Acute Pancreatitis

Pancreas is a gland present behind the stomach in the upper abdominal region. It secretes enzymes and hormones that aid in digestion, breakdown of nutrients and regulation of glucose in the body. Inflammation of this gland is known as pancreatitis.

Pancreatitis is of two types namely, acute and chronic. Acute pancreatitis has a sudden onset and lasts for days to months whereas chronic pancreatitis develops gradually over years and lasts for comparatively a more long time.

Globally, 17 million cases of pancreatitis occurred in 2013, and this resulted in about 123,000 deaths, up from 83,000 deaths in 1990.

The single most common cause of acute pancreatitis is gall stones, and the single most common cause of chronic pancreatitis is alcohol. These two factors contribute up to 80% of the total pancreatitis cases.

Other causes of pancreatitis include infection, trauma, hypothermia, smoking tumors, inheritance, and certain medications (such as corticosteroids, diuretics, anticonvulsants, and antipsychotics).

There are few risk factors associated with pancreatitis, the most important factors include:

  • Gender: Males are at a greater risk of developing pancreatitis compared to females.
  • Age: chronic pancreatitis starts between the ages of 30 and 40 and is rare in children.
  • Family history: Inheritance of genes which result in conditions such as cystic fibrosis result in pancreatitis.
  • Chronic alcohol and tobacco abuse: This may be the primary cause for the development of chronic pancreatitis.
  • Blockage of pancreatic duct: Auto accidents or trauma may lead to blockage of pancreatic duct also known as distal pancreatitis.

The most common signs and symptoms of pancreatitis are severe pain in the upper abdomen radiating to your back, associated with nausea and vomiting. You may even notice abdominal tenderness, reduced bowel sounds.

Fever can be seen in few cases of acute pancreatitis. Fatty stools, unintentional weight loss, and diarrhea may be seen in few cases of chronic pancreatitis.

Pancreatitis can cause serious complications such as infection, pseudocyst, diabetes, malnutrition, abscess formation, and organ failure. If the fluid levels drop suddenly, it results in hypovolemic shock which is a medical emergency. In few cases, chronic pancreatitis may also lead to pancreatic cancer.

Your doctor may initially perform a physical examination and review your medical history to diagnose the condition. Your doctor may also ask you questions about your lifestyle. Your doctor may also recommend other tests and procedures for diagnosis of pancreatitis, which include:

Blood tests – performed to evaluate blood levels of pancreatic enzymes (serum amylase and lipase).

Imaging tests – computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound to detect the presence of gallstones and inflammation of the pancreas; abdominal ultrasound is the most reliable test to confirm the diagnosis.

Stool test – performed to identify fat content in the feces.

Your doctor may confirm the condition as pancreatitis based on the diagnosis if you meet two of the following three criteria:

  • Upper abdominal pain radiating to the back
  • Elevation of pancreatic enzymes by more than three times the normal value
  • An imaging test showing characteristic changes

Management of pancreatitis often requires hospitalization (for stabilizing) followed by treatment of the underlying cause once inflammation of the pancreas is controlled.

To stabilize pancreas, your doctor may advise you to stop eating and gives pain killer medications. When the pancreatitis is controlled, you can start taking clear liquids and bland foods. Gradually, you can go for your normal diet. Intravenous fluids are administered to provide energy. In the case of chronic pancreatitis, pancreatic enzymes are prescribed in a tablet form to improve digestion. These pancreatic enzymes should be taken with each meal.

Once the pancreatitis is controlled, treatment is given to manage the underlying cause. If alcohol abuse is the main cause, your doctor recommends you to opt for a treatment program to abstain alcohol. If pancreatitis is due to the presence of gallstones, cholecystectomy is performed to remove the gallbladder. Surgery to the pancreas is performed in some cases to remove diseased tissue.

Following these measures may help you for a speedy recovery and prevents further complications:

  • Consuming diet which is low in fats
  • Eating small meals to minimize the burden on your digestive system
  • Stopping alcohol abuse to prevent further damage
  • Quitting smoking to fasten recovery
  • Trying yoga and relaxation techniques such as deep breathing to reduce pain