Everything You Need to Know About Pancreatitis
Pancreatitis is a condition caused by inflammation of the pancreas. Alcohol and gallstones are most common causes of pancreatitis, characterized by abdominal pain. The pancreas is a large gland that is located behind the stomach in the upper abdominal region, close to the small intestine. It produces digestive enzymes and hormones which facilitate glucose metabolism.
Symptoms of pancreatitis
The signs and symptoms may vary based on the type of pancreatitis (acute or chronic):
Symptoms of acute pancreatitis:
- Upper abdominal pain radiating to back
- Altered mental status
- Breathing difficulty
Symptoms of chronic pancreatitis:
- Constant or episodic pain in upper abdomen lasting for several days
- Unintentional weight loss
- Oily, foul smelling stools
Types of pancreatitis
There are mainly two types of pancreatitis. These include:
- Acute pancreatitis: Inflammation of the pancreas that occurs suddenly and usually lasts for a short period of time (few days to weeks). In most cases, it is typically resolved with appropriate treatment. In severe cases, acute pancreatitis may cause complications such as bleeding, Pancreatic fluid collection, infection, jaundice etc.
- Chronic pancreatitis: Inflammation of the pancreas that occurs over a longer period of time, generally after repeated episodes of acute pancreatitis. It may last for several months to years. Alcoholic damage is the most common cause of chronic pancreatitis. However, anomalies of pancreatic duct, drugs and hereditary pancreatitis are also the reasons in few cases.
Causes of pancreatitis
Activation of digestive enzymes while they are still in the pancreas, before reaching the small intestine, leads to irritation of the pancreas cells, causing inflammation. Some of the major causes of pancreatitis include:
- Excess alcohol intake: Consumptions of high amount of alcohol causes premature activation of digestive enzymes and secretions causing blockage of pancreatic ducts.
- Gallstones: Gallstone can cause blockage of the pancreatic duct, leading to obstruction of fluid flow through the pancreas. This results in damage to the pancreas.
- Abdominal surgery: Previous abdominal surgery may lead to pancreatic injury or damage, causing pancreatitis.
- Autoimmune diseases: A condition in which your body’s own immune system attacks healthy pancreatic cells, leading to pancreatitis.
- Excessive amount of fats (triglycerides) in the blood.
- Smoking causes damage to pancreatic cells, leading to pancreatitis.
- Medications: Certain medications including specific antibiotics, corticosteroids and estrogen can result in pancreatitis.
Other indirect causes include:
- Bacterial and viral infections
- Cystic fibrosis
- Family history of pancreatitis
- Pancreatic cancer
- High calcium levels.
Treatment of pancreatitis
Management of pancreatitis is carried out in two steps: Initial management/first line treatment followed by surgery if required.
First line treatment
Fasting: Fasting provides a chance for the pancreas to recover from inflammation.
Medications: Pain medication may be prescribed to relieve intense pain caused by pancreatitis.
Intravenous (IV) fluids: Pancreatitis and fasting may lead to dehydration. Intravenous fluids are administered to prevent dehydration and weakness.
Surgical intervention is indicated in cases of bile duct obstruction, gall stones, fluid drainage from the pancreas and removal of damaged tissue.
If alcohol addiction is the causative factor of pancreatitis, alcohol rehabilitation programs may be recommended.
Frequently Asked Questions (FAQs)
What is the main cause of pancreatitis?
Gallstones and alcoholism are two of the major factors which cause premature activation of digestive juices and obstruction of pancreatic ducts, leading to pancreatitis.
Can pancreatitis be cured?
Treatment of acute pancreatitis mainly addresses the causative factors and symptoms. It may include conservative methods such as fasting, medications and IV fluids, followed by surgery if required. Chronic pancreatitis however is not curable, but manageable. Pain can be managed by medicines, endoscopic treatment or by surgery. Weight loss can be managed with pancreatic enzyme replacement therapy in the form of pills. Diabetes due to chronic pancreatitis can be managed by Insulin and metformin.
How do you calm pancreatitis?
Pancreatitis may be associated with mild to severe abdominal pain. Fasting helps the pancreas to recover from inflammation. Pain relieving medications may be prescribed based on the severity of pain.
What causes pancreatitis to flare?
Alcohol consumption, smoking, certain medications, infections, and high lipid levels can cause pancreatitis to flare up.
Dr Vishnu A Raju
MBBS, M.D (General Medicine), D.M (Gastro)
Department of Gastroenterology and Therapeutic Endoscopy