Pancreatitis is inflammation of the pancreas, an organ that produces several enzymes to aid in the digestion of food, as well as the hormone insulin, which controls the level of sugar (glucose) in the blood. The pancreas is located in the upper abdomen, behind the stomach. When the pancreas is inflamed, the body is not able to absorb the nutrients it needs.
Pancreatitis may be either acute (sudden and severe) or chronic. Both types of pancreatitis can cause bleeding and tissue death in or around the pancreas. Mild attacks of acute pancreatitis can improve on their own, or with dietary changes. In the case of recurring pancreatitis, however, long-term damage to the pancreas is common, sometimes leading to malnutrition and diabetes.
Necrotizing pancreatitis (in which pancreatic tissue dies) can lead to cyst-like pockets and abscesses. Because of the location of the pancreas, inflammation spreads easily. In severe cases, fluid-containing toxins and enzymes leak from the pancreas through the abdomen. This can damage blood vessels and lead to internal bleeding, which may be life threatening.
Common signs and symptoms of pancreatitis include the following:
- Mild to severe, ongoing, sharp pain in the upper abdomen that may radiate to back or chest
- Nausea and vomiting
- Abdominal tenderness
- Rapid heart rate
- Rapid breathing
- Oily stools (chronic pancreatitis)
- Weight loss
What Causes Pancreatitis?
There are several possible causes of pancreatitis. The most common are gallstones, which block the duct of the pancreas (for acute pancreatitis), and excessive alcohol consumption (for chronic pancreatitis).
- Certain drugs, including azathioprine, sulfonamides, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics such as tetracycline
- Infection with mumps, hepatitis virus, rubella, Epstein-Barr virus (the cause of mononucleosis), and cytomegalovirus
- Abnormalities in the structure of the pancreas or the pancreatic or bile ducts, including pancreatic cancer
- High levels of triglycerides (fats) in the blood
- Surgery to the abdomen, heart, or lungs that temporarily cuts off blood supply to the pancreas, damaging tissue
- Hereditary diseases, such as cystic fibrosis
- Injury to the abdomen
- Chronic alcohol abuse. Interestingly, risk of acute pancreatitis has been linked with the amount of spirits consumed on a single occasion, but not with wine or beer consumption.
Acute pancreatitis may require hospitalization, where you will receive medication for pain. You will also fast to allow the pancreas to rest and stabilize. You will receive intravenous fluids and nutrition (parenteral nutrition). If you have gallstones, your doctor may recommend surgery or other procedures to remove them.
People with chronic pancreatitis may require treatment for alcohol addiction, if that is the cause. Treatment also includes pain management, enzyme supplements, and dietary changes. Treatment for patients who have pancreatitis due to high triglyceride levels includes weight loss, exercise, eating a low-fat diet, controlling blood sugar (if you have diabetes), and avoiding alcohol and medications that can raise triglycerides, such as thiazide diuretics and beta-blockers.
Different types of surgical procedures may be necessary depending on the cause of the pancreatitis. People who have pancreatic necrosis (tissue death) almost always require surgery to remove damaged and infected tissue. Surgery may also be required to drain an abscess. For chronic pancreatitis with pain that will not respond to treatment, doctors may need to remove a section of the pancreas. If the pancreatitis is a result of gallstones, a procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be necessary. In ERCP, a specialist inserts a tube-like instrument through the mouth and down into the duodenum to access the pancreatic and biliary ducts.