PANCREATITIS

General Information

DEFINITION--Inflammation of the pancreas. Chronic pancreatitis usually follows recurrent attacks of acute pancreatitis, because the pancreas does not recover completely between attacks. It gradually becomes unable to supply digestive juices and hormones necessary for good health.

BODY PARTS INVOLVED--Pancreas.

SEX OR AGE MOST AFFECTED--Adults.

SIGNS & SYMPTOMS

Severe acute pancreatitis:

• Extreme abdominal pain; vomiting; abdominal swelling and gas.
• Fever; muscle aches.
• Drop in blood pressure.

Chronic pancreatitis:

• Persistent, mild or severe pain, often after meals, in the upper abdomen, sometimes radiating to the back or generalized. Pain is aching, burning, gnawing or stabbing. Pain episodes may last days or weeks, but rarely less than 1 day.
• Mild jaundice (yellow skin and eyes, sometimes); rapid weight loss.

CAUSES

• Alcoholism.
• Disease of the gallbladder or bile ducts.
• Obstruction of the pancreatic duct by stones, scarring or slow-growing cancer (rare).
• Abdominal injury.
• Virus infection.
• Hyperlipidemia.
• Tumor.
• Medications.
• Trauma or surgery.

RISK INCREASES WITH

• Poor nutrition; obesity; excess alcohol consumption.
• Use of drugs, such as sulfa drugs, azathioprine, chlorothiazide or cortisone drugs.

HOW TO PREVENT--Don't drink more than 1 or 2 alcoholic drinks--if any--a day.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor. This may be difficult to diagnose.
• Laboratory studies, such as blood and urine tests and radioisotope scans (See Glossary).
• X-rays of the pancreas.
• CT scan or ultrasound of the pancreas; endoscopy (See Glossary for all).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Acute pancreatitis usually requires hospitalization for intravenous fluids, control of pain and vomiting, correction of metabolic abnormalities (replace calcium and magnesium). Surgery may be needed for gallstones, perforated peptic ulcer or to drain a source of infection.
• Chronic pancreatitis may be managed as an outpatient condition with medications, diet controls and abstinence from alcohol.

POSSIBLE COMPLICATIONS

• Diabetes mellitus.
• Chronic calcium deficiency.
• Secondary bacterial infection in the pancreas.
• Massive hemorrhage and destruction of the pancreas.
• Cyst or abscess of the pancreas.

PROBABLE OUTCOME--Acute pancreatitis is often curable with intensive care. Treatment includes resting the gastrointestinal tract completely and providing intravenous fluids and nourishment. About 5% of cases don't respond to treatment and are fatal. Chronic pancreatitis may recur for many years.

How To Treat

GENERAL MEASURES--

• Follow your doctor's instructions. Compliance with your medical treatment plan is essential for the best outcome.
• Stop drinking alcohol. Contact Alcoholics Anonymous or other support groups if you need help.
• Use heat from a heating pad, heat lamp or hot compresses to relieve pain.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Pain relievers.
• Digestive enzymes that the damaged pancreas cannot manufacture.
• Antibiotics, if bacterial infection develops.
• Stomach acid (H2) blockers.
• Insulin if diabetes present.

ACTIVITY--No restrictions.

DIET--

• Intravenous fluids during an acute attack, then slowly progressing to oral feedings.
• Abstain totally from drinking alcohol.

Call Your Doctor If

• You have symptoms of acute pancreatitis.
• The following occurs during or after treatment: Jaundice (yellow skin and eyes). Fever of 101F (38.3C) or higher. Continued weight loss. Signs of calcium deficiency, such as muscle cramps or seizures.