2. Pancreatitis is inflammation in the pancreas. The
pancreas is a long, flat gland that sits tucked behind
the stomach in the upper abdomen.
The pancreas produces enzymes that help digestion
and hormones that help regulate the way body
processes sugar (glucose).
Pancreatitis can occur as acute pancreatitis —
meaning it appears suddenly and lasts for days. Or
pancreatitis can occur as chronic pancreatitis, which
is pancreatitis that occurs over many years.
3. Cause
s
•
Gallstone
s
•
Abdominal surger
y
•
Certain medication
s
•
Cigarette smoking and alcoho
l
•
Cystic
fi
brosi
s
•
Family history of pancreatiti
s
•
High calcium levels in the blood (hypercalcemia
)
•
High triglyceride levels in the blood (hypertriglyceridemia
)
•
Infectio
n
•
Injury to the abdome
n
•
Pancreatic cance
r
. Endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to
treat gallstones, also can lead to pancreatitis.
5. Symptom
s
Signs and symptoms of pancreatitis may vary, depending on which type experience
.
Acute pancreatitis signs and symptoms include
:
•
Upper abdominal pai
n
•
Abdominal pain that feels worse after eatin
g
•
Feve
r
•
Rapid puls
e
•
Nause
a
•
Vomitin
g
•
Tenderness when touching the abdome
n
Chronic pancreatitis signs and symptoms include:
•
Upper abdominal pai
n
•
Losing weight without tryin
g
•
Oily, smelly stools (steatorrhea)
6. Complication
s
Pancreatitis can cause serious complications, including
:
•
Pseudocyst. Acute pancreatitis can cause
fl
uid and debris to collect in
cyst-like pockets in pancreas. A large pseudocyst that ruptures can cause
complications such as internal bleeding and infection
.
•
Infection. Pancreatitis can make pancreas vulnerable to bacteria and
infection. Pancreatic infections are serious and require intensive
treatment, such as surgery to remove the infected tissue
.
•
Malnutrition. Both acute and chronic pancreatitis can cause pancreas to
produce fewer of the enzymes that are needed to break down and
process nutrients from the food. This can lead to malnutrition, diarrhea
and weight loss, even though may be eating the same foods or the same
amount of food.
7. •
Kidney failure. Acute pancreatitis may cause kidney failure,
which can be treated with dialysis if the kidney failure is severe
and persistent
.
•
Breathing problems. Acute pancreatitis can cause chemical
changes in body that affect lung function, causing the level of
oxygen in blood to fall to dangerously low levels
.
•
Diabetes. Damage to insulin-producing cells in pancreas from
chronic pancreatitis can lead to diabetes, a disease that affects the
way body uses blood sugar
.
•
Pancreatic cancer. Long-standing infl
ammation in pancreas
caused by chronic pancreatitis is a risk factor for developing
pancreatic cancer.
8. Diagnosi
s
Tests and procedures used to diagnose pancreatitis include
:
•
Blood tests to look for elevated levels of pancreatic enzyme
s
•
Stool tests in chronic pancreatitis to measure levels of fat that could
suggest digestive system isn't absorbing nutrients adequatel
y
•
Computerized tomography (CT) scan to look for gallstones and assess
the extent of pancreas in
fl
ammatio
n
•
Abdominal ultrasound to look for gallstones and pancreas in
fl
ammatio
n
•
Endoscopic ultrasound to look for in
fl
ammation and blockages in the
pancreatic duct or bile duc
t
•
Magnetic resonance imaging (MRI) to look for abnormalities in the
gallbladder, pancreas and ducts
9. Treatmen
t
Initial treatments in the hospital may include
:
•
Fasting. Stop eating for a couple of days in the hospital in
order to give pancreas a chance to recover. Once the
in
fl
ammation in pancreas is controlled, may begin drinking
clear liquids and eating bland foods. With time, can go back to
normal diet
.
•
Pain medications. Pancreatitis can cause severe pain. Health
care team will give medications to help control the pain
.
•
Intravenous (IV)
fl
uids. As body devotes energy and
fl
uids to
repairing pancreas.
10. Once pancreatitis is under control, health care team can treat the underlying
cause of pancreatitis. Depending on the cause of pancreatitis, treatment may
include
:
•
Procedures to remove bile duct obstructions. A procedure called
endoscopic retrograde cholangiopancreatography (ERCP) uses a long tube
with a camera on the end to examine pancreas and bile ducts. The tube is
passed down throat, and the camera sends pictures of digestive system to a
monitor. ERCP can aid in diagnosing problems in the bile duct and pancreatic
duct and in making repairs
.
•
Gallbladder surgery. If gallstones caused pancreatitis, doctor may
recommend surgery to remove gallbladder (cholecystectomy)
.
•
Pancreas surgery. Surgery may be necessary to drain
fl
uid from pancreas or
to remove diseased tissue
.
•
Treatment for alcohol dependence.
11. Additional treatments for chronic pancreatiti
s
Depending on situation, chronic pancreatitis may require additional
treatments, including
:
•
Pain management. Chronic pancreatitis can cause persistent
abdominal pain. Doctor may recommend medications to control
pain and may refer to a pain specialist. Severe pain may be
relieved with options such as endoscopic ultrasound or surgery to
block nerves that send pain signals from the pancreas to the brain
.
•
Enzymes to improve digestion. Pancreatic enzyme supplements
can help body break down and process the nutrients in the foods.
Pancreatic enzymes are taken with each meal.
12. Lifestyle and home remedie
s
Once you leave the hospital, you can take steps to continue your recovery from
pancreatitis, such as
:
•
Stop drinking alcohol. If you're unable to stop drinking alcohol on your own,
ask your doctor for help. Your doctor can refer you to local programs to help
you stop drinking
.
•
Stop smoking. If you smoke, quit. If you don't smoke, don't start. If you can't
quit on your own, ask your doctor for help. Medications and counselling can
help you quit smoking
.
•
Choose a low-fat diet. Choose a diet that limits fat and emphasises fresh
fruits and vegetables, whole grains, and lean protein
.
•
Drink more
fl
uids. Pancreatitis can cause dehydration, so drink more
fl
uids
throughout the day. It may help to keep a water bottle or glass of water with
you.
13.
14. Why do elevated triglycerides cause acute pancreatitis? The exact
mechanism is unclear but it is thought to involve increased
concentrations of chylomicrons in the blood. Chylomicrons are
usually formed 1-3 hours post-prandially and cleared within 8 hours.
However, when triglycerides levels exceed 1,000mg/dL,
chylomicrons are almost always present. These low density particles
are very large and may obstruct capillaries leading to local ischemia
and acidemia. This local damage can expose triglycerides to
pancreatic lipases. The degradation of triglycerides to free fatty acids
can lead to cytotoxic injury resulting in further local injury that
increases in
fl
ammatory mediators and free radicals, eventually
manifesting as pancreatitis.
