Pancreatitis

At one time or another, most of us have experienced stomach pains. Dull or sharp abdominal pains may come and go as we challenge ourselves with new foods or undergo periods of stress. (Read about "Stress") Sometimes, though, stomach pain indicates a more serious problem. Many organs in your digestive system can create problems, including the pancreas. (Read about "Digestive System")

What is the pancreas and why is it there?

The pancreas, part of the digestive system, is a long and irregularly shaped gland located behind the stomach. It secretes special juices and enzymes into the small intestine, helping your body turn what you eat into digestible molecules. The pancreas also produces insulin and glucagon, which are hormones that regulate how your body uses sugar. Along with the gallbladder and liver, the pancreas is a very important organ in the body, but if it becomes inflamed, it can cause pain and serious medical problems.

What is pancreatitis?

Pancreatitis is an inflammation, or swelling, of the pancreas. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), between 50,000-80,000 Americans suffer from pancreatitis each year. Although pancreatitis is usually acute, it can become chronic. When the pancreas is inflamed, it can be attacked by its own digestive juices. Diagnosis and treatment of pancreatitis depends on whether the episode is acute or chronic.

Both acute and chronic pancreatitis may be diagnosed by physical exam, medical history, blood tests that measure pancreatic function (Read about "Laboratory Testing"), or measurement of the fat content of bowel movements to check for poor absorption. Sometimes x-rays, ultrasound tests, CT scans (Read about "X-rays" "Ultrasound Imaging" "CT Scan - Computerized Tomography") or tests that use fiber optic cameras are used.

Acute pancreatitis

Acute pancreatitis is a sudden inflammation of the pancreas. There is usually gradual or sudden mild or severe pain in the center of the upper abdomen, which may or may not radiate to the back, according to NIDDK. The National Pancreas Foundation (NPF) says this pain is often relieved by sitting up or bending forward. Other symptoms of acute pancreatitis, in addition to pain, can be:

• nausea
• vomiting
• diarrhea (Read about "Diarrhea")
• abdominal bloating and tenderness
• unexplained weight loss
• a yellowing of the skin or eyes called jaundice (Read about "Jaundice")
• symptoms of diabetes (Read about "Diabetes")

Sometimes the pancreas may become infected.

The American Gastroenterological Association (AGA) says the most common cause of acute pancreatitis is gallstones. (Read about "Gallstones") Like a plugged pipe, gallstones stuck in the bile duct can block the flow of digestive juices in the tubes from the pancreas, causing the enzymes to back up and irritate or damage this organ. Alcohol abuse is also a known cause of pancreatitis. (Read about "Alcoholism") Less common causes of acute pancreatitis may be trauma, heredity, mumps, medications (Read about "Medicine Safety") or excess fat particles in the blood. The cause is unknown in 15 percent of acute pancreatitis cases, according to NPF.

Besides asking about a person's medical history and doing a physical exam, a doctor will order a blood test to diagnose acute pancreatitis. A doctor may also order an abdominal ultrasound to look for gallstones and a CT scan to look for inflammation or destruction of the pancreas, as well as other potential problems.

Treatment for acute pancreatitis focuses on relieving pain and taking care of nutrition and metabolism. Sometimes a person will need to be hospitalized to receive medication and intravenous fluids to help rest and heal the pancreas. Antibiotics (Read about "Antibiotics") may be given if the pancreas has become infected. If the episode is severe, surgery may be necessary for drainage or for removal of part of the pancreas. If pancreatitis is caused by gallstones, the gallbladder may need to be removed.

Following an attack of acute pancreatitis, patients are sometimes given dietary guidelines to reduce the amount of fat in their diet (Read about "Low Fat Food Tips") as well as special enzyme medication to take with meals.

Chronic pancreatitis

Chronic pancreatitis can start as an acute episode, becoming chronic, as the pancreas gets damaged and scarred. Sometimes the condition is already chronic when it is first diagnosed. According to AGA, the most common cause is excessive alcohol consumption. Injury, as well as blockage or narrowing of the pancreatic ducts can also lead to chronic pancreatitis. Heredity can play a role. (Read about "Family Health History") In some cases, the cause is not known.

Chronic pancreatitis occurs more often in men than in women. In rare cases, AGA says, it can lead to pancreatic cancer. (Read about "Pancreatic Cancer")

Symptoms of chronic pancreatitis, according to the Food and Drug Administration (FDA), can include:

• persistent pain in the upper abdomen lasting for days or weeks
• jaundice
• diarrhea (Read about "Diarrhea")
• malnutrition or rapid weight loss

Over a period of time, chronic pancreatitis can also lead to diabetes, calcium deficiencies (Read about "Calcium" "Osteoporosis") or infections of the pancreas. It is possible for a person to have attacks of chronic pancreatitis over the course of many years. A chronically inflamed or damaged pancreas can lose its ability to make insulin, resulting in a particular type of diabetes. It may also stop producing the enzymes that the body needs for digestion, resulting in a variety of digestive problems.

Chronic pancreatitis is often diagnosed through physical exam, medical history and/or diagnostic tests such as ultrasonic imaging, endoscopic retrograde cholangiopancreatography (ERCP) and CT scans. (Read about "Ultrasound Imaging" "Endoscopy" "CT Scan - Computerized Tomography")

As with acute episodes, the treatment of chronic pancreatitis depends on the symptoms. Most treatment focuses on managing pain and providing appropriate nutrition, which sometimes includes enzyme supplements to help digest food. If the chronic condition has caused diabetes, insulin may be needed to control the levels of blood sugar in the body. Patients are often put on a low fat diet and may prefer eating frequent, small portions of food. Not drinking alcohol is key to managing the course of chronic pancreatitis, according to NPF.

When in doubt, call your doctor

AGA recommends that you contact your doctor or seek treatment if you have severe abdominal pain lasting more than 20 minutes. A health regimen that includes routine medical care and a healthy diet is always a good idea.

Related Information:

    Gallstones

    Heartburn