Learn About Pancreatitis

	Treatments for Pancreatitis

There are about 80,000 cases of pancreatitis a year in the United States.  Pancreatitis is an inflammation of the pancreas that occurs when enzymes are activated within the organ and they start to digest the pancreas itself. 

There are two main types of pancreatitis: acute and chronic.  About 90% of all cases of pancreatitis are acute; 10% are chronic.

Acute Pancreatitis

Acute pancreatitis is inflammation in the pancreas that comes on suddenly and results in severe abdominal pain. Pancreatic enzymes (amylase and lipase) that are normally secreted into the intestine by the pancreas become elevated in the blood, allowing the diagnosis to be made.

Symptoms of acute pancreatitis include a swollen, tender abdomen accompanied by nausea, fever, and vomiting.  If injury to the pancreas continues, chronic pancreatitis may result.  When this occurs, the patient may have pain, secretion of digestive enzymes, and later insulin dysfunction.  

Common causes of acute pancreatitis include alcohol ingestion, gallstones getting stuck in the bile duct near the pancreas duct, trauma, infection, and drug reactions.  In more than a third of cases, pancreatitis occurs in the absence of these or other known factors.  It can also be hereditary and will afflict family members with no precipitating event.

Acute pancreatitis can be accompanied by a number of secondary complications.  During the first week or so, complications can include lung, kidney, and heart insufficiency.  Local complications, such as abscesses or cysts, can be painful even after the acute episode is resolved, and may require surgery.  Even in the absence of one of these complications, scarring may occur in the pancreas as a result of the acute event, leading to chronic pancreatitis with persistent abdominal pain in some individuals.

If you think you may have acute pancreatitis, you should see your doctor immediately or go to an emergency room.

Chronic Pancreatitis

Depending on the stage of the disease, chronic pancreatitis may be easy or difficult to diagnose.  In general, the more advanced the chronic pancreatitis, the easier it is to diagnose.  Chronic pancreatitis is very painful. It can occur after known episode(s) of acute pancreatitis or it may develop without an identifiable episode.  The most common symptom is persistent abdominal pain, sometimes radiating into the back.  Other symptoms include diarrhea, anorexia, malabsorption, and diabetes.  Many people with chronic pancreatitis have experienced frequent hospitalizations or emergency room visits.

Chronic pancreatitis can be caused by a variety of things, including:

• chronic alcoholism,
• chronic obstruction of the pancreatic duct - the obstruction may be caused by pseudocysts, inflammation, tumors, cystic fibrosis,
• traumatic injury to the pancreatic duct,
• developmental variations in how the pancreas forms, or
• no specific causes.

Intermittent attacks of acute pancreatitis may be called relapsing pancreatitis.  Relapsing pancreatitis often leads to chronic pancreatitis in which the pancreas has become so scarred that amylase and lipase levels no longer elevate in the blood. In this case, the patient may also develop problems with intestinal absorption from a deficiency of the pancreas enzymes and have to take them in pill form.