- When to See the Doctor
What is pancreatitis?
In the United States, acute pancreatitis is one of the most common reasons people with gastrointestinal problems are admitted to the hospital. Pancreatitis is an inflammation of the pancreas. This inflammation occurs when digestive enzymes in the pancreas begin irritating or harming the pancreas instead of going into the small intestine through the pancreatic duct.
The pancreas is an essential organ. It’s located in your upper abdomen behind your stomach. It creates enzymes that help with digestion and makes hormones like insulin, which helps to regulate your body’s blood sugar.
Pancreatitis symptoms can range from mild to severe. Sudden pain in the center of your upper abdomen is a potential sign of pancreatitis. While a mild case may resolve on its own, most people will need treatment for their symptoms. Severe cases can lead to life-threatening complications.
Repeated incidents of acute pancreatitis can lead to damage to your pancreas and chronic pancreatitis. Recognizing the signs and symptoms of pancreatitis is important, so you can get the help you need to manage and treat your symptoms.
Signs and symptoms of pancreatitis
The signs and symptoms of pancreatitis vary per person depending on the severity of symptoms and whether it’s acute or chronic. For most people, upper abdominal pain is the primary symptom of their pancreatitis. This abdominal pain may also spread to your back.
Other common symptoms of pancreatitis include:
Types of pancreatitis
You can have acute or chronic pancreatitis. Acute pancreatitis typically happens suddenly and lasts for several days. Chronic pancreatitis is a progressive disease that damages your pancreas over many years.
With acute pancreatitis, the inflammation occurs suddenly. You typically have upper abdominal pain that ranges from mild to severe. It can last several days or more.
Chronic pancreatitis is a progressive disease that doesn’t heal over time. Chronic pancreatitis typically starts in people aged 30 to 40 and is more common in men. Initially, the symptoms are similar to acute pancreatitis. As the disease progresses, people with chronic pancreatitis can become malnourished and lose weight without trying. Additionally, their stool may appear oily (steatorrhea) due to fat malabsorption.
Causes of pancreatitis
Pancreatitis has several causes. In America, the most common cause of acute pancreatitis is gallstones, which are stones that build up in the gallbladder. Chronic alcohol use is the most common cause of chronic pancreatitis. Pancreatitis can also occur if you injure your pancreas or in response to certain medications or infections, such as Salmonellosis.
Common causes of pancreatitis include:
Acute pancreatitis can be caused by gallstones that get stuck in the common bile duct. The gallstone, which is a solid material, can block and prevent the flow of pancreatic fluid. This build-up causes inflammation of the pancreas. The longer the common bile duct blockage remains, the worse the symptoms and the greater the damage to the pancreas.
Chronic alcohol use
Chronic, heavy use of alcohol may initially cause episodes of acute pancreatitis. Continued heavy drinking can eventually cause chronic pancreatitis. In fact, about 40 - 70% of all chronic pancreatitis cases are due to longstanding, heavy alcohol use.
Why chronic alcohol use causes chronic pancreatitis in some individuals isn’t fully understood. However, it may be that alcohol gets transformed into a toxic chemical in the pancreas that causes damage. Another possibility is that alcohol may clog the small ductules in the pancreas.
A family history of pancreatitis increases the chance that you may get pancreatitis, suggesting a genetic component to some cases. For instance, individuals with cystic fibrosis are at an increased risk of pancreatitis. Fortunately, hereditary pancreatitis is a rare genetic disorder, where the person has recurring episodes of pancreatitis that leads to chronic pancreatitis.
When to see a doctor for pancreatitis
You should immediately contact your medical doctor if you’re experiencing severe abdominal pain, especially if you can’t get into a comfortable position or sit still due to pain. If you have less severe but persistent stomach pain, you should also call your doctor.
Acute pancreatitis can lead to significant complications, such as:
- Kidney failure or organ failure
- Infections to your pancreas
- Necrotizing pancreatitis (the death of some sections of the pancreas)
- Breathing problems
Your doctor will likely use blood tests, imaging tests, a physical exam, and a review of your medical history to diagnose pancreatitis and determine the potential cause. Knowing if you have a history of gallbladder disease, a family history of pancreatitis, or chronic alcohol misuse can help alert your doctor to the possibility of pancreatitis.
During your physical exam, the doctor will assess whether your abdomen is tender, the stomach wall muscles are rigid, and they will listen for intestinal sounds. They will likely ask questions about the onset of your pain, severity, and duration.
Imaging tests, like X-rays or ultrasound, can help determine if a gallstone is causing the problem. A computed tomography (CT) scan may be used if the diagnosis is uncertain or for additional information to help identify complications.
If a gallstone is causing your pancreatitis, it will likely need to be removed. If an infection is causing your pancreatitis, the doctor may need to collect a urine sample to look for certain elevated enzymes.
Treatments for pancreatitis
The primary goal for treating pancreatitis is to rest the pancreas and address the cause of the condition, if known. You may need a hospitalization to receive the proper treatments, whether you have acute or chronic pancreatitis.
During your hospital stay, you may receive intravenous (IV) fluids to prevent dehydration, pain medications, and require a low-fat diet. If you can’t eat, you may need a feeding tube. You may need additional treatments to address the cause of your pancreatitis, like surgery to remove a gallstone or medications to address a suspected infection.
For chronic pancreatitis, the doctor will help manage complications from this disease and help with pain management. To help address malabsorption problems, you may be given vitamins and medications to help the digestion process. You may require surgery to relieve pressure, a blockage, or remove damaged parts of your pancreas.
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Digestive Diseases and Sciences: "Complications of Chronic Pancreatitis."
Gastroenterology: "The Epidemiology of Pancreatitis and Pancreatic Cancer."
Institute for Quality and Efficiency in Health Care: "How does the pancreas work?"
Merck Manual: "Acute Pancreatitis."
National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms and Causes of Pancreatitis."
National Institute of Diabetes and Digestive and Kidney Diseases: "Treatment for Pancreatitis."
The National Pancreas Foundation: "About Chronic Pancreatitis"
The National Pancreas Foundation: "Acute Pancreatitis Testing and Diagnosis."
The National Pancreas Foundation: "Fact Sheet - Pancreatic Disease."
The National Pancreas Foundation: "Hereditary pancreatitis."
StatPearls: "Alcoholic Pancreatitis."
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