Pancreatitis is pain and swelling (inflammation) of the pancreas. Acute pancreatitis is a temporary condition that can cause severe abdominal pain, and often involves a short hospital stay. Chronic pancreatitis is an ongoing condition that results from permanent damage to the pancreas. In time, the pancreas may stop producing the enzymes your body needs to digest and absorb nutrients from food.
The most common symptom of pancreatitis is severe pain in the upper abdomen, sometimes spreading to the back. This pain may come on suddenly, or develop over a period of time. Other symptoms may include:
- Jaundice (yellowing of the skin and the whites of the eyes)
- Clammy skin
- Weight loss
Sitting up and leaning forward may sometimes relieve the pain of pancreatitis.
The main causes of acute pancreatitis are gallstones, gallbladder (biliary) disease, and the effects of long-time alcohol use. A gallstone can block one of the ducts leading from the gallbladder or pancreas, and change the behavior of the enzymes created by the pancreas. These enzymes will digest the pancreatic tissue - instead of the food they normally digest - and cause pain and swelling.
Repeated cases of acute pancreatitis can permanently damage the pancreas, and lead to chronic pancreatitis. Chronic pancreatitis is also caused by the effects of long-time alcohol use.
Your doctor may perform one or more of the following tests to see if you have pancreatitis:
- A blood test, to check if digestive enzymes have leaked into your blood. This happens when the pancreas is inflamed, or if a gallstone has blocked a duct from the pancreas.
- An abdominal ultrasound, which uses sound waves to create images of your internal organs
- An endoscopic ultrasound allows your doctor to place an ultrasound probe inside the digestive (GI) tract, very close to an area where you might have problems. These images are far more detailed than those of a traditional ultrasound. You will be given medication to make you relaxed and drowsy, and will need someone to drive you home after the procedure.
- An abdominal CT (Computed Tomography) scan, which will show if your pancreas has become enlarged
- Endoscopic retrograde cholangiopancreatography (ERCP) uses a thin, flexible tube with a tiny video camera on the end to find problems in the liver, bile ducts, and pancreas. The test uses X-rays and a liquid dye to locate gallstones, tumors, and other problems. In some cases, these problems can be treated at the same time.
Most patients with acute pancreatitis are hospitalized for a short time, where they will be given supplemental nutrition, intravenous fluids, and pain medications.
In some cases, endoscopic retrograde cholangiopancreatography (ERCP) is needed to remove gallstones or other obstructions near the pancreas. ERCP uses a thin, flexible tube with a tiny video camera on the end to find problems. A doctor can use a special, tiny tool to remove or repair any blockages.
In severe cases, surgery may be necessary to remove permanently damaged pancreatic tissue.
Patients with chronic pancreatitis can manage their symptoms in several ways:
- Eating a low-fat diet
- Adding vitamins and calcium to their diet
- Taking enzymes to replace the ones their pancreas is not producing
- Taking mild medicines to manage their pain
- Avoiding all alcoholic drinks
- Keeping track of blood sugar levels, since the pancreas is no longer producing the insulin it needs to regulate blood sugar