Pancreatitis, Acute

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KEY POINTS

• Pancreatitis is swelling and irritation of the pancreas, which is an organ behind the stomach. It makes digestive enzymes, insulin, and glucagon. Pancreatitis may be painful and can damage the pancreas.
• You will need to stay in the hospital to receive IV fluids and pain medicine. You may not eat or drink anything for a few days. You may need surgery.
• Follow the instructions your healthcare provider gives you when you go home. Do not drink alcohol. Ask if you need to be on a special diet.

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What is acute pancreatitis?

Pancreatitis is swelling and irritation of the pancreas. The pancreas is an organ behind the stomach. It makes digestive enzymes and hormones called insulin and glucagon. The digestive enzymes flow into the small intestine to help break down food. Insulin and glucagon are released into the blood to control the level of sugar in the blood.

Pancreatitis can be acute or chronic. Acute pancreatitis is a sudden attack. After acute pancreatitis, most people recover completely, especially if the disease is diagnosed and treated early enough. Pancreatitis that doesn’t go away or keeps coming back is called chronic pancreatitis. These repeated attacks can cause permanent damage to the pancreas.

What is the cause?

The most common causes of acute pancreatitis are:

• Gallstones, which can block the flow of digestive enzymes into your intestines. The buildup of enzymes can irritate your pancreas.
• Drinking too much alcohol
• Smoking

Less frequent causes are:

• Too much fat in your blood (a very high triglyceride level)
• Damage from surgery in nearby organs, such as the stomach or intestines
• Injury, such as a hit in the belly
• Side effects from some medicines
• Damage from chronic diseases, such as inflammatory bowel disease
• Radiation treatment for cancer if your belly was exposed to the radiation

Sometimes the cause of pancreatitis is not known.

What are the symptoms?

The main symptom is severe pain in your upper belly. The pain:

• Often happens 12 to 24 hours after a large meal or heavy drinking
• Spreads to your back and chest
• Is steady and sharp
• Gets worse when you move
• Feels better when you sit or lean forward
• Causes nausea and usually makes you vomit

Other symptoms may include:

• Fever
• Bloating

In severe cases, you may have signs of shock, including:

• Restlessness
• A fast heartbeat
• Lightheadedness
• Confusion
• A cold sweat

If you have any of these signs of shock, get emergency care or call 911 right away.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood and urine tests
• X-rays of your belly and chest
• An ultrasound, which uses sound waves to show pictures of the pancreas and gallbladder
• CT scan, which uses X-rays and a computer to show detailed pictures of the pancreas
• ERCP, which uses X-rays and a flexible, lighted tube passed through your mouth and into the stomach to see the inside of the stomach and the first part of the small intestine
• MRCP, which uses a strong magnetic field and radio waves to show detailed pictures of the pancreas and gallbladder

How is it treated?

The treatment for pancreatitis depends on its cause, your symptoms, and any other health problems you may have. You will probably stay in the hospital for treatment.

You may need to rest your pancreas by not eating or drinking anything for a few days. During this time, you will be given fluids through an IV and pain medicine. Your healthcare provider will let you know when you can start drinking clear liquids. As you get better, you will start to eat soft foods that are easy to digest.

If you have gallstones, you may need surgery to remove them. If you are very ill, gallstones may not be removed until you are feeling better.

If you have pancreatitis caused by drinking too much alcohol, you need to stop drinking to prevent more damage to your pancreas.

How can I take care of myself?

• Follow the instructions your healthcare provider gives you. This includes how you take prescribed medicines and how active you can be. Don't take any other medicines, including nonprescription drugs, without asking your healthcare provider.
• Ask your provider if you need a special diet.
• Don’t drink alcohol.
• Try to get at least 7 to 9 hours of sleep each night.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent another attack of acute pancreatitis?

To help prevent another attack of pancreatitis:

• Ask your healthcare provider what seems to have caused your pancreatitis.
• Avoid drinking alcohol. If you need help to quit drinking, talk to your healthcare provider about referral to an alcohol treatment center or a group like Alcoholics Anonymous.
• If you smoke, try to quit. Smoking makes it more likely the pancreatitis will come back. And combining alcohol and cigarettes increases your chance of having pancreatitis even more. Talk to your healthcare provider about ways to quit smoking.
• Eat a healthy diet. Ask your provider about the benefits of talking to a dietitian to learn what you need in a healthy diet.
• Work with your provider to keep your blood fats (cholesterol) normal.
• If injury was the cause of your pancreatitis, follow your healthcare provider's recommendations for rest and for ways to be physically active without hurting the pancreas again.