Pancreatitis (Acute & Chronic)
Pancreatitis is inflammation of the pancreas, an organ behind the stomach that produces digestive enzymes and hormones like insulin. Acute pancreatitis appears suddenly and lasts for days, while chronic pancreatitis develops over many years and can lead to permanent damage. Both can be serious conditions requiring prompt medical attention. At Blume Health, our gastroenterology team provides comprehensive care for all forms of pancreatitis.
Causes
- Gallstones (the most common cause of acute pancreatitis)
- Alcohol abuse (a leading cause of both acute and chronic pancreatitis)
- High triglyceride levels or hypercalcemia
- Certain medications
- Abdominal trauma or surgery
- Autoimmune conditions
- Genetic disorders (such as hereditary pancreatitis)
- Pancreatic cancer or tumors
- Viral or bacterial infections
- ERCP (endoscopic retrograde cholangiopancreatography) complications
- Smoking (especially for chronic pancreatitis)
- Cystic fibrosis
Signs and Symptoms
- Acute Pancreatitis:
- Upper abdominal pain that may radiate to the back
- Pain that worsens after eating
- Tenderness when touching the abdomen
- Fever
- Rapid pulse
- Nausea and vomiting
- Chronic Pancreatitis:
- Persistent upper abdominal pain
- Weight loss without trying
- Oily, smelly stools (steatorrhea)
- Diabetes
- Malnutrition due to poor absorption of nutrients
- Both Types:
- Abdominal pain and swelling
- Digestive problems
- Nausea and vomiting
Diagnosis
Blood Tests
To look for elevated levels of pancreatic enzymes (amylase and lipase) and other markers of inflammation or infection.
Imaging Tests
Abdominal ultrasound, CT scan, or MRI to visualize the pancreas and surrounding organs, looking for inflammation, gallstones, or structural abnormalities.
ERCP (Endoscopic Retrograde Cholangiopancreatography)
A procedure that combines endoscopy and X-rays to examine the pancreatic and bile ducts, and can also be used to remove gallstones or place stents.
Endoscopic Ultrasound (EUS)
A specialized endoscopic procedure that uses sound waves to create detailed images of the pancreas and can be used to obtain tissue samples.
Stool Tests
To check for fat malabsorption, which can indicate that the pancreas isn't producing enough digestive enzymes (more common in chronic pancreatitis).
Pancreatic Function Tests
To measure how well the pancreas produces digestive enzymes and hormones like insulin.
Treatment Options
Acute Pancreatitis Treatment
Treatment typically includes hospital admission, fasting to rest the pancreas, intravenous fluids, pain medications, and treating the underlying cause (such as removing gallstones). Severe cases may require intensive care, nutritional support, and sometimes surgery.
Chronic Pancreatitis Treatment
Management focuses on pain control, improving digestion with pancreatic enzyme supplements, dietary changes, and treating complications like diabetes. Avoiding alcohol and tobacco is crucial.
Pain Management
Pain medications ranging from over-the-counter options to prescription pain relievers, and in some cases, nerve blocks or other interventional procedures for chronic pain.
Nutritional Support
Dietary modifications (low-fat diet, small frequent meals) and pancreatic enzyme replacement therapy to help with digestion and prevent malnutrition.
Treatment of Underlying Cause
Addressing the primary cause, whether it's gallstone removal, alcohol cessation programs, or management of other conditions.
Home Remedies
Low-Fat Diet
Following a low-fat diet can reduce the workload on the pancreas and minimize symptoms. Focus on lean proteins, fruits, vegetables, and whole grains.
Small, Frequent Meals
Eating smaller meals throughout the day rather than three large meals can help reduce pancreatic stimulation and ease digestion.
Avoid Alcohol and Tobacco
Complete abstinence from alcohol and smoking is crucial for managing pancreatitis and preventing further damage.
Stay Hydrated
Drinking plenty of clear fluids helps maintain hydration and can support overall digestive health.
Stress Management
Stress reduction techniques such as meditation, yoga, and deep breathing exercises may help manage pain and improve quality of life.
Preventive Care
- Limit alcohol consumption or abstain completely
- Stop smoking
- Maintain a low-fat, nutritious diet
- Stay hydrated
- Manage triglyceride and calcium levels
- Control diabetes effectively
- Avoid medications known to cause pancreatitis (when possible)
- Get vaccinated against infections that can trigger pancreatitis
- Maintain a healthy weight
- Regular medical check-ups, especially if you have risk factors
Surgical Options
Gallbladder Removal (Cholecystectomy)
If gallstones are causing recurrent acute pancreatitis, removal of the gallbladder may be recommended to prevent future attacks. This can be performed laparoscopically in most cases.
Learn More About This ProcedurePancreatic Pseudocyst Drainage
If fluid collections (pseudocysts) develop as a complication of pancreatitis, they may need to be drained through endoscopic, percutaneous, or surgical approaches.
Learn More About This ProcedureNecrosectomy
In severe acute pancreatitis, portions of the pancreas may die (necrosis). If this necrotic tissue becomes infected, surgical removal may be necessary.
Learn More About This ProcedurePancreatic Duct Surgery
For chronic pancreatitis with ductal obstruction, procedures like lateral pancreaticojejunostomy (Puestow procedure) may help relieve obstruction and pain.
Learn More About This ProcedureTotal Pancreatectomy with Islet Autotransplantation (TPIAT)
In severe cases of chronic pancreatitis that don't respond to other treatments, the entire pancreas may be removed. Insulin-producing islet cells are harvested and transplanted to the liver to help prevent diabetes.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of pancreatitis (acute & chronic), our expert team is here to help you find the right treatment approach for your specific needs.