Your pancreas plays a key role in the digestive system. It not only secretes digestive enzymes into the small intestine, it produces hormones such as insulin. Pancreatitis though, inflames the pancreas which causes digestive enzymes to attack the tissue that produces them. Symptoms include severe pain in the center part of the upper abdomen – which goes through to your back. This pain may worsen when you eat. Nausea, vomiting, fever, jaundice (yellowing of the skin) and weight loss may also occur. Acute pancreatitis occurs soon after the pancreas becomes damaged by its own enzymes. Pancreatitis is labeled “chronic” when the pancreas becomes scarred – usually due to years of excessive alcohol consumption.

Your Charleston Gastroenterology Center doctors have a variety of options, giving most a good prognosis if they follow the required treatment plan. The first course of action is to consult your Charleston Gastroenterology Center doctor when the first symptoms occur.

Causes, incidence, and risk factors

The pancreas is an organ located behind the stomach that produces chemicals called enzymes, as well as the hormones insulin and glucagon. Most of the time, the enzymes are only active after they reach the small intestine, where they are needed to digest food.

When these enzymes somehow become active inside the pancreas, they eat (and digest) the tissue of the pancreas. This causes swelling, bleeding (hemorrhage), and damage to the pancreas and its blood vessels.

Acute pancreatitis affects men more often than women. Certain diseases, surgeries, and habits make you more likely to develop this condition.

The condition is most often caused by alcoholism and alcohol abuse (70% of cases in the United States). Genetics may be a factor in some cases. Sometimes the cause is not known, however.

Symptoms

The main symptom of pancreatitis is abdominal pain felt in the upper left side or middle of the abdomen.

The pain:

  • May be worse within minutes after eating or drinking at first, especially if foods have a high fat content
  • Becomes constant and more severe, lasting for several days
  • May be worse when lying flat on the back
  • May spread (radiate) to the back or below the left shoulder blade
  • People with acute pancreatitis often look ill and have a fever, nausea, vomiting, and sweating.

Other symptoms that may occur with this disease include:

  • Clay-colored stools
  • Gaseous abdominal fullness
  • Hiccups
    Indigestion
  • Mild yellowing of the skin and whites of the eyes (jaundice)
  • Skin rash or sore (lesion)
  • Swollen abdomen
  • Signs and tests

The doctor will perform a physical exam, which may show that you have:

  • Abdominal tenderness or lump (mass)
  • Fever
  • Low blood pressure
  • Rapid heart rate
  • Rapid breathing (respiratory) rate
  • Laboratory tests will be done.

Tests that show the release of pancreatic enzymes include:

  • Increased blood amylase level
  • Increased serum blood lipase level
  • Increase urine amylase level

Other blood tests that can help diagnose pancreatitis or its complications include:

  • Complete blood count (CBC)
  • Comprehensive metabolic panel

Imaging tests that can show inflammation of the pancreas include:

  • Abdominal CT scan
  • Abdominal MRI
  • Abdominal ultrasound
  • Treatments

Treatment often requires a stay in the hospital and may involve:

  • Pain medicines
  • Fluids given through a vein (IV)
  • Stopping food or fluid by mouth to limit the activity of the pancreas
  • Occasionally a tube will be inserted through the nose or mouth to remove the contents of the stomach (nasogastric suctioning). This may be done if vomiting or severe pain do not improve, or if a paralyzed bowel (paralytic ileus) develops. The tube will stay in for 1 – 2 days to 1 – 2 weeks.
  • Treating the condition that caused the problem can prevent repeated attacks.

In some cases, therapy is needed to:

  • Drain fluid that has collected in or around the pancreas
  • Remove gallstones
  • Relieve blockages of the pancreatic duct
  • In the most severe cases, surgery is needed to remove dead or infected pancreatic tissue.
  • Avoid smoking, alcoholic drinks, and fatty foods after the attack has improved.
  • Expectations (prognosis)
  • Most cases go away in a week. However, some cases develop into a life-threatening illness
  • Complications
  • Acute kidney failure
  • Acute respiratory distress syndrome (ARDS)
  • Buildup of fluid in the abdomen (ascites)
  • Cysts or abscesses in the pancreas
  • Heart failure
  • Low blood pressure
  • Preventions
  • You may lower your risk of new or repeat episodes of pancreatitis by taking steps to prevent the medical conditions that can lead to the disease:

Avoid aspirin when treating a fever in children, especially if they may have a viral illness, to reduce the risk of Reye syndrome.
Do NOT drink too much alcohol.
Make sure children receive vaccines to protect them against mumps and other childhood illnesses.