Pancreatitis is an inflammation or an infection of the pancreas. It may be acute or chronic. Acute pancreatitis means that symptoms develop suddenly. Chronic pancreatitis is a long-standing inflammation of the pancreas.
What is going on in the body?
The pancreas is a leaf-shaped gland that is located behind the stomach. It secretes digestive enzymes and the hormones insulin and glucagon. It also secretes sodium bicarbonate, which neutralizes the acid coming from the stomach.
In pancreatitis, the pancreatic duct gets blocked, and the flow of pancreatic juices is impaired. These juices accumulate in the pancreas. They begin to digest the cells of the pancreas, and cause inflammation. The pancreas is then unable to provide the digestive enzymes and hormones needed for the rest of the body to function normally.
What are the causes and risks of the disease?
Causes of pancreatitis include:
biliary tract disease, or disorders of the tubes draining bile from the gallbladder
medications such as glucocorticoids, furosemide, and azathioprine
complications from infections, such as mumps
high blood levels of triglycerides
damage to the pancreas from surgery or trauma
cancer of the pancreas
In severe cases of pancreatitis, blood pressure may fall, causing shock. Pancreatitis can be life-threatening.
Symptoms & Signs
What are the signs and symptoms of the disease?
Symptoms of pancreatitis include:
severe abdominal pain, usually in the upper mid-abdomen, possibly penetrating to the back
nausea and vomiting
mild jaundice, or a yellow tint to the skin
fever and chills
rapid heart beat
shallow, rapid breathing
light colored and greasy stools, which are more common in chronic pancreatitis
Diagnosis & Tests
How is the disease diagnosed?
A thorough history and physical examination are the first steps in diagnosis of pancreatitis. Blood tests may show an elevated white blood count, and amylase, lipase, and glucose levels. Other tests used to diagnose pancreatitis include:
an electrocardiogram, or ECG, to monitor the activity of the heart
abdominal x-rays and chest x-rays
Prevention & Expectations
What can be done to prevent the disease?
The prevention of pancreatitis depends on the cause. For example, avoiding alcohol will help prevent pancreatitis caused by alcoholism. Prompt treatment of gallstones and a diet low in fat may be helpful.
What are the long-term effects of the disease?
Chronic pancreatitis can lead to diabetes due to the destruction of the cells in the pancreas that produce insulin. Weight loss may be caused by poor absorption of nutrients. Severe bleeding, damage to the pancreas, or a secondary infection in the pancreas may occur. Some cases of pancreatitis can be fatal.
What are the risks to others?
Pancreatitis is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the disease?
Usually a person with pancreatitis is hospitalized. The person is not allowed to eat or drink anything, because this stimulates the pancreas to produce more enzymes. Fluids and nutrients are given through an intravenous line, which is a thin tube inserted into a vein.
A stomach tube is inserted through the nose into the stomach to remove fluids and air. Oxygen is given through a facemask, or through a tube that sits just inside the nose. Narcotics such as meperidine are used to control the pain. Antibiotics such as gentamicin, clindamycin, or chloramphenicol are used to treat infection. Surgery may be necessary to treat pancreatitis that is due to an injury, an infection that needs to be drained, or gallstones.
What are the side effects of the treatments?
There are side effects with any medication. Antibiotics may cause stomach upset, diarrhea, or an allergic reaction. Narcotics may cause an allergic reaction, or trouble breathing. Possible side effects of surgery include bleeding, infection, and allergic reactions to anesthesia.
What happens after treatment for the disease?
If the pancreatitis is due to alcoholism, the prognosis is good if the person avoids alcohol. But if the person drinks, a recurrence of pancreatitis is likely. Pancreatitis from other causes can have varying outcomes, depending on the cause.
How is the disease monitored?
Pancreatitis is monitored by the health care provider. Blood tests may be done to check the white blood count and amylase and lipase levels. Any new or worsening symptoms should be reported to the health care provider.