What is pancreatitis?
Pancreatitis is the
redness and swelling (inflammation) of the pancreas. This happens when
digestive juices or enzymes attack the pancreas.
The pancreas lies behind
your stomach on the left side of your belly. It is close to the first part of
your small intestine (the duodenum).
Acute
pancreatitis
- Is a sudden
inflammation
- Lasts for a
short time
- Lets the
pancreas return to normal afterward
- May cause
serious problems or be deadly in severe cases
Chronic
pancreatitis
- Is a
long-lasting inflammation that comes and goes over time
- Causes
permanent damage to the pancreas
- Often
causes scarring of pancreatic tissue
- May cause
the pancreas to stop making enzymes and insulin in severe cases
What causes pancreatitis?
The most common causes of pancreatitis include:
- Alcohol
abuse
- Lumps of
solid material (gallstones) found in the gallbladder. Gallstones block the
pancreatic duct so the enzymes can’t get out of the pancreas.
Other
causes of pancreatitis include:
- Belly
injury or surgery
- High levels
of fat particles (triglycerides) in the blood
- Very high
levels of calcium in the blood
- Certain
medicines, such as estrogens, steroids, and thiazide diuretics
- Infections,
such as mumps, hepatitis A or B, or salmonella
- Cystic
fibrosis
- A tumor
- Certain
genetic defects
- Congenital
abnormalities in the pancreas
- Trauma to
the pancreas
- Cigarette
smoking
What are the symptoms of pancreatitis?
Each person’s symptoms
may vary. Symptoms may include:
- Severe belly pain that may spread to your back or chest
(it may feel worse after you eat)
- Nausea
- Vomiting
- Rapid heart rate
- Fever
- Swelling and feeling sore or tender in your upper belly
- Fluid buildup in your belly
- Lowered blood pressure
- Yellowing of the skin and eyes (jaundice)
The symptoms of
pancreatitis may look like other health problems. Always see your healthcare
provider to be sure.
How is pancreatitis
diagnosed?
Your healthcare provider
will look at your past health. He or she will give you a physical exam.
You may have some blood
tests done. You may also have some imaging tests including:
·
Belly
X-ray. Makes images of
internal tissues, bones, and organs.
·
Ultrasound
(also called sonography). Uses sound waves to see the internal organs of the belly. It
also checks how blood is flowing through different blood vessels.
·
EUS
(endoscopic ultrasound). This
is an internal type of ultrasound done through a flexible tube (endoscope)
inserted through the mouth while you are sleeping.
·
ERCP
or endoscopic retrograde cholangiopancreatography. This is used to find and treat problems in
your liver, gallbladder, bile ducts, and pancreas. It uses X-ray and a long,
flexible tube with a light and camera at one end (an endoscope). The tube is
put into your mouth and throat. It goes down your food pipe (esophagus),
through your stomach, and into the first part of your small intestine
(duodenum). A dye is put your bile ducts through the tube. The dye lets the
bile ducts be seen clearly on X-rays.
·
CT
scan (computed tomography scan). This imaging test shows detailed images of any part of the body
such as the bones, muscles, fat, and organs. CT scans are more detailed than
regular X-rays.
·
MRCP
(magnetic resonance cholangiopancreatography). This uses MRI (magnetic resonance imaging) to
make detailed images of your pancreas, gallbladder, and pancreatic and bile
ducts. A dye is shot (injected) into your vein so that the images can be seen
more clearly.
How is pancreatitis treated?
The treatment goal is to
rest the pancreas and let it heal.
In most cases, you:
- Will be in the hospital for a few days
- Will be given IV (intravenous) fluids
- Will be given pain medicine and medicines that fight
bacterial infections (antibiotics)
- If mild, you may be able to eat clear liquids or a
low-fat diet. However, if severe, you may not be able to eat or drink for
a few days to let your pancreas rest. A feeding tube may need to be used
in some situations.
Pancreatitis often gets
better in a few days.
If any problems happen,
treatment may include:
- NG tube (nasogastric tube). This is a thin tube passed down your nose and into your
stomach. It is used if vomiting is a problem. The tube can be used for a
few weeks. It can be used to remove fluid and air and give your pancreas
more time to heal. It can also be used to put liquid food into your
stomach as you heal.
- ERCP (endoscopic retrograde cholangiopancreatography). This is used to find and treat problems in your
liver, gallbladder, bile ducts, and pancreas. It uses X-ray and a long,
flexible, lighted tube (an endoscope). The tube is put into your mouth and
throat. It goes down your food pipe (esophagus), through your stomach, and
into the first part of your small intestine (duodenum). A dye is injected
into the bile ducts through the tube. The dye lets the bile ducts be seen
clearly on X-rays. The tube has tools in it. The tools can remove fluid
and blockages and take out gallstones. They can also put stents (firm
tubes) in the ducts to keep them open.
- Surgery to remove gallstones or your gallbladder. This is done if gallstones or your gallbladder
are causing pancreatitis.
If you have chronic
pancreatitis you may also:
- Have to avoid alcohol (if your pancreatitis is caused
by alcohol abuse)
- Have to stop smoking
- Need enzyme supplements to help digest your food
- Need insulin (if you get diabetes)
- Need to eat small high-protein, low-fat meals
- Need surgery to remove the permanently damaged part of
your pancreas. In advanced situations, a special transplant called islet
cell transplant is done.
- Need medicine for chronic pain
Medicine that causes pancreatitis
The following drugs seem to cause pancreatitis: azathioprine,
thiazides, sulfonamides, furosemide, estrogens, and tetracycline. Less convincing, but suggestive evidence exists for:
1-asparaginase, iatrogenic hypercalcemia, chlorthalidine, corticosteroids,
ethacrynic acid, phenformin, and procainamide And statine group.
