in the pancreatic duct. Jaundice (yellowing of the skin) may occur with this type of pancreatitis. Cholecystectomy (surgical removal of the gallbladder) is necessary to prevent gallstone pancreatitis from occurring again. Because acute gallstone pancreatitis may be a severe illness, several days of supportive care (which may include antibiotics and intravenous fluids in the hospital) may be required before a person is ready to have the gallbladder removed.
Chronic pancreatitis is inflammation and scarring of the pancreas that occurs over a long period. Heavy alcohol use is a common cause. Persons with chronic pancreatitis may have abdominal pain that is either constant or episodic (comes and goes). Scarring in the pancreas destroys insulin-producing cells, leading to diabetes. Persons who have acute or chronic pancreatitis may develop a complication called a pseudocyst. This is a fluid collection in or around the pancreas. It may push on or cause pressure on other abdominal organs, creating other symptoms. These pseudocysts can also become infected, causing serious illness.
Note: The materials presented in this section are for general information and do not substitute for medical advice. Patients have the right to receive accurate, easily understood information about their health plans, professionals, and facilities, and to a choice of health care providers sufficient to ensure access to appropriate high-quality health care.