Pancreatitis is an inflammation of the
pancreas. It is estimated to affect 50,000 to 80,000 people a year in the United States.
Understanding the Pancreas
The pancreas is a large gland behind the stomach and close to the duodenum, the upper part of the small intestine. The pancreas secretes digestive enzymes (lipase, protease, and amylase) into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones
insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.
Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food; however, if these enzymes become active inside the pancreas, they start "digesting" the pancreas itself.
There are two types of pancreatitis:
The acute form occurs suddenly, lasts for a short period of time, and usually resolves on its own. The chronic form does not resolve itself and results in a slow destruction of the pancreas.
Either type can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts (accumulations of fluid and tissue debris) may also develop. In addition, enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.
There are many possible causes of pancreatitis. By far, the two most common causes are gallstones and alcoholism.
Symptoms of pancreatitis vary somewhat, depending on whether a person is experiencing acute or chronic symptoms.
Symptoms of this condition may include:
- Upper abdominal pain that may reach to the back or other areas
- Swollen and tender abdomen
- Nausea
- Vomiting
- Fever
- Rapid pulse.
More severe symptoms may include:
(Click Symptoms of Pancreatitis for more information.)
Besides asking about a person's medical history and doing a physical exam, a doctor may order blood or urine tests and possibly imaging tests to diagnose this condition.
Treatment options depend on a number of factors. These factors include:
Depending on the factors above, treatment may include:
- Medications
- Surgery
- Diet and lifestyle changes.
(Click Pancreatitis Treatment for more information.)
A diet for pancreatitis is one that is high in carbohydrates and low in fat. A pancreatitis diet should also include smaller, more frequent meals and no alcohol.
A doctor may prescribe
pancreatic enzymes to take with meals if the
pancreas does not secrete enough of its own. The enzymes should be taken with every meal to help the body digest food and regain some weight.
Pancreatic enzymes contain the ingredients pancreatin and pancrelipase, both of which contain the enzymes lipase, protease, and amylase. These enzymes break down fats (lipase), proteins (protease), and complex carbohydrates (amylase) to allow absorption of these nutrients into the body.
Gallstones can cause pancreatitis, and they usually require surgical removal. Ultrasound or a CAT scan can detect gallstones and can sometimes give an idea as to the severity of the pancreatitis. When gallstone surgery can be scheduled depends on the severity of the pancreatitis. If the pancreatitis is mild, gallstone surgery may proceed within about a week. More severe cases may mean gallstone surgery is delayed for a month or more.
After the gallstones are removed and inflammation goes away, the pancreas usually returns to normal.
(Click Gallstones for more information on gallstones.)
Key Facts About Pancreatitis
Remember these important facts about pancreatitis:
- Pancreatitis begins when the digestive enzymes become active inside the pancreas and start "digesting" it.
- Pancreatitis has two forms: acute and chronic.
- Common causes are gallstones or alcohol abuse. Sometimes no cause for pancreatitis can be found.
- Symptoms of acute pancreatitis include abdominal pain, nausea, vomiting, fever, and a rapid pulse.
- Treatment for acute pancreatitis can include intravenous fluids, oxygen, antibiotics, or surgery.
- Acute pancreatitis becomes chronic when pancreatic tissue is destroyed and scarring develops.
- Treatment for chronic pancreatitis includes easing the pain, eating a high-carbohydrate and low-fat diet, and taking enzyme supplements. Surgery is sometimes needed as well.
