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Pancreatitis

What is pancreatitis?

Pancreas is an organ behind the stomach and its swelling is known as pancreatitis. The pancreas produces digestive enzymes (chemicals needed to break down food) and insulin (which regulates the level of glucose in the blood). The digestive enzymes flow into the small intestine but insulin is released directly into the blood.

Acute pancreatitis occurs as a sudden episode after which the pancreas usually returns to its normal condition. Chronic pancreatitis means an ongoing inflammation/swelling in the pancreas leading to permanent damage.
How does it occur?

The cause of acute pancreatitis is not completely understood. About half the people having pancreatitis also have gallstones. Alcohol is another important cause. Other less common causes are stomach or duodenal ulcers, injury or viral infections.
What are the symptoms?

The main symptom is severe pain in the stomach (precisely the middle of upper abdomen). It generally spreads to the back and chest, becoming worse on walking or lying down, and lessens on sitting or leaning forward. It may be associated with profuse vomiting. Pain often occurs 12 to 24 hours after a large meal or heavy drinking.

Severe cases may have signs of shock, like restlessness, fast heartbeat, disorientation and cold, and sweaty extremities. Call the doctor immediately if these symptoms are present along with severe pain in the abdomen.
How is it diagnosed?

The doctor will enquire about the medical history, particularly about alcohol intake and symptoms of gallstones. The doctor will examine and order blood tests. A sample of urine may also be tested. The following tests may also be done:
X-rays of the abdomen and chest.
Ultrasound examination and/or a CT scan of the abdomen especially the pancreas.
ERCP, a way of looking at the pancreas through a slim flexible tube called an endoscope, which is passed through the mouth into the intestines.

How is it treated?

Pancreatitis usually requires rest and stay in the hospital. To decrease the amount of pancreatic enzymes, avoid eating or drinking anything for some time. Intravenous (IV) fluids are given through the vein. A nasogastric tube may be put through the nose into the stomach to remove fluids and prevent nausea and vomiting. A pain reliever will be given for the pain. Medication to reduce the flow of pancreatic enzymes may be given.

Clear liquids may be taken later, gradually progressing to a diet of low-fat foods when the pain stops. Most people on treatment start feeling better in a couple of days and usually go home in a week. Severe disease requires treatment in an intensive care unit (ICU) and a hospital stay of several weeks.

How long do the effects last?

Most people recover completely, especially if the disease is diagnosed early enough. Severe pancreatitis can be fatal. If gallstones are detected, they may be removed to prevent another attack of pancreatitis.