What is pancreatitis?
Pancreatitis is inflammation of the pancreas (one of the organs of your digestive system). It occurs when the digestive enzymes that your pancreas produces to break down food attack the pancreas itself.
There are two types of pancreatitis — acute (which comes on suddenly and is usually short-lived) and chronic (an ongoing condition that persists for years). Pancreatitis, especially the acute form, can be a serious condition, and almost always causes moderate to severe abdominal pain.
The main symptom of acute pancreatitis is upper abdominal pain that may feel as though it is going through to your back. The pain may be made worse by eating or drinking alcohol, and made better by sitting or bending forward.
Other common symptoms include:
- vomiting; and
Most people with chronic pancreatitis have intermittent episodes of abdominal pain that last for hours, several days or even weeks. The pain can be severe and, as with acute pancreatitis, is made worse by drinking alcohol and eating. Some people have constant pain that varies in intensity. Other symptoms include nausea and fever.
Chronic pancreatitis sufferers also have symptoms that result from long-term damage to the pancreas. Normally, your pancreas produces enzymes to help digest food, and hormones (insulin and glucagon) to regulate blood sugar levels. Inflammation of the pancreas can cause irreversible damage to the cells that perform these functions.
If your pancreas is not able to make enough digestive enzymes to properly digest food, fat and other nutrients cannot be absorbed from your intestine, resulting in fatty stools, weight loss and malnutrition. And significant damage to the insulin-producing cells can cause diabetes.
Causes of pancreatitis
Gallstones and prolonged alcohol abuse are the 2 most common conditions associated with acute pancreatitis. There are several other, less common causes of acute pancreatitis, including:
- certain medicines (e.g. steroids and some diuretics);
- high levels of triglycerides (a type of fat) in the blood;
- high blood calcium levels;
- surgery or trauma to the abdomen; and
Sometimes it is not possible to determine the cause of pancreatitis, but it is thought that a combination of inherited and environmental factors is involved in most cases.
Chronic pancreatitis is usually caused by years of heavy alcohol use. Sometimes, chronic pancreatitis follows an episode of acute pancreatitis. There is also an inherited form of this disease, known as hereditary pancreatitis, and people with cystic fibrosis (an inherited condition) also have an increased risk of developing chronic pancreatitis.
If your doctor suspects you have pancreatitis, he or she will perform blood tests, looking for elevated levels of pancreatic enzymes in your blood. The levels of enzymes in the blood can also indicate the severity of the pancreatitis.
You may also need to have an ultrasound, X-ray or CT scan of your abdomen, looking for evidence of damage to your pancreas and gallstones (one of the main causes of pancreatitis).
Most people with acute pancreatitis need to be treated in hospital. If you have this type of pancreatitis, you will most likely have to stop eating and drinking for a few days, and receive fluids through a drip. You may need to have a strong pain medicine, such as morphine, for pain relief. People with severe pancreatitis may also be treated with antibiotics.
If there is an obvious cause of pancreatitis, such as gallstones, then your doctor will treat that condition as well. Sometimes surgery is required to remove damaged areas of pancreas or to treat complications.
Lifestyle changes are a major component of the treatment for chronic pancreatitis — eliminating alcohol and eating a reduced-fat diet are usually recommended. You may need to take digestive enzyme supplements to improve digestion, and if the damage to your pancreas means you have developed diabetes, you may also need insulin injections. However, many people with chronic pancreatitis can control their blood sugar levels with diet and exercise.
For some people, giving up alcohol may be all that is needed to control the pain of chronic pancreatitis. But many people need to take pain relievers, such as paracetamol or codeine, to treat persistent abdominal pain. Unfortunately, the pain associated with chronic pancreatitis can sometimes be difficult to manage with conventional pain relievers.
Some people find that taking pancreatic enzyme supplements helps to treat their pain. In cases where medicines fail to control pain, stronger pain relievers or surgery (either to remove damaged parts of the pancreas or to block the nerves transmitting pain from the pancreas) may be tried.
Most people who get acute pancreatitis recover, but unfortunately, in some people it can be a fatal disease. Typically it takes about a week to recover from mild, acute pancreatitis. People with moderate or severe disease will need longer to get better, and some people have further episodes of pancreatitis. Every time the pancreas becomes inflamed, there is a risk that it will become permanently damaged.
People with chronic pancreatitis tend to have lifelong problems with intermittent pain and malabsorption.
- 1. Acute pancreatitis (revised February 2011). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Nov. http://online.tg.org.au/complete/ (accessed Mar 2013).
2. Chronic pancreatitis (revised February 2011). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Nov. http://online.tg.org.au/complete/ (accessed Mar 2013).
3. National Digestive Diseases Information Clearinghouse. Pancreatitis (updated 16 Aug 2012). http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/ (accessed Mar 2013).