What Is Pancreatitis?
What Causes Pancreatitis?
In the majority of cases, acute pancreatitis is caused by gallstones and alcohol use. Other causes include medications, lipid (triglyceride) disorders, infections, surgery, or trauma to the abdomen. In up to 30% of people with pancreatitis, the cause is unknown.
In many people with chronic pancreatitis, the condition is caused by prolonged alcohol use, resulting in pancreatic damage and scarring. In other cases of chronic pancreatitis, the cause may be hereditary, gallstones, lupus, or high triglycerides. In about 25% of cases, the cause of chronic pancreatitis is unknown.
What Are the Risk Factors for Pancreatitis?
Pancreatitis can happen to anyone; however, it is more common in people with certain risk factors.
Risk factors of acute pancreatitis include:
- Gallstone disease
- Heavy alcohol consumption
Acute pancreatitis may be the first sign of gallstone disease. The link between gallstones and acute pancreatitis is the anatomical union of the ducts that drain the gallbladder and pancreas, called the ampulla or major papilla of the duodenum. The passage of gallstones from the gallbladder can become blocked at the ampulla, causing an obstruction of the pancreatic duct, which causes acute pancreatitis.
Risk factors for chronic pancreatitis include:
- Prolonged alcohol use
- Certain hereditary conditions, such as cystic fibrosis
- Conditions such as high triglycerides and lupus
People with chronic pancreatitis are usually men between the ages of 30 and 40, but chronic pancreatitis may occur in females as well.
How Is Pancreatitis Diagnosed?
Pancreatitis is primarily suspected when a person reports symptoms of pancreatitis and also has risk factors such as heavy alcohol use or gallstone disease. To confirm acute pancreatitis, the doctor measures levels in the blood of the two digestive enzymes, amylase and lipase. High levels of these two enzymes strongly suggest acute pancreatitis.
Diagnosis can be difficult but is aided by a number of techniques such as pancreatic function tests and radiographic imaging of the pancreas. In more advanced stages of the disease, when malabsorption or diabetes is present, blood, urine, and stool tests will confirm the progression.
Diagnostic tests for pancreatitis include:
Pancreatic function test, to determine if the pancreas is producing the appropriate levels of digestive enzymes
Glucose tolerance test to measure damage to the cells in the pancreas that make insulin
Ultrasound, which can produce images of the pancreas so that abnormalities may be detected
CT scan (computed tomography scan), which can produce images of the pancreas so that abnormalities may be detected
ERCP (endoscopic retrograde cholangiopancreatography) to look at the pancreatic and bile ducts using contrast and X-rays
Endoscopic ultrasound (EUS) and biopsy, an exam in which a fine needle is inserted into a localized abnormality of the pancreas to remove a small tissue sample for study.
How Is Pancreatitis Treated?
Treatment for acute pancreatitis