Pancreatitis

Topic Overview

What is pancreatitis?

Pancreatitis is inflammation of the pancreas, an organ that makes the hormones insulin and glucagon. These two hormones help control the body's metabolism. The pancreas also makes other hormones and enzymes that help you digest food.

Inflammation of the pancreas happens when digestive enzymes, usually contained in tubes within the pancreas, leak into the rest of the pancreas and irritate it. The inflammation may develop suddenly (acute pancreatitis) or over many years (chronic pancreatitis). Over time, it can damage and scar the pancreas.

What causes pancreatitis?

Gallstones and alcohol abuse are the most common causes of pancreatitis. Less common causes of pancreatitis are certain infections, high triglycerides, certain medicines, and injury.

Long-term pancreatitis may develop after one attack or after several attacks over many years. Long-term abuse of alcohol causes 70% to 90% of the cases of ongoing pancreatitis in Western countries.¹ In some cases, the cause is not known.

What are the symptoms?

The main symptom of an attack of pancreatitis is moderate to severe pain in the upper area of the belly (abdomen). The pain may spread to the back. Some people may have other symptoms too, such as nausea, vomiting, fever, or sweating.

How is pancreatitis diagnosed?

A doctor diagnoses pancreatitis by asking questions about your symptoms and past health and by doing a physical exam and tests. You may have blood tests to see whether certain enzymes are higher than normal—signs of possible pancreatitis. Other lab tests may include a complete blood count (CBC), liver tests, and a stool analysis.

Abdominal ultrasound can be used to spot gallstones that may cause pancreatitis. Other imaging tests that might be used include a CT scan and an MRI. A test called endoscopic retrograde cholangiopancreatogram (ERCP) may be used to help diagnose long-term pancreatitis. It can also be used to remove gallstones that are blocking the common bile duct.

How is it treated?

Most attacks of pancreatitis are treated in the hospital with pain medicine and fluids given through a vein (IV) until the inflammation goes away. If vomiting is severe, you may have a tube placed through your nose and into your stomach to remove fluids and air that can build up in your stomach because of inactivity. This will help make the pancreas less active and inflamed.

Although most people recover fully from an attack of pancreatitis, complications may develop. These can include bleeding, cysts, infection, or death of pancreatic tissue.

Surgery sometimes is needed to remove the gallbladder or a part of the pancreas that has been damaged.

If you have long-term pancreatitis, it is important that you stop drinking alcohol and follow a low-fat diet. You may also take medicines to manage ongoing pain. If your pancreas has been severely damaged, you may have to take both insulin to help your body regulate blood sugar and pancreatic enzyme pills to help your body digest fat and protein.

Frequently Asked Questions

Learning about pancreatitis:	What is pancreatitis? What causes pancreatitis? What are the symptoms of pancreatitis? Will pancreatitis come back after it is treated? What can I do to keep pancreatitis from coming back?
Being diagnosed:	How is pancreatitis diagnosed? How are bile duct blockages that cause pancreatitis diagnosed? How is the level of the enzyme amylase used to diagnose pancreatitis? How is the level of the enzyme lipase used to diagnose pancreatitis? How is a CT scan used to diagnose pancreatitis and its complications?
Getting treatment:	How is pancreatitis treated? Can pancreatitis be treated with medicine? How is the pain of chronic pancreatitis managed?

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Author:	Monica Rhodes	Last Updated: July 2, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Brent Shoji, MD - General Surgery
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