What Is Pancreatitis?
The pancreas is a large gland behind your stomach and next to your small intestine. Your pancreas does two main things:
- It releases powerful digestive enzymes into your small intestine to help you digest food.
- It releases insulin and glucagon into your bloodstream. These hormones help your body control how it uses food for energy.
Your pancreas can be damaged when digestive enzymes begin working before your pancreas releases them.
Types of Pancreatitis
The two forms of pancreatitis are acute and chronic.
- Acute pancreatitis is sudden inflammation that lasts a short time. It can range from mild discomfort to a severe, life-threatening illness. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can cause bleeding, serious tissue damage, infection, and cysts. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.
- Chronic pancreatitis is long-lasting inflammation. It most often happens after an episode of acute pancreatitis. Another top cause is drinking lots of alcohol for a long period of time. Damage to your pancreas from heavy alcohol use may not cause symptoms for many years, but then you may suddenly have severe pancreatitis symptoms.
Symptoms of acute pancreatitis
- Higher heart rate
- Nausea and vomiting
- Swollen and tender belly
- Pain in the upper part of your belly that goes into your back. Eating may make it worse, especially foods high in fat.
Symptoms of chronic pancreatitis
The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. But you may also have:
- Constant pain in your upper belly that radiates to your back. This pain may be disabling.
- Diarrhea and weight loss because your pancreas isn’t releasing enough enzymes to break down food
- Upset stomach and vomiting
Pancreatitis Causes and Risk Factors
Acute pancreatitis causes include:
- Autoimmune diseases
- Drinking lots of alcohol
- Metabolic disorders
In up to 15% of people with acute pancreatitis, the cause is unknown.
Chronic pancreatitis causes include:
- Cystic fibrosis
- Family history of pancreas disorders
- High triglycerides
- Longtime alcohol use
In about 20% to 30% of cases, the cause of chronic pancreatitis is unknown. People with chronic pancreatitis are usually men between ages 30 and 40.
Pancreatitis can have severe complications, including:
- Diabetes if there’s damage to the cells that produce insulin
- Infection of your pancreas
- Kidney failure
- Malnutrition if your body can’t get enough nutrients from the food you eat because of a lack of digestive enzymes
- Pancreatic cancer
- Pancreatic necrosis, when tissues die because your pancreas isn’t getting enough blood
- Problems with your breathing when chemical changes in your body affect your lungs
- Pseudocysts, when fluid collects in pockets on your pancreas. They can burst and become infected.
To diagnose acute pancreatitis, your doctor tests your blood to measure two digestive enzymes: amylase and lipase. High levels of these two enzymes mean you probably have acute pancreatitis.
Other tests can include:
- Pancreatic function test to find out whether your pancreas is making the right amounts of digestive enzymes
- Ultrasound, CT scan, and MRI, which make images of your pancreas
- ERCP, in which your doctor uses a long tube with a camera on the end to look at your pancreatic and bile ducts
- Biopsy, in which your doctor uses a needle to remove a small piece of tissue from your pancreas to be studied
In some cases, your doctor may test your blood and poop to confirm the diagnosis. They may also do a glucose tolerance test to measure damage to the cells in your pancreas that make insulin.
Treatment for acute pancreatitis
You’ll probably need to stay in the hospital, where your treatment may include:
- Antibiotics if your pancreas is infected
- Intravenous (IV) fluids, given through a needle
- Low-fat diet or fasting. You might need to stop eating so your pancreas can recover. In this case, you’ll get nutrition through a feeding tube.
- Pain medicine
If your case is more severe, your treatment might include:
- ERCP to take out gallstones if they’re blocking your bile or pancreatic ducts
- Gallbladder surgery if gallstones caused your pancreatitis
- Pancreas surgery to clean out fluid or dead or diseased tissue
Treatment for chronic pancreatitis
If you have chronic pancreatitis, you might need more treatments, including:
- Insulin to treat diabetes
- Pain medicine
- Pancreatic enzymes to help your body get enough nutrients from your food
- Surgery or procedures to relieve pain, help with drainage, or treat blockages
Because many cases of pancreatitis are caused by alcohol abuse, prevention often focuses on limiting how much you drink or not drinking at all. If your drinking is a concern, talk to your doctor or health care professional about an alcohol treatment center. A support group such as Alcoholics Anonymous could also help.
Stop smoking, follow your doctor's and dietitian's advice about your diet, and take your medications so you’ll have fewer and milder attacks of pancreatitis.