The Symptoms, Causes, and Treatment of Pancreatitis

Pancreatitis, or inflammation of the pancreas, can cause severe abdominal pain. Learn more about the symptoms, causes, and treatment of pancreatitis.

Written and verified by Farmacéutica Clara Sebastin.

Last update: 16 December, 2022

Pancreatitis is inflammation of the pancreas, which can be acute or chronic. The pancreas is a gland that produces enzymes that are important for the digestion of proteins. It also produces hormones, such as insulin or glucagon. When pancreatic enzymes build up and aren’t released into the intestine, they become activated and destroy tissues. Therefore, inflammation occurs that causes intense pain, especially in acute cases. Learn more about the symptoms, causes, and treatment of pancreatitis in the following article.

The symptoms of pancreatitis

The most common symptoms of acute pancreatitis are:

• Continuous and very severe abdominal pain, which may spread to the back
• Sickness
• Vomiting
• Fever
• Tachycardia
• Hypotension
• Bruises on the side and/or abdomen

In chronic pancreatitis, we mainly find the following symptoms:

• Abdominal pain, which increases after eating
• Weightloss
• Swelling of the abdomen
• Yellowish and foul-smelling fatty stools: Steatorrhea.

The causes of pancreatitis

The most common causes of acute pancreatitis are excessive alcohol consumption and gallstone obstruction. Alcoholism is the main cause in men and biliary obstruction in women. It can also be due to the use of certain medications, as well as surgery, infections, smoking, or very high levels of calcium in the blood (hypercalcemia). In many cases, the cause is unknown (idiopathic pancreatitis).

If the inflammation isn’t corrected, permanent injury can occur. Therefore, these cases lead to chronic pancreatitis. Here, there’s tissue destruction, which is replaced by inert tissue. Because of this, the gland may shrink and stop working.

The complications of pancreatitis

Most of the time, there are no complications. What’s more, in mild cases, recovery is usually complete. However, when complications do appear, they can be very serious. They manifest themselves at the local level and in other organs.

Local complications

• Pancreatic tissue infection: The more the infection spreads, the greater the risk of affecting other organs. Cell necrosis or death can also occur.
• Pseudocysts: Fluid accumulates in a kind of sac, which can become infected and rupture. If this happens, bleeding, pain, or obstruction of the digestive tract occurs.
• Pancreatic cancer

Systemic complications

• Respiratory failure: The lungs don’t oxygenate the blood properly.
• Diabetes: The pancreas is responsible for producing insulin, which is the hormone that controls blood sugar levels. When damaged, insulin isn’t released and blood sugar levels rise. This can lead to diabetes.
• Bowel or bile duct obstructions.
• Malnutrition: Nutrients aren’t well assimilated.
• Kidney failure: The kidneys don’t filter waste substances properly, so they can accumulate and damage the body. Dialysis may be needed.
• Cardiovascular collapse: Not enough oxygenated blood is delivered to the tissues.

Diagnosing pancreatitis

For diagnosis, two enzymes are measured in the blood, which are amylase and lipase. Both are almost always elevated in acute pancreatitis. However, their levels are normal in the chronic form. These enzymes are the most important diagnostic tool.

Stool is also tested for fat. High fat content and shiny, diarrheal stools indicate poor fat digestion. This is very common in late forms of the disease.

In addition, a CT scan of the abdomen is usually performed to assess severity. CT (computerized axial tomography) is a very accurate and fast diagnostic imaging test used to explore internal parts of the body. Likewise, other imaging tests such as MRI can be done to see possible gallstones or inflammation. An abdominal ultrasound is also usually performed.

The treatment of pancreatitis

There’s no specific treatment for pancreatitis. However, certain steps are taken in the hospital to improve symptoms:

• Fasting: Fating helps the pancreas to rest. It takes only a few days. Then, the patient can go back to a normal oral diet.
• Fluid replacement: This is usually done intravenously.
• Medicines to relieve pain and vomiting: Pancreatitis causes very severe pain.
• If necessary, enzymes that the pancreas isn’t producing can also be given.

In severe cases or complications of pancreatitis, the treatment also includes:

• Surgery: To remove dead tissue or pseudocysts.
• Antibiotics – to treat infections.
• Tube or IV feeding.
• Endoscopic retrograde cholangiopancreatography (ERCP): This is a procedure that removes gallstones. This intervention is performed through an endoscope, which is inserted through the mouth.

Therefore, the most important thing is to take steps to prevent pancreatitis. This includes avoiding alcohol or certain medications. In addition, the cause of the original inflammation must be treated and eliminated.