Acute pancreatitis is a serious condition where the pancreas becomes inflamed over a short period of time. The pancreas is a small organ located behind the stomach and below the ribcage.
Most people with acute pancreatitis improve within a week and experience no further problems, but severe cases can have serious complications and can even be fatal.
Acute pancreatitis is different to chronic pancreatitis, where the inflammation of the pancreas persists for many years.
The most common symptoms of acute pancreatitis include:
The pancreas is a large gland behind the stomach and next to the small intestine. The pancreas does two main things:
Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas.
There are two forms of pancreatitis: acute and chronic.
Acute pancreatitis. Acute pancreatitis is a sudden inflammation that lasts for a short time. It may range from mild discomfort to a severe, life-threatening illness. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.
Chronic pancreatitis. Chronic pancreatitis is long-lasting inflammationof the pancreas. It most often happens after an episode of acute pancreatitis. Heavy alcohol drinking is another big cause. Damage to the pancreas from heavy alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms.
What Are the Symptoms of Pancreatitis?
Symptoms of acute pancreatitis:
Symptoms of chronic pancreatitis:
The symptoms of chronic pancreatitis are similar to those of acute pancreatitis. Patients frequently feel constant pain in the upper abdomen that radiates to the back. In some patients, the pain may be disabling. Other symptoms are weight loss caused by poor absorption (malabsorption) of food. This malabsorption happens because the gland is not releasing enough enzymes to break down food. Also, diabetes may develop if the insulin-producing cells of the pancreas are damaged.
In most cases, acute pancreatitis is caused by gallstones or heavy alcohol use. Other causes includemedications, infections, trauma,metabolic disorders, and surgery. In up to 15% of people with acute pancreatitis, the cause is unknown.
In about 70% of people, chronic pancreatitis is caused by long-time alcohol use. Other causes includegallstones, hereditary disorders of the pancreas, cystic fibrosis, hightriglycerides, and certain medicines. In about 20% to 30% of cases, the cause of chronic pancreatitis is unknown.
Pancreatitis can happen to anyone, but it is more common in people with certain risk factors.
Risk factors of acute pancreatitis include:
Acute pancreatitis may be the first sign of gallstones. Gallstones can block the pancreatic duct, which can cause acute pancreatitis.
Risk factors for chronic pancreatitis include:
People with chronic pancreatitis are usually men between ages 30 and 40, but chronic pancreatitis also may occur in women.
How Is Pancreatitis Diagnosed?
To diagnose acute pancreatitis, doctors measure levels in the blood of two digestive enzymes, amylase and lipase. High levels of these two enzymes strongly suggest acute pancreatitis.
Doctors may also use other tests, such as:
Pancreatic function test to find out if the pancreas is making the right amounts of digestive enzymes
In more advanced stages of the disease, doctors may use blood, urine, and stool tests to confirm the diagnosis.
Why it happens
It’s thought that acute pancreatitis occurs when a problem develops with some of the enzymes (chemicals) in the pancreas, which causes them to try to digest the organ.
Acute pancreatitis is most often linked to:
By reducing your alcohol intake and altering your diet to make gallstones less likely, you can help to reduce your chances of developing acute pancreatitis.
Most cases of acute pancreatitis are closely linked to gallstones or to alcohol consumption, although the exact cause isn’t always clear.
Gallstones are hard pieces of stone-like material that form in your gallbladder. They can trigger acute pancreatitis if they move out of the gallbladder and block the opening of the pancreas.
The blockage can disrupt some of the enzymes (chemicals) produced by the pancreas. These enzymes are normally used to help digest food in your intestines, but they can start to digest the pancreas instead if the opening is blocked.
However, not everyone with gallstones will develop acute pancreatitis. Most gallstones don’t cause any problems.
It’s not fully understood how alcohol causes the pancreas to become inflamed. One theory is that it interferes with the normal workings of the pancreas, causing the enzymes to start digesting it.
Whatever the cause, there is a clear link between alcohol use and acute pancreatitis. A very large study found that people who regularly drank more than 35 units of alcohol a week were four times more likely to develop acute pancreatitis than people who never drank alcohol (35 units is the equivalent of drinking around 16 cans of strong lager or four bottles of wine a week).
Binge drinking, which is drinking a lot of alcohol in a short period of time, is also thought to increase your risk of developing acute pancreatitis.
