Pancreatitis is the inflammation of the pancreas, a gland located behind the stomach that plays a crucial role in digestion and blood sugar regulation. Pancreatitis can be acute, meaning it occurs suddenly and is usually short-lived, or chronic, indicating persistent and long-term inflammation.
Acute Pancreatitis:
Causes:
- Gallstones: One of the most common causes, gallstones can block the pancreatic duct, leading to inflammation.
- Alcohol Consumption: Excessive alcohol intake is a significant risk factor for acute pancreatitis.
- Trauma: Injuries to the pancreas, such as those resulting from accidents or surgery, can cause inflammation.
- Infections: Viral or bacterial infections, such as mumps or certain parasites, can trigger pancreatitis.
- High Triglyceride Levels: Elevated levels of triglycerides in the blood can contribute to pancreatitis.
Symptoms:
- Sudden, severe pain in the upper abdomen that may radiate to the back.
- Nausea and vomiting.
- Abdominal tenderness.
- Elevated heart rate and breathing.
Diagnosis and Treatment:
- Diagnosis involves blood tests to assess pancreatic enzyme levels, imaging studies (CT scans, MRI, ultrasound), and sometimes endoscopic tests.
- Treatment focuses on relieving symptoms, managing pain, and addressing the underlying cause (e.g., gallstone removal, alcohol cessation).
- Fasting and supportive measures like intravenous fluids and pain management are often part of acute pancreatitis treatment.
- Very rarely bad attacks of acute pancreatitis require surgery
Chronic Pancreatitis:
Causes:
- Recurrent Acute Pancreatitis: Multiple episodes of acute pancreatitis can lead to chronic inflammation.
- Long-term Alcohol Abuse: Chronic alcohol consumption is a common cause.
- Genetic Factors: Inherited conditions, such as cystic fibrosis or hereditary pancreatitis, can contribute.
- Pancreatic Duct Blockage: Conditions that obstruct the pancreatic duct, like tumors or strictures, can lead to chronic pancreatitis.
Symptoms:
- Persistent abdominal pain.
- Weight loss.
- Steatorrhea (fatty, foul-smelling stools).
- Diabetes, as chronic pancreatitis can affect insulin production.
Diagnosis and Treatment:
- Diagnosis involves imaging studies, pancreatic function tests, and sometimes endoscopic tests.
- Treatment aims to manage symptoms, address the underlying cause, and prevent complications.
- Lifestyle changes, such as alcohol cessation and dietary modifications, are crucial.
- Enzyme replacement therapy and insulin may be needed for pancreatic insufficiency and diabetes.
- Surgery to alleviate obstruction of the pancreatic duct or removal of diseased parts of the pancreas.
Complications of Pancreatitis:
- Pseudocysts: Fluid-filled sacs that can develop in the pancreas. (Click here to learn more about pseudocysts)
- Infection: Pancreatic infections can occur, requiring antibiotics.
- Pancreatic Insufficiency: Impaired digestion due to reduced enzyme production.
- Diabetes: Chronic pancreatitis can lead to insulin deficiency.
It’s essential to seek medical attention if symptoms of pancreatitis occur. Prompt diagnosis and appropriate management are crucial to prevent complications and improve outcomes.
Jesse Sulzer MD PhD 