Less common causes of acute pancreatitis include:
accidental damage or injury to the pancreas – for example, during a procedure to remove gallstones or examine the pancreas
certain types of medication, such as some antibiotics orchemotherapy medication – acute pancreatitis can be an unexpected side effect of these in a small number of people
a viral infection – such as mumps or measles
a complication of cystic fibrosis
certain rare conditions – including hyperparathyroidism, Reye’s syndrome and Kawasaki disease
Little is known about why some people develop severe acute pancreatitis. Factors thought to increase your risk include:
being 70 years of age or over
being obese (a person is considered obese if they have a body mass index (BMI) of 30 or above)
having two or more alcoholic drinks a day
smoking
Researchers have also discovered that people with a specific genetic mutation, known as the MCP-1 mutation, are eight times more likely to develop severe acute pancreatitis than the general population. A genetic mutation is where the instructions (DNA) found in all living cells become scrambled, resulting in a genetic disorder or a change in characteristics.
The main symptom of sudden (acute) pancreatitis is sudden moderate to severe pain in the upper area of the belly (abdomen). Long-term (chronic) pancreatitis also causes severe pain in the upper abdomen. As the condition progresses, fat may be released into the stools, indicating that your body is not absorbing fat and protein. Other symptoms of an attack of pancreatitis are:
o Nausea and vomiting
o Fever
o Fast heart rate
o Sweating
o Yellowing of the skin or the whites of the eyes (jaundice)
Treatment for acute pancreatitis
People with acute pancreatitis are typically treated with IV fluids and pain medications in the hospital. In some patients, the pancreatitis can be severe and they may need to be admitted to an intensive care unit (ICU). In the ICU, the patient is closely watched because pancreatitis can damage the heart, lungs, or kidneys. Some cases of severe pancreatitis can result in death of pancreatic tissue. In these cases, surgery may be necessary to remove the dead or damaged tissue if an infection develops.
An acute attack of pancreatitis usually lasts a few days. An acute attack of pancreatitis caused by gallstones may require removal of the gallbladder or surgery of the bile duct. After the gallstones are removed and the inflammation goes away, the pancreas usually returns to normal.
Treatment for chronic pancreatitis
Chronic pancreatitis can be difficult to treat. Doctors will try to relieve the patient’s pain and improve thenutrition problems. Patients are generally given pancreatic enzymes and may need insulin. A low-fat diet may also help.
Surgery may be done in some cases to help relieve abdominal pain, restore drainage of pancreatic enzymes or hormones, treat chronic pancreatitis caused by blockage of the pancreatic duct, or reduce the frequency of attacks.
Patients must stop smoking and drinking alcoholic beverages, follow their doctor’s and dietitian’s dietary advice, and take the proper medications in order to have fewer and milder attacks of pancreatitis.
Because most cases of pancreatitis are caused by alcohol abuse, prevention is directed at responsible drinking or no drinking at all. If heavy drinking is a concern, talk to your doctor or health careprofessional about a referral to an alcohol treatment center. Also, you may benefit from a support group such as Alcoholics Anonymous.
As acute pancreatitis is often caused by gallstones or excessive alcohol consumption, a healthy lifestyle can reduce your chances of developing the condition.
The most effective way of preventing gallstones is eating a healthy, balanced diet that includes plenty of fresh fruit and vegetables (at least five portions a day).
Your diet should also include wholegrains, found in wholemeal bread, oats and brown rice. This helps lower the amount of cholesterol in your body.
There is also evidence that regularly eating nuts, such as peanuts or cashews, can help reduce your risk of developing gallstones.
Because of the role cholesterol appears to play in the formation of gallstones, it’s advisable to avoid eating too many fatty foods with a high cholesterol content.
Foods high in cholesterol include:
Being overweight also increases your chances of developing gallstones, so maintaining a healthy weight by eating a balanced diet and taking plenty of regular exercise can also help reduce your risk of developing the condition.
See exercise, healthy eating and losing weight for more information and advice.
Limiting the amount of alcohol you drink can help prevent your pancreas being damaged, and reduce your risk of developing acute pancreatitis. It can also lower your chances of developing other serious conditions, such as liver cancer.
A unit of alcohol is equal to about half a pint of normal-strength lager or a pub measure (25ml) of spirits. A small glass of wine or an alcopop is 1.5 units.